RT Elements (4.5)

by Brainlab — Innovating Medtech for Better Patient Outcomes
Neurosurgery Oncology Radiology

Regulatory Status Disclosed

Overview

RT Elements (4.5) is an advanced software platform for radiation therapy treatment planning, developed by Brainlab AG. It is designed to assist medical professionals, including radiation oncologists, medical physicists, and neurosurgeons, in creating precise and efficient treatment plans for various lesions. The system leverages AI and machine learning for tasks such as tumor segmentation, enhancing the accuracy and speed of contouring and dose optimization.

The software provides a comprehensive suite of applications, including tools for multiple brain metastases radiosurgery (SRS), cranial SRS, spine SRS, and a general RT Planning Platform. Key functionalities encompass dose review, retreatment review, and advanced segmentation capabilities for anatomical regions like cranial, basal ganglia, head & neck, pelvic, spine, and extracranial areas.

RT Elements (4.5) aims to streamline workflows, spare organs at risk, and deliver highly conformal radiation doses, ultimately improving patient outcomes in stereotactic, conformal, and Linac-based radiation treatments.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • AI Tumor Segmentation RT (Cranial tumors on contrast-enhanced T1-weighted MRI)
  • Multiple Brain Mets SRS planning
  • Cranial SRS planning
  • Spine SRS planning
  • RT Planning Platform
  • Dose Review (isodose lines, DVHs, dose comparison/summation)
  • Retreatment Review (overview of previous and new targets, dose overlays)
  • Elements Segmentation (Cranial, Basal Ganglia, Head & Neck, Pelvic, Spine, Thoracic & Spine, Extracranial)
  • SmartBrush (Angio, Spine) RT
  • Object Management RT

Use Cases

  • Stereotactic Radiosurgery (SRS) for brain and spine lesions
  • Fractionated Stereotactic Radiotherapy (SRT)
  • Stereotactic Ablative Radiotherapy (SABR) / Stereotactic Body Radiation Therapy (SBRT)
  • Automated template-based radiation treatment plan simulation for tumor boards
  • Patient-specific quality assurance (RT QA)
  • Retreatment planning for recurrent multiple metastases

What Physicians Need to Know

Key Capabilities
RT Elements 4.5 is a software suite for radiation therapy treatment planning and dose optimization, supporting stereotactic radiosurgery (SRS), fractionated stereotactic radiotherapy (SRT), and stereotactic ablative radiotherapy (SABR/SBRT). It includes modules for multiple brain metastases SRS, cranial SRS, spine SRS, and cranial SRS with cones. The software features AI/ML-powered cranial tumor segmentation, automated image fusion, and advanced 3D visualization. It also offers a 'Retreatment Review' application for managing recurrent multiple metastases by providing an overview of previous treatments and new lesions. The system utilizes both Pencil Beam (PB) and Monte Carlo (MC) dose calculation algorithms.
Clinical Utility
RT Elements 4.5 is designed to enhance the planning process for cranial, head and neck, and extracranial lesions. It aims to standardize treatment planning for cranial SRS with predefined templates and protocols. The software facilitates personalized decision-making and dose planning with indication-specific tools, enabling automated processes and standardized workflows for generating and adapting radiosurgery treatment plans. It helps clinicians achieve accurate target placement and optimize treatment plans for various complex cases.
Integration Options
The Brainlab Elements suite is designed for seamless integration across various clinical subspecialties, including neurosurgery, spine surgery, orthopedics, and radiation oncology. It integrates with platforms like Curve™ Image Guided Surgery and Buzz® Digital O.R. to enhance workflow efficiency. RT Elements 4.5 also has an interface to Art-Plan (by TheraPanacea) for extracranial workflows, allowing for auto-segmentation of extracranial structures. It is compatible with mobile devices and workstations, supporting collaboration across departments and locations. The software is often used in conjunction with Brainlab's ExacTrac System for image-guided radiotherapy, ensuring a seamless end-to-end workflow.
Compliance Status
Brainlab RT Elements has received CE approval and is FDA cleared. Specifically, RT Elements 4.5 has received 510(k) premarket notification clearance (K250440). The software has been verified and validated according to Brainlab's product design and development processes, demonstrating compliance with safety and performance standards.
Pricing Model
Brainlab offers flexible business models for its Elements suite, allowing facilities to access and utilize the software according to their needs, from simple single licenses to multiple offerings across departments.
User Experience
Brainlab Elements is described as a powerful, flexible, and user-friendly suite of tools. It streamlines pre-planning workflows with intuitive modules for automation, contouring, merging, and viewing. The software aims to simplify the planning process with predefined templates and protocols. Training programs are available to refresh and refine planning skills for RT Elements, focusing on complex radiosurgery cases and advanced plan optimization techniques.
Support Quality
Brainlab provides technical support for its Elements suite, which is scalable to the evolving needs of any department. Advanced Clinical Courses are offered by certified Brainlab instructors and experienced clinical teams to share insights on clinical implementation and requirements for successful radiotherapy and radiosurgery programs.
Implementation Complexity
The implementation of Brainlab Elements requires a computing environment that meets specific hardware criteria and trained personnel for correct interpretation and utilization of processed images. However, the reference beam model provided by Brainlab can accelerate the commissioning process for the treatment planning system. Studies have shown that commissioning can be completed efficiently, for example, within one day by a qualified medical physicist and a resident.
Evidence Base
Clinical validation of Brainlab Elements has demonstrated its effectiveness in pre-planning for surgeries and radiotherapy. Studies have evaluated the Monte Carlo and Pencil Beam dose calculation algorithms in Brainlab Elements (v4.0 and v4.5) for cranial and spinal planning, showing clinically acceptable agreement with measured doses. Research also indicates that newer versions of Brainlab Elements can generate SRS plans with comparable quality to manually optimized plans in a shorter time and with less planner involvement. Comparisons with other planning systems have shown that Brainlab Elements can produce plans with better dose conformality, dose gradient, and lower doses to normal organs.
Physician Tip

