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Cranial Planning

One suite for all
your planning needs

Discover more

Discover more

Cranial Planning

One suite for all
your planning needs

Discover more

Brainlab Elements offer interactive and semi-automated planning modules designed for and tailored to your patient’s needs, ensuring state-of-the-art planning for image guided cranial surgery.

Discover our comprehensive suite of planning tools designed for precision in neurosurgical procedures.


Streamline your workflow with 3D visualization of patient datasets, supporting the clinical decision-making process.

Image Fusion

Achieve a high level of accuracy with fully automated image fusion across multiple modalities, essential for defining and contouring.

Distortion Correction Cranial

Compensate for distortions in MR datasets effectively with deformable co-registration, enabling more precise contouring and fiber tracking.


Minimize variability in tumor delineation with intelligent, computer-assisted object outlining that integrates multiple modalities.

Segmentation Cranial

Automate the segmentation of anatomical brain structures with our knowledge-based system, adapting flexibly to various anatomies and modalities.


Enhance anatomical images with patient-specific white matter details, potentially preserving vital functions via diffusion weighted MR imaging. Switch between DTI and CSD1-based tractography.

BOLD MRI Mapping2

Utilize resting-state and task-based analysis2 for visualizing eloquent cortical areas, potentially aiding in the identification of optimal surgical paths.

Trajectory Planning

Plan neurosurgical approaches with multiple trajectories, integrating essential data like target structures, segmented objects and fiber tracts in one place.

Virtual iMRI Cranial

Enhance surgical decision-making by bridging the gap between preoperative plans and intraoperative scans. Reliably update preoperative image and functional data through brain shift compensation.

Image Fusion Angio

Co-register 2D DSA and 3D CTA/MRA data with no need for a frame, supporting in the definition of vascular objects for the treatment of intracranial vascular structures.

SmartBrush Angio

Automatically generate cranial vascular 3D objects from defined regions of interest, potentially facilitating the differentiation of feeding and draining vessels.

Precision at every step of planning

Elevate surgical precision before surgery even begins. Brainlab Elements for Cranial Planning provide you with state-of-the-art tools to potentially help you achieve safer tumor resections and increased accuracy. Infuse precision into each step of planning, from image fusion, distortion correction and segmentation to target outlining, fiber tracking and trajectory planning.

Everything your plan needs in one place

Access unparalleled flexibility and sophistication with this advanced, all-in-one planning suite. These seamlessly designed applications take the complexity out of planning in even the most complex cases. Through intelligent data selection, semi-automated processes and user-centric and intuitive workflows, you can experience time-saving automation at every stage.

Plans as unique as your patients
Equipped with advanced segmentation tools, white matter tractography, and state-of-the-art rendering and visualization, you can delve into your patient’s individual anatomy, allowing you to create a highly personalized plan to support your desired outcomes for each patient.

Learn more about our technology from industry leaders

The significance of preoperative planning in cranial surgery

Francesco Latini, MD, PhD, University Hospital Uppsala, Sweden

Science that is making waves in the industry

Up to 44%

of surgeons altered the surgical corridor

after the results of fiber tracking were taken into account.

Source: Sharma M et al. (2023), Journal: World Neurosurg., DOI: 10.1016/j.wneu.2023.09.091; Manan AA et al. (2022), Journal: Cancers (Basel), DOI: 10.3390/cancers14102466


(21% -> 11%) reduction of pooled adverse event rate

of postsurgical permanent neurological deficits when preoperative fMRI mapping was performed in brain tumor resection.

Source: Luna LP et al. (2021), Journal: Radiology, DOI: 10.1148/radiol.2021204723


studies agreed that resting-state fMRI is a suitable and useful

pre-operative mapping tool.

Source: Manan HA et al. (2021), Journal: Eur J Cancer Care (Engl), DOI: 10.1111/ecc.13428

Tailor-made for all your planning needs

that matters

Brainlab Elements Fibertracking brings research-grade probabilistic tractography1 into clinical practice

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State-of-the-art planning in one suite

Outlining of pathological structure in the brain

Elements Viewer

Increase clinical workflow efficiency with Elements Viewer, providing 3D visualizations of patient datasets to support the clinical decision-making process.

