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Objective: This study aims to evaluate the clinical utility of using 3D Slicer software for volumetric measurement of the cranial cavity and cerebral ventricular system, particularly in hydrocephalus patients. We also provide detailed steps for performing the measurements. Methods: Volumetric measurements were performed on 186 healthy volunteers, 117 hydrocephalus patients with intact skulls, and 72 hydrocephalus patients with incomplete skulls using 3D Slicer based on computed tomography (CT) data. CT scans were performed using a GE Discovery750 scanner and analyzed with 3D Slicer software (version 5.0.2). Cranial cavity volumes were measured using two methods: the Swiss Skull Stripper module and the Segment Editor tool. Ventricular volumes were assessed by segmenting the ventricles and periventricular structures with anatomical markers. Data were analyzed for consistency and accuracy using SPSS version 25.0, with statistical significance set at p ≤ 0.05. Results: Intracranial volume measurements showed no significant differences between healthy controls and HANPH patients, nor between different measurement methods. In healthy controls, males had larger ventricular volumes than females, and older individuals had larger volumes, except for the fourth ventricle. The left lateral ventricle was larger than the right. No discrepancies were found between measurements taken by two neurosurgeons. Conclusion: The volumetric measurement of cranial cavity and cerebral ventricular system with 3D Slicer software based on CT data are accurate, repeatable and consistent, providing methodological and technical support for hydrocephalus research, especially for incomplete skull patients, the third ventricle and the fourth ventricle. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Background: Acute subdural hematoma (aSDH) is associated with a high risk of epilepsy, a complication linked to poor outcomes. Craniotomy is a known risk factor, with an epilepsy incidence of approximately 25%. This study evaluated radiomic features from preoperative CT scans to predict epilepsy risk in aSDH patients undergoing craniotomy. Methods: A retrospective analysis of 178 adult aSDH patients treated between 2016 and 2022 identified 64 patients meeting inclusion criteria. Radiomic features (e.g., Feret diameter, elongation, flatness, surface area, and volume) from preoperative CT scans within 24 h of surgery were analyzed alongside clinical factors, including cardiac comorbidities, pupillary response, SOFA score, age, and anticoagulation status. Results: Of the 64 patients, 18 (28%) developed generalized seizures. Univariate analysis showed significant associations with Feret diameter (p = 0.045), elongation (p = 0.005), cardiac comorbidities (p = 0.017), and SOFA score (p = 0.036). ROC analysis showed excellent discriminatory ability for elongation (AUC = 0.82). Multivariate analysis identified elongation as an independent predictor (p = 0.003); elongation ≥ 1.45 increased seizure risk 7.78-fold (OR = 7.778; 95% CI = 1.969–30.723). Conclusions: Radiomic features, particularly elongation, may help predict epilepsy risk in aSDH patients undergoing craniotomy. Prospective validation is needed. [ABSTRACT FROM AUTHOR]

Purpose: Given the potential role of nasolacrimal duct (NLD) morphometry in the aetiology of primary acquired obstructions, it is imperative that clinicians have access to detailed anatomical information. The aim of this study was to determine normative data on nasolacrimal duct morphometry in the Turkish population sample and to provide guidelines for clinicians. Methods: The study included retrospectively computed tomography images of a healthy Turkish population sample of 151 individuals, 79 of whom were female and 72 of whom were male. Images were modeled and analyzed using 3D Slicer version 5.2.2. Results: The total volume and area of the NLD were smaller in females than in males. The right- and left-sided volume of the NLD were smaller in females than in males (In male, right side 219.28 ± 77.53 mm3 and left side 213.14 ± 73.82 mm3; in female, right side 193.82 ± 75.71 mm3, left side, 190.34 ± 82.54 mm3). Although the anteroposterior and transverse diameters of the right-sided NLD were not statistically different between the genders, the anteroposterior and transverse diameters of the left-sided NLD and distance between right and left NLD were smaller in female than in males. The volume and surface area of the right-sided NLD and the distance between the right and left NLD were larger with increasing age. The anteroposterior diameter was observed to be larger on the right side than on the left in both sexes, whereas the transverse diameter was larger on the right side than on the left side exclusively in females. Conclusion: The results of this study may assist clinicians in the surgical approaches. [ABSTRACT FROM AUTHOR]

