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Spine metastases workflow

Spare the Spinal Cord
with Steep Dose Falloff

Spine metastases workflow

Spare the Spinal Cord with Steep Dose Falloff

Opt for automation to support spinal cord sparing

This automation-supported workflow is optimized for the treatment of spinal metastases and produces very steep dose falloff between the target and the spinal cord. The workflow ensures enhanced spinal cord sparing and offers automatic CTV and OAR proposals in line with the International Spine Consortium Guidelines.

Demo Spine SRS in three minutes

Preparing for spine metastases planning

We’ve built automation into every step of the pre-planning workflow including anatomical mapping, curvature correction and target definition. Save time with fast and easy-to-use tools, add consistency and gain confidence from the submillimetric accuracy you’ll achieve along the way.

Compensating for spine curvature variations

Variations in the position of the patient in different scans can prevent accurate image fusion. The unique algorithm of Elements Spine Curvature Correction combines information from the Brainlab internal tissue classification to account for rigidity and deformability of different tissue types which is then used to highlight and correct deviations in spinal curvatures.

Accurately segmenting spinal anatomy

Curvature corrected, fused images are essential to establishing a solid foundation for segmentation. Automatic segmentation of spinal anatomy with Elements Anatomical Mapping uses our patented synthetic tissue model to identify and label the individual levels of the spine. Easy metal implant contouring and the use of material-specific electron density enable highly accurate Pencil Beam and Monte Carlo dose calculation1. This software fundamentally streamlines extracranial treatment planning and supports standardization.

Software screenshot of Elements SmartBrush software as used for segmenting parts of the spine for a spinal radiotherapy treatment.

Delineating spine metastases

The fused and segmented image can now be used as the basis of spine metastases delineation. Elements SmartBrush Spine SRS provides spinal tumor outlining tools for GTV contouring and automatically proposes the corresponding CTV and the cropped spinal canal object based on International Consortium Guidelines.

Creating the dose plan with Elements Spine SRS

Elements Spine SRS software is an automation-supported treatment planning software, optimized for the creation of high-quality spine metastases dose plans.

Software screenshot showing the various views and information available to planners to create a radiotherapy treatment plan with Elements Spine SRS.

High-quality VMAT planning designed for spine radiosurgery

This automatic spinal VMAT algorithm can achieve superior plans in terms of gradient index for better dose fall-off, conformity index and spinal cord sparing.

Highly precise beam modeling and dose calculation

By using Brainlab reference beam models, the measurements for the highly accurate Monte Carlo dose calculation algorithm are reduced by 90% for all TrueBeam platforms with HD120 or Millenium MLC with 6MV and 10MV, standard and FFF mode.

Click on the link below to learn more about how the Brainlab Reference Beam Models were developed and validated.

Download white paper
Software screenshot of Elements Spine SRS and the various tools it provides to visualize the dose created for a radiotherapy plan.

Dose evaluation in 3D

Customized views enable the evaluation of steep dose gradients for the spinal cord interface and decreased dose to the spinal cord.

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Explore more about the spine metastases workflow

Clinical paper

Trager et al. 2020

Read more about the evaluation of Elements Spine SRS plan quality for SRS and SBRT treatment of spine metastases.

Read more

Clinical literature library

Advancing medical technology through scientific evidence

Brainlab Clinical Affairs conducts advanced research and gathers scientific evidence to help create safe, efficient, cost-effective medical technology.

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Separation Surgery + Radiosurgery for Spine Metastasis Patient

Luke Macyszyn, MD, MA, Tania B. Kaprealian, MD, MBA, and Nzhde Agazaryan, Ph.D., DABR, FAAPM from UCLA Medical Center, Los Angeles, California present their experiences of clinical treatment of metastatic spine disease using a novel surgical approach and radiation techniques. They share the unique perspectives of a surgeon, radiation oncologist and medical physicist and review the options of multidisciplinary treatment planning and more.

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1 Not yet commercially available in several countries. Please contact your sales representative.