Brainlab’s Color Coded Brain Imaging Software Debuts in Ireland

The New Elements Smartbrush Angio, a technology that color-codes blood flow in 2D imaging of the brain in order to define a patient’s cranial arteriovenous malformation (AVM) nidus, has been used for the first time in Ireland. Clinicians at St. Luke’s Radiation Oncology Centre at Beaumont Hospital in Dublin used the software, which is made by Brainlab AG, to differentiate the AVM nidus from related arteries and veins.

Beaumont Hospital used Elements SmartBrush Angio to plan and deliver a frameless radiosurgery treatment to a 30-year-old male patient who was experiencing seizures due to a mesial temporal AVM involving the hippocampus and abutting the midbrain. Clinicians correlated multiple imaging modalities; identified the AVM nidus by incorporating the diverse information captured by each individual modality; and, facilitate shielding for connecting arteries and veins during subsequent treatment planning. Establishing a direct link between the various data sets is designed to eliminate both the need for repeat angiography on the day of treatment and the requirement for patient fixation with an invasive head-ring. This benefits patients and caregivers alike as it permits utilization of diagnostic angiography data for treatment planning and unlocks the potential of frameless radiosurgery.

“With SmartBrush Angio we can deliver highly sophisticated frameless radiosurgical treatment of brain AVMs,” explained Seyed Mohsen Javadpour, M.D., neurosurgeon and clinical senior lecturer at Beaumont Hospital. “In particular, this software eliminates the need for additional planning digital subtraction angiography (DSA) for nidus identification as it allows us to fuse the pre-existing diagnostic DSA with volumetric MRI and CT images. Therefore our patients avoid the discomfort and risks associated with invasive catheter cerebral angiography (such as stroke), receiving an overall highly sophisticated treatment. We will use SmartBrush Angio for all patients with cerebral AVMs undergoing stereotactic radiosurgery. Beyond radiosurgery, we see great promise with the use of this software for surgical planning in patients undergoing image-guided resection of brain AVMs. Fusion of multiple imaging modalities is easy with this software and it makes radiosurgical and surgical planning for AVMs more accurate.”

The information gathered by Smartbrush is presented in such a way that it distinguishes arteries and veins from the nidus, reducing the final target size and thereby enabling targeted stereotactic radiosurgery to the AVM nidus with protection of the surrounding healthy tissue.

“SmartBrush Angio offers multiple, critical benefits to our hospital,” said David Fitzpatrick, M.D., radiation oncologist, SLROC at Beaumont Hospital. “For clinicians, we can quickly complete the volumetric assessment of the AVM nidus with Smartbrush Angio. The software allows for dynamic use of existing diagnostic DSA images for enhanced visualization and identification of the AVM nidus during radiosurgery planning. By having the ability to use pre-existing DSA images, the hospital has the potential to save both bed days and costs.”

Brainlab CEO and Founder Stefan Vilsmeier said that the software is emblematic of the company’s vision of “indication-specific and highly automated software applications aimed at transforming practice patterns in radiosurgery.”

New Elements Smartbrush Angio has not been submitted for 510(k) clearance in the United States yet.

Brainlab is based in Munich, Germany.