Background/Objectives: Traumatic acute subdural hematoma (aSDH) often requires surgical intervention, such as craniotomy, to relieve mass lesions and pressure. The extent of hematoma evacuation significantly impacts patient outcomes. This study utilizes 3D Slicer software to analyse post-craniotomy hematoma volume changes and evaluate their prognostic significance in aSDH patients. Methods: Among 178 adult patients diagnosed with aSDH from January 2015 to December 2022, 64 underwent hematoma evacuation via craniotomy. Initial scans were performed within 24 h of trauma, followed by routine postoperative scans to assess residual hematoma. We conducted radiomic analysis of preoperative and postoperative volumes, surface area, Feret diameter, sphericity, flatness, and elongation. Clinical parameters, including SOFA score, APACHE score, pupillary response, comorbidities, age, anticoagulation status, and preoperative haematocrit and haemoglobin levels, were also evaluated. Results: Changes in Δ surface area significantly correlated with 30-day outcomes (p = 0.03) and showed moderate predictive accuracy (AUC = 0.65). Patients with a Δ surface area > 30,090 mm2 experienced poorer outcomes (OR = 6.66, p = 0.02). Significant features included preoperative surface area (p = 0.009), Feret diameter (p = 0.0012). In multivariate analysis, only the Feret diameter remained significant (p = 0.01). Conclusions: Postoperative Δ surface area is, among other variables, a strong predictor of 30-day outcomes, while in multivariate analysis, preoperative Feret diameter remains the only independent predictor. Radiomic analysis with 3D Slicer may enhance prognostic accuracy and inform tailored therapeutic strategies. [ABSTRACT FROM AUTHOR]

Abstract Objective This study aims to evaluate the clinical utility of using 3D Slicer software for volumetric measurement of the cranial cavity and cerebral ventricular system, particularly in hydrocephalus patients. We also provide detailed steps for performing the measurements. Methods Volumetric measurements were performed on 186 healthy volunteers, 117 hydrocephalus patients with intact skulls, and 72 hydrocephalus patients with incomplete skulls using 3D Slicer based on computed tomography (CT) data. CT scans were performed using a GE Discovery750 scanner and analyzed with 3D Slicer software (version 5.0.2). Cranial cavity volumes were measured using two methods: the Swiss Skull Stripper module and the Segment Editor tool. Ventricular volumes were assessed by segmenting the ventricles and periventricular structures with anatomical markers. Data were analyzed for consistency and accuracy using SPSS version 25.0, with statistical significance set at p ≤ 0.05. Results Intracranial volume measurements showed no significant differences between healthy controls and HANPH patients, nor between different measurement methods. In healthy controls, males had larger ventricular volumes than females, and older individuals had larger volumes, except for the fourth ventricle. The left lateral ventricle was larger than the right. No discrepancies were found between measurements taken by two neurosurgeons. Conclusion The volumetric measurement of cranial cavity and cerebral ventricular system with 3D Slicer software based on CT data are accurate, repeatable and consistent, providing methodological and technical support for hydrocephalus research, especially for incomplete skull patients, the third ventricle and the fourth ventricle. Clinical trial number Not applicable.

Abstract To explore techniques, advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization technology combined with transcranial neuroendoscopy in ventriculoperitoneal shunt surgery. Retrospective analysis of clinical data of patients with hydrocephalus treated by ventriculoperitoneal shunt surgery using 3D Slicer reconstruction and 3D printing positioning technology combined with transcranial neuroendoscopy in our hospital from October 2021 to March 2023. A total of 33 patients with complete data were collected, including 19 males and 14 females, aged 10–81 years. Pre operative use of 3D Slicer reconstruction and 3D printing localization, and intraoperative use of neuroendoscopy assisted catheterization to complete ventriculoperitoneal shunt surgery. The drainage tube position was confirmed by brain CT and 3D Slicer reconstruction after operation, of which 30 cases were located in the frontal horn or center of the ipsilateral lateral ventricle, and 3 cases were located in the frontal horn or center of the contralateral lateral ventricle. All patients were successfully catheterized and well positioned. According to the unique ventricular system characteristics of each hydrocephalus patient, the 3D Slicer reconstruction technology was used to determine the individualized puncture point and direction, measure the puncture depth, accurately locate the puncture through the 3D printing guide plate, and accurately send the tip of the ventricular catheter into the frontal or central part of the lateral ventricle with the assistance of neuroendoscopic visualization, which improved the success rate of the operation and reduced the risk of tube blockage. At the same time, our team has newly developed a puncture point (“Cai’s point”), which has a puncture path in a non-vascular area and can reduce the risk of puncture bleeding. However, further prospective clinical research is needed to determine its routine location.