  • Fast and easy access to medical image data
  • Quick and direct interaction with DICOM images
  • Simplified user interface supporting multi-touch gestures
  • Rapid learning curve with intuitive usability
  • Advanced 3D Viewer supports procedures that require a high level of spatial anatomic orientation

Elements Image Fusion

Consider every angle with Elements Image Fusion. Dataset correlation brings the plan together for indispensable definition and contouring.

  • Fully automated and highly accurate image fusion
  • Mutual information algorithm for dataset correlation within seconds
  • Region-of-interest definition for dataset correlation in areas with similar anatomy
  • Multi-modal outlining side-by-side or as overlay
  • Flexibility to contour on any dataset
Segmentation cranial - adapts to various anatomies and modalities
Server functions as healthcare data center, accessible by connected clinicians

Elements Distortion Correction Cranial

Compensate for distortions in MR datasets with deformable co-registration. Elements Distortion Correction Cranial creates datasets with more accurate co-registrations enabling high-precision contouring and tractography across modalities.

  • Multi-modal deformable co-registration (MR–MR, MR–CT)
  • Creation of an additional, deformed dataset while keeping original data
  • Correction of diffusion tensor imaging (DTI) sequences to increase fiber tracking precision
  • Visualization of location and magnitude of MR distortions
  • Interactive comparison of rigid and distortion-corrected fusion results

Elements SmartBrush

Elevate surgical planning with Elements SmartBrush, a semi-automatic tool for fast and easy multi-modal outlining of cranial tumors. Intelligent computer-assisted object outlining deeply expands target definition, incorporating multiple modalities and exploiting multi-planar volume definition.

  • Immediate and interactive target delineation
  • Streamlined, multi-planar volume definition
  • Smart contour expansion with a click of the mouse or touch of the finger
  • Multi-modal outlining side-by-side or as overlay
  • Performant machine learning technology potentially speeds-up planning1
  • Potential reduction of inter-observer variability1
Automatic fusion of numerous modalities
Hospital IT integration with ‘thin client’ technology and high security HTTPS and SSL encryption

Elements Segmentation Cranial

Define the case from the start with fully automated, knowledge-based anatomical segmentation. Elemental to treatment planning, Elements Segmentation Cranial flexibly adapts to various anatomies and modalities and generates anatomical structures.

  • Unique technology based on a patented synthetic tissue model
  • Automatic segmentation of all relevant anatomical brain structures
  • Efficient and consistent automation of time-consuming contouring process
  • Intuitive, easy-to-use review and editing tools

Elements Fibertracking

Enrich anatomical images with detailed visualization about eloquent white matter structures to preserve vital functions. Elements Fibertracking revolutionizes the visualization and analysis of brain white matter pathways by means of constrained spherical deconvolution (CSD)-based1 analysis, potentially enhancing patient care. Switch between deterministic DTI- and probabilistic CSD-based tractography to see what’s critical for your specific case with Elements Fibertracking.

  • Research-grade probabilistic tractography for clinical practice to identify multiple fiber directions and address crossing and fanning fibers, as well as fibers in edema region with ease1
  • Intuitive user interface and instant updates assist with a seamless functional tumor workflow for patient-specific planning with combined MRI and DWI data
  • Selection of tracking templates (e.g., corticospinal tract, arcuate fasciculus, inferior fronto-occipital fasciculus1) enable efficient, standardized and reproducible tracking of important white matter tracts with unique parameter combinations for each template
BOLD MRI Mapping
Elements Fibertracking

Elements BOLD MRI Mapping2

Enhance anatomical images to visualize eloquent areas in cortical structures in the brain.

