{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:23:48Z","timestamp":1761110628673,"version":"3.41.2"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stereotactic body radiotherapy (SBRT) is a treatment option for spine metastases. The International Spine Radiosurgery Consortium (ISRC) has published consensus guidelines for target delineation in spine SBRT. A new software called Elements\u2122 Spine SRS by Brainlab<jats:sup>\u00ae<\/jats:sup> that includes the module Elements SmartBrush Spine (v3.0, Munich, Germany) has been developed specifically for SBRT treatment of spine metastases, and the latter provides the ability to perform semiautomatic clinical target volume (CTV) generation based on gross tumor volume (GTV) localization and guidelines. The aims of our study were to evaluate this software by studying differences in volumes between semiautomatic CTV contours compared to manual contouring performed by an expert radiation oncologist and to determine the dosimetric impact of these differences on treatment plans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 35 volumes (\u201cExpert GTV\u201d and \u201cExpert CTV\u201d) from 30 patients were defined by a single expert. A semiautomatic definition of these 35 CTVs based on the location of \u201cExpert GTV\u201d and following ISRC guidelines was also performed in Elements SmartBrush Spine (\u201cBrainlab CTV\u201d). The spatial overlap between \u201cBrainlab\u201d and \u201cExpert\u201d CTVs was calculated using the Dice similarity coefficient (DSC). We considered a threshold of 0.80 or above to indicate that Elements SmartBrush Spine performed very well with adequate contours for clinical use. Two dosimetric treatment plans, each corresponding to a specific planning target volume (PTV; Expert PTV, Brainlab PTV), were created for 11 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We showed that \u201cBrainlab CTV\u201d and \u201cExpert CTV\u201d mean volumes were 29.8 \u00b1 16.1 and 28.7 \u00b1 15.7 cm<jats:sup>3<\/jats:sup>, respectively (p = 0.23). We also showed that the mean DSC for semiautomatic contouring relative to expert manual contouring was 0.85 \u00b1 0.08 and less than 0.80 in five cases. For metastases involving the vertebral body only (n = 13,37%), the mean DSC was 0.90 \u00b1 0.03, and for ones involving other or several vertebral regions (n = 22.63%), the mean DSC was 0.81 \u00b1 0.08 (p &amp;lt; 0.001). The comparison of dosimetric treatment plans was performed for equivalent PTV coverage. There were no differences between doses received by organs at risk (spinal cord and esophagus) for Expert and Brainlab PTVs, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results showed that the semiautomatic method had quite good accuracy and can be used in clinical routine even for complex lesions.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2022.827195","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T05:07:23Z","timestamp":1652332043000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of a Dedicated Software \u201cElements\u2122 Spine SRS, Brainlab\u00ae\u201d for Target Volume Definition in the Treatment of Spinal Bone Metastases With Stereotactic Body Radiotherapy"],"prefix":"10.3389","volume":"12","author":[{"given":"Maximilien","family":"Rog\u00e9","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Hadj","family":"Henni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasmine Adda","family":"Neggaz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romain","family":"Mallet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Hanzen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Dubray","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elyse","family":"Colard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Gensanne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00e9bastien","family":"Thureau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.02.008","article-title":"Update of the International Consensus on Palliative Radiotherapy Endpoints for Future Clinical Trials in Bone Metastases","volume":"82","author":"Chow","year":"2012","journal-title":"Int J Radiat Oncol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2016.12.04","article-title":"Efficacy of Single Fraction Conventional Radiation Therapy for Painful Uncomplicated Bone Metastases: A Systematic Review and Meta-Analysis","volume":"6","author":"Chow","year":"2017","journal-title":"Ann Palliat Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.07.009","article-title":"Lack of Clinical Evidence for Postoperative Radiotherapy After Surgical Fixation of Impending or Actual Pathologic Fractures in the Long Bones in Patients With Cancer; a Systematic Review","volume":"121","author":"Willeumier","year":"2016","journal-title":"Radiother Oncol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2017.01.013","article-title":"\u00c9tat Des Lieux De La Radioth\u00e9rapie En Conditions St\u00e9r\u00e9otaxiques Vert\u00e9brale En France En 2016","volume":"21","author":"Pougnet","year":"2017","journal-title":"Cancer\/Radioth\u00e9rapie"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2546","article-title":"Efficacy and Safety of Different Fractions in Stereotactic Body Radiotherapy for Spinal Metastases: A Systematic Review","volume":"8","author":"Gong","year":"2019","journal-title":"Cancer Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32487-5","article-title":"Stereotactic Ablative Radiotherapy Versus Standard of Care Palliative Treatment in Patients With Oligometastatic Cancers (SABR-COMET): A Randomised, Phase 2, Open-Label Trial","volume":"393","author":"Palma","year":"2019","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00818","article-title":"Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Phase II Randomized Trial","volume":"38","author":"Palma","year":"2020","journal-title":"J Clin Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00201","article-title":"Local Consolidative Therapy Vs. 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