INTRODUCTION: COVID-19 has profoundly impacted global health systems since its emergence in 2019. The association between various biomarkers and COVID-19 has been investigated, with a particular focus on CRP, ferritin, fibrinogen, and D-dimer levels. Although these biomarkers alone are not diagnostic for COVID-19, their elevation is associated with disease severity and prognosis. In recent years, new horizons have opened in radiology with artificial intelligence and computer software that can obtain quantitative or semi-quantitative data. The 3D slicer program is completely open free software that can be used to obtain this data and has many medical patch support programs. This study aimed to quantitatively evaluate lung parenchymal involvement in COVID-19 patients using 3D Slicer software and correlate it with biochemical parameters. METHODS: In a retrospective analysis of 213 hospitalized patients with COVID-19 pneumonia, this study evaluated CRP, ferritin, and their ratios for disease severity and lung involvement potential. Examining gender differences in biochemical parameters. RESULTS: According to the study results, the study included 54,5% males and 45,5% females. Mean CRP levels were significantly higher in males (88,74+-75,78) than in females (68,26+-66,07) (P=0.034). Ferritin levels were significantly higher in males than in females (P

Background: The main surgical interventions for chronic subdural hematoma (CSDH) include craniotomy for hematoma evacuation, neuroendoscopic hematoma evacuation, and burr hole drainage.However, elderly patients often present with significant comorbidities, which limit their ability to tolerate general anesthesia and invasive surgical procedures.Minimally invasive soft-channel drainage under local anesthesia has emerged as a viable alternative, particularly suitable for elderly patients or those with high surgical risk.This study aims to evaluate the clinical outcomes and complication rates of minimally invasive soft-channel drainage assisted by 3D Slicer software for the treatment of CSDH. It also aims to provide new clinical evidence to help improve and optimize treatment protocols for this condition. Methods: A retrospective analysis was conducted involving 83 patients with CSDH treated in our department between January 2021 and December 2023. Patients were categorized into two groups based on the surgical intervention: the control group (burr-hole drainage, n = 42) and the intervention group (minimally invasive soft-channel drainage, n = 41).Baseline characteristics, anesthesia methods, perioperative metrics, and complications were compared. Clinical outcomes were evaluated using the Barthel Index and the modified Rankin Scale (mRS) preoperatively and three months postoperatively. Results: The drainage retention duration, operative time, and hospitalization period in the intervention group were significantly reduced compared to the control group, with reduced intraoperative blood loss (all P < 0.05). There was no significant difference in residual hematoma volume between the groups on postoperative day one (P > 0.05). The incidence of postoperative complications, including pulmonary infection, recurrent subdural hemorrhage, cerebrospinal fluid leakage, and intracranial pneumatosis, was significantly lower in the intervention group compared to the control group (all P < 0.05). No intracranial infections were observed in either group, and there was no statistically significant difference in hematoma recurrence rates (P > 0.05). Similarly, no significant differences were observed in the preoperative and three-month postoperative Barthel Index and mRS scores between groups (all P > 0.05). However, both groups demonstrated significant improvement in mRS and Barthel Index scores at three months postoperatively compared to preoperative levels(all P < 0.001). Conclusion: Both minimally invasive soft-channel drainage assisted by 3D Slicer and burr-hole drainage are safe and effective interventions for CSDH. Nevertheless, the minimally invasive approach provides significant benefits in terms of reducing intraoperative blood loss, shortening operative time, minimizing surgical trauma, and reducing the rate of complications. This approach is only advantageous for patients with well-liquefied hematomas and those with relative contraindications to general anesthesia. [ABSTRACT FROM AUTHOR]

Key points: Using 3D modeling, we studied the influence of orbital tumor morphology on post‐operative outcomes.Orbital tumor volume did not influence postoperative complication rates.Less spherical tumors may be correlated with a more extensive surgical approach. [ABSTRACT FROM AUTHOR]