  • Resting-state (correlation map) and task-based (activation map) analysis options2
  • May help identify the shortest and safest path to the pathology of interest
  • Detection of BOLD responses from activity due to tasks performed by the patient during MR scanning or stimuli
  • Creation of correlation maps to identify which plausible brain areas might be functionally connected to the seed region of interest (ROI)
  • Combination of BOLD analysis and fiber tractography creates potential for more precision in functional pre-planning

Elements Trajectory Planning

Plan multiple trajectories for neurosurgical approaches with preconfigured view modes. Comprising all relevant data such as target structure, segmented objects and fiber tracts in one place, Elements Trajectory Planning Cranial allows for well-informed approach planning.

  • Interactive target and entry point positioning
  • Flexible definition of trajectories based on AC/PC-relative or DICOM coordinates
  • Adjustable 3D trajectory shapes for case-specific visualization
  • Axial, coronal, sagittal, inline and probe’s eye views for trajectory verification
Screenshot of Elements Cranial Product Virtual iMRI
Brainlab Elements DICOM Viewer

Elements Virtual iMRI Cranial

Bridge the gap between preoperative plans and intraoperative scans. With intraoperative MR or CT images available, Elements Virtual iMRI Cranial simulates the status quo of surgical plans.

  • Facilitates continued use of preoperative treatment plans
  • Deforms a preoperative plan based on an intraoperative scan (MR or CT)
  • Simulates anatomical changes caused by the intervention
  • Potentially eliminates the need to repeat planning steps like fiber tractography or segmentation
  • Helps to estimate tissue deformation due to brain shift and supports surgical decision making with regards to extent of resection

Elements Image Fusion Angio

Merge image data, previously considered incompatible, as a starting point for effective neurovascular treatment planning. Elements Image Fusion Angio co-registers 2D DSA and 3D CTA/MRA data with no need for a frame.

  • Use of diagnostic images saves extra scan with localizer frame, reducing radiation exposure and complexity
  • Supports frontal, lateral and oblique 2D DSA data
  • Supports 3D CT-Angio and 3D MR-Angio (with contrast or TOF) data
  • Direct visualization of vessels as Maximum Intensity Projection instead of vessel segmentation
  • Colored visualization of blood flow for clear recognition of early and late contrast phases
  • User-defined best DSA frame and region-of-interest contribute to robust fusion results

Elements SmartBrush Angio

Go with the flow and create a nidus object interactively under consideration of dynamic contrast flow. Elements SmartBrush Angio is a contouring tool that generates a cranial vascular 3D object based on a user-defined region of interest.

  • Color Intensity Projection for easy DSA frame selection and region-of-interest definition
  • Side-by-side outlining on 2D DSA and fused 3D images helps differentiate feeding and draining vessels
  • 3D nidus object refinement possibilities include SmartBrush, 2D Brush and 3D Brush
  • Seamless export of Nidus object to Cranial Navigation or RT planning applications
  • Enables consistent contouring and report generation over time

Explore clinical papers about Cranial Planning with Brainlab Elements

Elements Fibertracking

Sollmann et al. 2020

Evaluates the utility of nTMS based functional mapping combined with Elements Fibertracking for the risk assessment of surgery-related decline of motor or language function.

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Elements BOLD MRI Mapping

Wang et al. 2016

Assesses the validity of Elements BOLD MRI Mapping by comparison to gold standard ECS results and investigates the impact and predictive value of lesion-to-activation distance on functional motor outcome.

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Literature Library

Scientific validation of Cranial Planning with Elements

Read more about the techniques, clinical utility and benefits of cranial planning with Brainlab Elements.

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Additional information

iPlan Flow flyer


Elements BOLD MRI Mapping scientific one-pager


Elements Fibertracking scientific one-pager


Elements Virtual iMRI scientific one-pager


Mixed Reality Viewer Cranial scientific one-pager


Elements Fibertracking and Elastic Fusion scientific one-pager




Not yet commercially available. Please contact your sales representative.

Elements BOLD MRI Mapping resting state feature not yet commercially available in the US.