Familiarize yourself with the AI/ML-powered cranial tumor segmentation to potentially expedite contouring workflows. Leverage the 'Retreatment Review' for comprehensive patient history when managing recurrent metastases. Utilize the advanced optimization tools and predefined templates to standardize and streamline your SRS planning. Consider attending Brainlab Academy courses to refine your skills, especially for complex radiosurgery cases and advanced plan optimization techniques. Ensure your team is adequately trained to maximize the benefits of the software's advanced features and to correctly interpret the processed images.

RT Elements 4.5 is designed for broad integration within the Brainlab ecosystem, including seamless connections with Curve™ Image Guided Surgery and Buzz® Digital O.R. It also offers an interface to third-party contouring systems like Art-Plan for extracranial workflows. For optimal end-to-end workflow and precise patient positioning, integrate with Brainlab's ExacTrac System. The platform's compatibility with mobile devices and workstations facilitates collaborative planning and review across different departments and locations.

Details

Category Oncology AI, Surgical AI
Pricing Unknown
DeploymentOn-premise (software for workstations) and potentially cloud-based for data integration.
Mobile App1
Data ExportUnknown
TrainingUnknown
Compliance
BAA AvailableUnknown
HIPAA Compliant Yes AI-estimated
FDA Status Cleared AI-estimated
Integrations
EHR Not specified
Specialties Neurosurgery, Oncology, Radiology

Support & Reliability

Training ProvidedUnknown

What the Web Says

Brainlab RT Elements (4.5) is a radiation treatment planning software that utilizes AI for tasks like tumor segmentation and aims to provide precise and efficient treatment planning, particularly for stereotactic radiosurgery (SRS). It is designed to integrate with other Brainlab systems, such as ExacTrac, for a seamless workflow. The software has undergone verification and validation processes, including performance data for accurate dose computation and formative usability evaluations. Studies suggest it can achieve high-quality SRS plans with improved dose conformality and reduced planning time compared to previous versions.

Overall: Positive

Strengths

  • Provides precise and efficient radiation treatment planning.
  • Utilizes AI for tasks like cranial tumor segmentation.
  • Integrates with other Brainlab systems for a seamless workflow.
  • Can achieve high-quality SRS plans with superior dose conformality and lower dose to normal organs.
  • Reduces treatment planning time and planner involvement.
  • Supports personalized decision-making and dose planning through indication-specific tools.

Limitations

  • No summative usability evaluation has been performed for RT Elements 4.5.
  • AI-based tumor segmentation, while promising, may still be limited in certain cases and requires expert review.
  • Independent evidence of real-world effectiveness and deployment is sparse.
  • Some limitations in conformity and gradient index calculations were noted in earlier versions of Brainlab Elements.

Based on reviews from: datavagyanik.com, reachmd.com, parikhradiology.com, physicianaitools.com, fda.gov, healtharatus.com, nih.gov, researchgate.net, lifehealthcare.co.za, lensa.com, instagram.com, novaliscircle.org, aapm.org

Last updated: 2026-10-29

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Videos

Product demos, reviews, and walkthroughs for RT Elements (4.5).

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Frequently Asked Questions

RT Elements (4.5) incorporates AI, particularly in its RT Contouring 4.5 feature, for cranial tumor segmentation. The AI algorithm, a Convolutional Neural Network (CNN), was trained using MRI image data of contrast-enhancing tumors from various clinical sites, encompassing diverse scanner models and patient characteristics.
RT Elements (4.5) has received FDA clearance in the US and CE approval in Europe. It is intended for radiation treatment planning in stereotactic, conformal, computer-planned, Linac-based radiation treatments for cranial, head and neck, and extracranial lesions.
While RT Elements (4.5) offers advanced planning capabilities, potential limitations can include the need for manual adjustments in plan optimization, even with automated features, to achieve optimal planning target volume coverage and minimize organ-at-risk dosage. Additionally, older versions of the Pencil Beam algorithm on GPU had a known issue with incorrect dose distribution calculations for large tissue models exceeding 512 MB, which has since been addressed by Brainlab.
Several other AI-driven solutions exist in oncology treatment planning. These include MVision AI for auto-contouring, Varian Ethos for adaptive radiotherapy, RayStation for AI-based planning optimization, TheraPanacea ART-Plan for vendor-neutral adaptive radiotherapy, and Imbio Lung Suite for radiomics and image-based prognostics.
Brainlab prioritizes data privacy and security by employing a HIPAA/Security & Data Privacy Officer and dedicated HIPAA-responsible personnel. Brainlab Cloud Services offer features like pseudonymization of patient data, individual and group privacy settings, SSL encryption, and secure data centers that are ISO 27001, SOC 1/SSAE 16/ISAE 3402, and FISMA certified. Patient data for US users is stored on US servers, and for European users, on EU servers.

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Suggest an Edit → | Report an issue | Last Verified: 2026-04-17 | First Added: 2026-04-17
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