Objective To explore the application value of 3D Slicer in vestibular schwannoma surgery. Methods Twenty-nine patients with benign auditory nerve tumors treated in Shanghai Donglei Brain Hospital from August 2021 to August 2022 who underwent cerebellar pontine angle tumor resection were included in the experimental group. 3D Slicer software was used to process the original data and reconstruct the skull, brain stem, tumor, peripheral blood vessels and nerves, combined with the actual tumor location and adjacent anatomical structure during the operation to verify the preoperative reconstruction effect. At the same time, the rate of facial auditory nerve injury, total tumor resection rate, operation time, understanding extent of patients' family members and understanding extent of young doctors were compared with those who had undergone vestibular schwannoma surgery (control group). Results Among the 29 patients in the experimental group, 23 underwent total tumor resection. The average operation time was 2.89 ± 0.18 hours. No limb dysfunction or death occurred. In the control group, 20 of the 27 patients underwent total resection, with an average operation time of 3.60 ± 0.19 hours, no limb dysfunction and no death. Conclusions The 3D Slicer perform multimodal fusion and three- dimensional visualization technology can display the relationship between tumor and surrounding structures in a more intuitive, multi-dimensional and three-dimensional dynamic manner especially the relationship between brain stem and cranial nerves, which can effectively improve the surgical efficiency of the surgeon, improve the understanding of young doctors on the anatomical structure related to vestibular schwannoma, shorten the operation time and reduce the facial auditory nerve injury rate. [ABSTRACT FROM AUTHOR]

Aim: CT images can identify structural and opacity alterations of the lungs while nuclear medicine's lung perfusion studies show the homogeneity (or lack of) of blood perfusion on the organ. Therefore, the use of SPECT/CT in lung perfusion scintigraphies can help physicians to assess anatomical and functional alterations of the lungs and to differentiate between acute and chronic disease. Objective: To develop a computer-aided methodology to quantify the total global perfusion of the lungs via SPECT/CT images and to compare these results with parenchymal alterations obtained in CT images. Methods: 39 perfusion SPECT/CT images collected retrospectively from the Nuclear Medicine Facility of Botucatu Medical School's Clinics Hospital in São Paulo, Brazil, were analyzed. Anatomical lung impairments (emphysema, collapsed and infiltrated tissue) and the functional percentage of the lungs (blood perfusion) were quantified from CT and SPECT images, with the aid of the free, open-source software 3D Slicer. The results obtained with 3D Slicer (3D-TGP) were also compared to the total global perfusion of each patient's found on their medical report, obtained from visual inspection of planar images (2D-TGP). Results: This research developed a novel and practical methodology for obtaining lungs' total global perfusion from SPECT/CT images in a semiautomatic manner. 3D-TGP versus 2D-TGP showed a bias of 7% with a variation up to 67% between the two methods. Perfusion percentage showed a weak positive correlation with infiltration (p = 0.0070 and ρ = 0.43) and collapsed parenchyma (p = 0.040 and ρ = 0.33). Conclusions: This research brings meaningful contributions to the scientific community because it used a free open-source software to quantify the lungs blood perfusion via SPECT/CT images and pointed that the relationship between parenchyma alterations and the organ's perfusion capability might not be so direct, given compensatory mechanisms. [ABSTRACT FROM AUTHOR]

As the significance of simulation in medical care and intervention continues to grow, it is anticipated that a simplified and low-cost platform can be set up to execute personalized diagnoses and treatments. 3D Slicer can not only perform medical image analysis and visualization but can also provide surgical navigation and surgical planning functions. In this paper, we have chosen 3D Slicer as our base platform and monocular cameras are used as sensors. Then, We used the neural radiance fields (NeRF) algorithm to complete the 3D model reconstruction of the human head. We compared the accuracy of the NeRF algorithm in generating 3D human head scenes and utilized the MarchingCube algorithm to generate corresponding 3D mesh models. The individual's head pose, obtained through single-camera vision, is transmitted in real-time to the scene created within 3D Slicer. The demonstrations presented in this paper include real-time synchronization of transformations between the human head model in the 3D Slicer scene and the detected head posture. Additionally, we tested a scene where a tool, marked with an ArUco Maker tracked by a single camera, synchronously points to the real-time transformation of the head posture. These demos indicate that our methodology can provide a feasible real-time simulation platform for nasopharyngeal swab collection or intubation. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 has profoundly impacted global health systems since its emergence in 2019. The association between various biomarkers and COVID-19 has been investigated, with a particular focus on CRP, ferritin, fibrinogen, and D-dimer levels. Although these biomarkers alone are not diagnostic for COVID-19, their elevation is associated with disease severity and prognosis. In recent years, new horizons have opened in radiology with artificial intelligence and computer software that can obtain quant itative or semi-quantitative data. Instead of visually subjective data scales, technological developments that can now provide clearer numerical data are taking place in our lives. Options include lesion detection, determination of morphological characteri stics, 3D volumetric imaging, and segmentation. The 3D slicer program is completely open free software that can be used to obtain this data and has many medical patch support progr ams. This study aimed to quantitatively evaluate lung parenchymal involvement in COVID-19 patients using 3D Slicer software and correlate it with biochemical parameters. Materials and Methods: In this retrospective analysis of 213 hospitalized patients with COVID-19 pneumonia, this study evaluated CRP, ferritin, and their ratios for disease severity and lung involvement potential. Examining gender differences in biochemical parameters. Results: According to the study results, the study included 54.5% males and 45.5% females. Mean CRP levels were significantly higher in males (88.74±75.78) than in females (68.26±66.07) (p=0.034). Ferritin levels were significantly higher in males than in females (p<0.001). CRP, ferritin, and fibrinogen levels were correlated with lung involvement, indicating prognostic potential. Conclusion: The findings underscore the importance of biochemical markers in assessing disease severity and highlight gender -specific differences in COVID-19 management. However, no significant correlation was found between the ferritin/CRP ratio and lung involvement rates. These insights provide personalized strategies for pandemic control. [ABSTRACT FROM AUTHOR]

