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Elements Spine SRS presents solutions to many of the current challenges in spine radiosurgery and automatically produces a highly conformal dose to avoid the critical spinal cord structure.

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Spine SRS header
Automatic Treatment Planning


Planning critical lesions like those for spine stereotactic radiosurgery often demands significant experience and time from treatment planners. Automatic treatment planning is a way of raising the overall plan quality, to consistently create high-quality treatment plans in an efficient manner. Users need only define OAR constraints once using protocols for specific fractionation schemes.

  • Protocol-driven treatment plan creation 
  • Traffic light display of clinical constraints based on treatment protocol
  • Specialized gradient approach for target-cord interface
  • Arc number is automatically adjusted to patient requirements
Enhanced Spinal Blocking

Selective vertebral exposure for enhanced spinal blocking

Creating a highly conformal dose for spinal lesions can be complex due to the unusual shape of vertebrae. The Elements Spine SRS algorithm internally breaks down the PTV into a number of smaller targets to achieve excellent dose planning metrics.

  • Spinal cord sparing achieved with minimal user input
  • Leaf motion taken into account for robust dosimetry and highly conformal dose
  • Efficient delivery time while at the same time enhancing normal tissue sparing


Dynamic Gradient and MU Optimization


In order to create the sharpest dose gradient and most MU-efficient plans, the unique Brainlab VMAT approach is an elegant mixture of automation and control. It is characterized by intuitive optimization tools that enable the user to make subtle plan modifications.

  • Spine-specific VMAT creates sharp dose gradient at spinal cord interface
  • Unique VMAT algorithm accesses high dose rates necessary for SRS treatment
  • Support of both flattened and unflattened beams
  • Plans are MU efficient; using specialized optimization constraint techniques
  • Plan modifications can be quickly visualized and implemented with intuitive tools, affecting MU and normal tissue metrics (CI and GI)
Monte Carlo Optimization


To achieve balance between calculation speed and accuracy, plans are classically generated with an approximate dose calculation to determine optimum machine parameters and then recalculated with a more accurate dose engine. Elements Spine SRS offers a tightly integrated approach to combine speed with even higher accuracy.

  • Classic approach: Pencil beam dose calculation during optimization and Monte Carlo for the final dose calculation for fast planning
  • Integrated approach: Hybrid method that uses both pencil beam and Monte Carlo at different stages of the optimization and Monte Carlo for the dose calculation in the final optimization step
Dose Illustration of Vertebra-Spine Cord Interface


Control over planning parameters is facilitated via straightforward views and unique dose displays. These have been implemented for not only PTV but also for the most critical OAR so that trade-offs can be readily assessed.

  • Comprehensive dose evaluation in 3D
  • Dose distributions are displayed simultaneously on various image sets, showing dose effects on as much anatomical information as possible
  • The dose surface view, maximum intensity projection view, beams eye view and arc view allow the user to see coverage, conformity, MLC motion and arc distribution simultaneously
  • Vertebral blocking can be viewed for the entire gantry motion in the beams eye view