The Headline: Advances in autosegmentation open new areas of investigation into organ at risk sparing.
The Study: In COG-SRS, 92 patients were treated with brain SRS optimized to spare the connectome. The connectome is kind of like a wiring diagram of the brain describing how different regions are interconnected. In the trial, 10 discrete eloquent bilateral white matter tracts, the corpus callosum, and the hippocampi were autocontoured and then optimized to receive a Dmax of 12 Gy for white matter tracts and 8.5 Gy for the hippocampi (or the 3-5 fraction equivalents). The trial found that connectome sparing was feasible, and 74% had stable to improved performance across 5 cognitive domains.
TBL: Strategically minimizing dose to the connectome during SRS planning is feasible, and most patients maintain excellent cognitive function. | Puett, ASCO 2026
The Study: In COG-SRS, 92 patients were treated with brain SRS optimized to spare the connectome. The connectome is kind of like a wiring diagram of the brain describing how different regions are interconnected. In the trial, 10 discrete eloquent bilateral white matter tracts, the corpus callosum, and the hippocampi were autocontoured and then optimized to receive a Dmax of 12 Gy for white matter tracts and 8.5 Gy for the hippocampi (or the 3-5 fraction equivalents). The trial found that connectome sparing was feasible, and 74% had stable to improved performance across 5 cognitive domains.
TBL: Strategically minimizing dose to the connectome during SRS planning is feasible, and most patients maintain excellent cognitive function. | Puett, ASCO 2026