Abstract To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9–59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team’s newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research.

Confocal microscopy has evolved to be a widely adopted imaging technique in molecular biology and is frequently utilized to achieve accurate subcellular localization of proteins. Applying colocalization analysis on image z-stacks obtained from confocal fluorescence microscopes is a dependable method of revealing the relationship between different molecules. In addition, despite the established advantages and growing adoption of 3D visualization software in various microscopy research domains, there have been few systems that can support colocalization analysis within a user-specified region of interest (ROI). In this context, several broadly employed biological image visualization platforms are meticulously explored in this study to understand the current landscape. It has been observed that while these applications can generate three-dimensional (3D) reconstructions for z-stacks, and in some cases transfer them into an immersive virtual reality (VR) scene, there is still little support for performing quantitative colocalization analysis on such images based on a user-defined ROI and thresholding levels. To address these issues, an extension called ColocZStats (pronounced Coloc-Zee-Stats) has been developed for 3D Slicer, a widely used free and open-source software package for image analysis and scientific visualization. With a custom-designed user-friendly interface, ColocZStats allows investigators to conduct intensity thresholding and ROI selection on imported 3D image stacks. It can deliver several essential colocalization metrics for structures of interest and produce reports in the form of diagrams and spreadsheets. [ABSTRACT FROM AUTHOR]

To explore the advantages and disadvantages of 3D Slicer reconstruction and 3D printing localization combined with transcranial neuroendoscope in the surgical treatment of deep cerebral micro cavernous hemangiomas. Method The clinical data of patients with deep cerebral micro cavernous hemangiomas treated by our hospital from June 2022 to February 2023 using 3D Slicer reconstruction and 3D printing localization technology combined with transcranial endoscopic surgery were retrospectively analyzed. A total of 5 cases with complete data were collected, including 2 males and 3 females, aged 9–59 years. All 5 patients had deep supratentorial cavernous hemangiomas with a diameter of less than 1.5 cm, and had clinical symptoms such as headache or epilepsy, and had been diagnosed by CT or MRI. Repeated bleeding from small cavernous hemangiomas in the deep brain can lead to clinical symptoms such as recurrent headache and epilepsy, and is required surgical treatment. However, cavernous hemangiomas often have smaller lesions and are difficult to locate in the deep part. Without neuronavigation, surgery can become extremely difficult. Our team's newly developed 3D Slicer reconstruction and 3D printing localization technology which could provide new options for surgical treatment of small cavernous hemangiomas or other small lesions in the deep brain, but its accuracy and safety still need to be verified by further clinical research. [ABSTRACT FROM AUTHOR]

The diaphragm is the main inspiratory muscle and separates the thorax and the abdomen. In COPD, the evaluation of the diaphragm shape is clinically important, especially in the case of hyperinflation. However, delineating the diaphragm remains a challenge as it cannot be seen entirely on CT scans. Therefore, the lungs, ribs, sternum, and lumbar vertebrae are used as surrogate landmarks to delineate the diaphragm. We herein describe a CT-based method for evaluating the shape of the diaphragm using 3D Slicer—a free software that allows delineation of the diaphragm landmarks—in ten COPD patients. Using the segmentation performed with 3D Slicer, the diaphragm shape was reconstructed with open-source Free Pascal Compiler. From this graduated model, the length of the muscle fibers, the radius of curvature, and the area of the diaphragm—the main determinants of its function—can be measured. Inter- and intra-user variabilities were evaluated with Bland and Altman plots and linear mixed models. Except for the coronal length (p = 0.049), there were not statistically significant inter- or intra-user differences (p values ranging from 0.326 to 0.910) suggesting that this method is reproducible and repeatable. In conclusion, 3D Slicer can be applied to CT scans for determining the shape of the diaphragm in COPD patients. [ABSTRACT FROM AUTHOR]

