SmartBrush

Make sure you choose the correct software version by selecting the Brainlab logo in the bottom corner of the corresponding software

Automatic Generation of Clinical Objects

General Information

The automatic generation of a clinical target object follows the guidelines as published by Brett W. Cox et al in 2012. Cox B.W., Spratt D.E., Lovelock M., et al. International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 2012; 83:e597-605

Smartbrush generates a cropped OAR which is calculated based on the position of the clinical target (i.e., the cropped OAR covers the length of the spine where the CTV is located +/- 5 mm from top/bottom). This is visible in both 2D and 3D views.

About Clinical Target Objects

As soon as you start a GTV, SmartBrush generates:

  • CTV
  • OAR e.g., Spinal Canal, cropped (default)
No. Explanation

Gross Tumor (GTV)

Clinical Target Volume (CTV)

Organ at Risk (OAR) e.g., Spinal Canal, cropped

Object Linking

All three objects are linked, if any changes are made to the GTV through outlining, this propogates to the CTV.

The flow is unidirectional:

Clinical Target Volume Example



No.

Explanation

Vertebral body

Pedicle

Transverse processes/laminae

Spinous process

Transverse processes/laminae

Pedicle

Rules for Clinical Target Generation

The automatic generation of a clinical target object follows these rules:

  • When the Gross Tumor Volume involves a unilateral pedicle, the pedicle and the ipsilateral transverse process/lamina are included in the Clinical Target Volume.
  • When the Gross Tumor Volume involves the spinous process, the entire spinous process and bilateral laminae are included in the Clinical Target Volume.
  • When the Gross Tumor Volume involves the vertebral body and bilateral pedicle/transverse processes, the entire vertebral body, bilateral pedicles, transverse processes/laminae and spinous process are included in the Clinical Target Volume.
  • When the Gross Tumor Volume involves the vertebral body and one unilateral pedicle, the entire vertebral body, pedicle and ipsilateral transverse process/lamina are included in the Clinical Target Volume.
  • When the intersection between the Gross Tumor Volume and one sector is not empty, this sector is included in the Clinical Target Volume.
  • The sector selection dynamically updates when changes occur to the Gross Tumor Volume.
  • The Clinical Target Volume calculation updates with every change to the Gross Tumor Volume except for, changing the name, color or comments. Those changes do not trigger an update of the Clinical Target Volume (only the role and actual object data).

Objects with Disconnected Volumes

A dialog is displayed if you leave SmartBrush after generating objects (new or modified) with disconnected volumes. An object is treated as a disconnected volume if the total object volume minus the volume of the biggest component is bigger than 0.1 cm³.

Reviewing Objects

A dialog is displayed if you leave SmartBrush without reviewing the automatically generated objects. The objects are saved even if they are not reviewed.

Article No. 60917-26EN

Date of publication: 2016-12-22