Novalis Circle Team
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Novalis Circle is now in your pocket
Expert questions, cases, events and your clinical groups, on iPhone and Android. This is a preview of the new Novalis Circle app; tell us what you think.
Novalis Circle Team
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Conference 2027: call for abstracts is open
The 11th Novalis Circle Conference takes place in Munich from 20 to 22 May 2027. Submit your abstract for the clinical, physics or RTT track by 15 January 2027.

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Tomás Ferreira
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Ten metastases, one isocentre: plan review welcome
Teaching case (fictional): ten lesions, largest 14 mm, smallest 3 mm. Single-isocentre dynamic conformal arcs, total treatment time under 20 minutes. I'd like feedback on the low-dose spill between the two frontal lesions.
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Dr. Amara Nwosu
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Hippocampal sparing with 12+ metastases: is it still worth it?

For patients with more than twelve small metastases, do you still go for SRS with hippocampal sparing or move to whole brain? Interested in how you decide and what you tell patients.

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Dr. Mateo García
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Spine SBRT with epidural extension: contouring question
Teaching case (fictional): T9 lesion with minor epidural extension. How would you contour the CTV around the epidural part, and would you go for separation surgery first?
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Hannah Schultz
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Surface guidance thresholds for frameless SRS

What intra-fraction thresholds do you use before you stop the beam? We use 1 mm and 1 degree but get a lot of interruptions with anxious patients.

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Novalis Circle Team
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Three more centres achieve Novalis Certification
Congratulations to three more centres on completing Novalis Certification this quarter. Their teams share what they learned in the Novalis Certified Centres group.

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Dr. Mateo García
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Spinal cord constraint for re-irradiation after conventional RT

Patient had 30 Gy in 10 fractions to the same level two years ago. What cumulative cord constraint do you use for SBRT re-irradiation?

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Dr. Arjun Mehta
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Liver SBRT: fiducials or not?

Are you still placing fiducials for liver SBRT, or relying on soft-tissue imaging?

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Dr. James Whitfield
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Five years of Novalis Certification: what changed for our patients
When we started the certification process, we thought it was about QA documents. It turned out to change how our whole team works together. Here is what we learned in five years.

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Dr. Kenji Mori
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Large AVM: staged volume approach
Teaching case (fictional): 12 cm³ AVM, eloquent location. We are considering volume staging over two sessions six months apart. Experiences with staging versus hypofractionation?
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Dr. Omar Haddad
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Small-field output factors: detector choice for commissioning

We are commissioning next quarter. Which detectors did you use for the smallest cones and how much did your detectors disagree?

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Dr. Fatima Al-Sayed
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Preparing for Novalis Certification: what took longest?

We plan to start the certification process next year. For certified centres: which areas of review took you the longest to prepare?

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Dr. Sofia Lindqvist
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Lung SBRT with large respiratory motion
Teaching case (fictional): lower-lobe lesion moving 22 mm. We compared an internal target volume plan with a gated plan. The gated plan reduced the lung V20 considerably, at the cost of longer treatment.

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Novalis Circle Team
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New in the video library: clinical talks from Conference 2026
Selected plenary talks, physics sessions and the poster walk from Conference 2026 are now in the video library.

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Dr. Grace Liu
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Trigeminal neuralgia: single shot or two isocentres?

For classic TN, what is your current target and dose? We see different practice between our consultants.

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Dr. Yuna Park
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Patient-reported outcomes after SRS: which instruments?

We want to collect PROMs for all radiosurgery patients. Which questionnaires are practical in a busy clinic?

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Dr. Lukas Weber
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End-to-end test failure: what we found
Our quarterly end-to-end test showed a 1.2 mm offset. The cause was a recalibrated imaging isocentre that had not been updated in one system. Sharing our root-cause checklist.

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Dr. Mei-Ling Chen
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Vestibular schwannoma: follow-up imaging intervals

How often do you image after SRS for vestibular schwannoma, and when do you stop?

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Dr. Fatima Al-Sayed
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Glioma re-irradiation with SRS: any experience?

We are seeing more requests for re-irradiation of small recurrent gliomas. Anyone using SRS or hypofractionated SRT for this?

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Dr. Helena Brandt
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Trigeminal neuralgia after failed microvascular decompression
Teaching case (fictional): recurrent pain two years after MVD. Targeting was harder because of postoperative changes. Imaging and targeting approach in the comments.
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Dr. Kenji Mori
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AVM obliteration: when do you call it a failure?

At what point after SRS do you consider retreatment for a partially obliterated AVM?

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Dr. Omar Haddad
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Building an SRS programme from scratch in 18 months
Our centre went from an empty bunker to our first radiosurgery patient in 18 months. Staffing, commissioning, training and the mentors who helped us along the way.

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Dr. Elena Rossi
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MR fibre tracking in planning: worth the effort?

We have started using fibre tracking near eloquent tracts. Has it changed your plans in practice?

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