🏥 Just sharing an interesting case we recently had at CHR Metz-Thionville: Our patient presented with 3 brain metastases, with 12 cm between the two farthest volumes. One of the metastases was irregular and located 1 cm to the brainstem. The prescribed regimen was 3 fractions of 8.8 Gy @80% IDL.

💡 We utilized the new Hybrid Optimization of the Brainlab Elements Multiple Brain Mets V4.0 to quickly devise an optimal treatment plan. This involved mixing 10 DCA and VMAT arcs in a single isocenter, resulting in great coverage index (1.13-1.19) and treatment statistics.

⚙️ Moreover, all dose constraints to OARs were meticulously met, ensuring that the maximum dose to the brainstem was limited to 3.5 Gy.

📊 The 3%/1 mm local gamma passing rate for the whole plan was 99.6% 😍 (measured with the PTW Octavius 4D and the 1600 SRS matrix in non-coplanar mode and a low-dose threshold of 20%).

⏱️ The average treatment time was approximately 14 minutes, with the longest session taking less than 20 minutes for the patient to be in and out.

⁉ How would have managed this case? Let us know so we can continue improving our workflow!