First U.S. Patient Treated With Automatic Brain Metastases Planning Software by Brainlab

Last month, Brainlab, a global medical technology company based in Munich, announced its new Automatic Brain Metastases Planning software had been used for the first time in the United States at Jefferson Hospital for Neuroscience in Philadelphia to deliver a tailored radiosurgery treatment to a patient with cancer that had metastasized to the brain.

The procedure, in which all five of the patient’s brain metastases were treated, took less than 20 minutes, including setup time using the Brainlab technology. Using the traditional method, it could have taken as much as three hours … or roughly 30 minutes per tumor.

When treating such patients, the manufacturer said Automatic Brain Metastases Planning (ABMP) offers improvements over the current standard of Whole Brain Radiation Therapy (WBRT) treatment, which involves applying low doses of radiation to the entire brain over time and with many sessions that can sometimes lead to cognitive deficits. ABMP software can automatically render a clinically ready treatment plan in typically less than two minutes.

Using a unique, dedicated algorithm, ABMP software by Brainlab allows delivery of highly conformal, single-session treatments while helping to minimize dose spread to surrounding healthy tissue. By treating multiple brain metastases at one time, planning and treatment time can be significantly reduced, even with as many as 10 tumors to treat.  

 “In our first patient treatment, we targeted five metastatic brain tumors in one frameless treatment session,” commented David W. Andrews, MD, professor in the Department of Neurosurgery and director of the Division of Neuro-oncologic Neurosurgery and Stereotactic Radiosurgery at Jefferson, who added his team would use the technology to treat “up to 10 metastatic tumors at once, helping prevent unnecessary loss of brain function that can occur with whole brain radiation therapy, such as memory loss or other cognitive deficits.”

He added, “Patients with diseases that cause brain lesions often require multiple treatments that are lengthy and cause discomfort. We are enthusiastic about any advances in practice that can limit the time a patient needs to undergo treatment and minimalize distress.”

To learn more about ABMP, visit brainlab.com/brainmets.

Personal Factors, Not Neighborhood Determines Who Calls EMS for Stroke

Despite earlier indications to the contrary, a new study finds neighborhood factors do not influence the use of emergency medical services (EMS) for stroke as strongly as individual factors do. A study published online last month in Annals of Emergency Medicine found that neighborhood characteristics like poverty, the number of older adults living in the area, and violent crime matter much less than stroke severity when it comes to seeking prompt treatment for stroke (“Neighborhood Influences on Emergency Medicine Services Use for Acute Stroke – A Population-Based Cross Sectional Study”).

“Using an ambulance to get to the hospital really greases the wheels of the process and can lead to better outcomes, but many patients still do not understand the importance of early intervention with stroke,” said lead study author William Meurer, MD, MS of the Departments of Emergency Medicine and Neurology at the University of Michigan, Ann Arbor. “The proportion of neighborhood stroke cases arriving by EMS varied widely: from 17 percent in one neighborhood to 81 percent in another, but no single factor accounted for that disparity. The worrisome finding is that fewer than one-third (31.7 percent) of patients overall arrived at the ER within 3 hours of the onset of stroke.”  

Overall, fewer than half of all stroke patients studied arrived by EMS (47.6 percent). Individual factors associated with decreased odds of EMS use for stroke were lower stroke severity, younger age, Mexican-American ethnicity, ischemic stroke (versus intracerebral hemorrhage) and female gender. Neighborhood factors associated with lower use of EMS for stroke were higher family income and a larger percentage of older adults.

“One positive finding was that more disadvantaged populations, despite potentially having lower levels of education and stroke awareness, more frequently use EMS to access acute treatment for stroke,” said Meurer. “Individual factors, especially how severe the stroke is, still outweigh demographic ones.  This tells us that interventions to improve EMS use for stroke should focus on individuals learning to recognize less severe strokes.”

WEB:

Brainlab: www.brainlab.com

Annals of Emergency Medicine Stroke Study: http://www.annemergmed.com/article/S0196-0644(15)01114-2/fulltext