Limited medical image data hinders the training of deep learning (DL) models in the biomedical field. Image augmentation can reduce the data-scarcity problem by generating variations of existing images. However, currently implemented methods require coding, excluding non-programmer users from this opportunity.We therefore present ImageAugmenter, an easy-to-use and open-source module for 3D Slicer imaging computing platform. It offers a simple and intuitive interface for applying over 20 simultaneous MONAI Transforms (spatial, intensity, etc.) to medical image datasets, all without programming.ImageAugmenter makes accessible medical image augmentation, enabling a wider range of users to improve the performance of DL models in medical image analysis by increasing the number of samples available for training.

The SlicerBatchBrainMRTumorSegmentation is a graphical user interface (GUI) based Python scripted module within 3D Slicer. Its purpose is to perform automated brain tumour segmentation for numerous patients while preserving data integrity and organization. Through automation, manual intervention at each stage of the Brain Tumor Segmentation (BraTS) toolkit becomes unnecessary, resulting in efficient processing of multiple patient cases. Being an open-source software implementation, the SlicerBatchBrainMRTumorSegmentation is licensed under the BSD (Berkeley Source Distribution) 3-Clause License, facilitating its use by the broader research community. This tool empowers users to explore diverse segmentation approaches, fosters research advancements, and stimulates innovation in the field of brain tumour analysis.

Sophie Lau Rui Han,1,&ast; Jie Xiang,1,&ast; Xiang-Xiang Zeng,2 Pei-Di Fan,1 Qiao-Yu Cheng,1 Xue-Man Zhou,1 Zheng Ye,2 Xin Xiong,1 Jun Wang1 1State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 2Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xin Xiong; Jun Wang, State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, People’s Republic of China, Tel +86-28-85503898 ; +86-28-85501425, Email drxiongxin@scu.edu.cn; wangjunv@scu.edu.cnPurpose: This study aimed to investigate the relationship between temporomandibular joint (TMJ) effusion and TMJ pain, as well as jaw function limitation in patients via two-dimensional (2D) and three-dimensional (3D) magnetic resonance imaging (MRI) evaluation.Patients and Methods: 121 patients diagnosed with temporomandibular disorder (TMD) were included. TMJ effusion was assessed qualitatively using MRI and quantified with 3D Slicer software, then graded accordingly. In addition, a visual analogue scale (VAS) was employed for pain reporting and an 8-item Jaw Functional Limitations Scale (JFLS-8) was utilized to evaluate jaw function limitation. Statistical analyses were performed appropriately for group comparisons and association determination. A probability of p< 0.05 was considered statistically significant.Results: 2D qualitative and 3D quantitative strategies were in high agreement for TMJ effusion grades (κ = 0.766). No significant associations were found between joint effusion and TMJ pain, nor with disc displacement and JLFS-8 scores. Moreover, the binary logistic regression analysis showed significant association between sex and the presence of TMJ effusion, exhibiting an Odds Ratio of 5.168 for females (p = 0.008).Conclusion: 2D qualitative evaluation was as effective as 3D quantitative assessment for TMJ effusion diagnosis. No significant associations were found between TMJ effusion and TMJ pain, disc displacement or jaw function limitation. However, it was suggested that female patients suffering from TMD may be at a risk for TMJ effusion. Further prospective research is needed for validation.Keywords: temporomandibular disorder, temporomandibular joint pain, three-dimensional analysis, 3D slicer

Abstract To explore the techniques, safety, and feasibility of minimally invasive neurosurgery through the supraorbital eyebrow arch keyhole approach by neuroendoscopy. Retrospective analysis of clinical data of patients with various cranial diseases treated by transcranial neuroendoscopic supraorbital eyebrow keyhole approach in our hospital from March 2021 to October 2023. A total of 39 complete cases were collected, including 21 cases of intracranial aneurysms, 9 cases of intracranial space occupying lesions, 5 cases of brain trauma, 3 cases of cerebrospinal fluid rhinorrhea, and 1 case of cerebral hemorrhage. All patients’ surgeries were successful. The good prognosis rate of intracranial aneurysms was 17/21 (81%), and the symptom improvement rate of intracranial space occupying lesions was 8/9 (88.9%). Among them, the initial symptoms of one patient with no improvement were not related to space occupying, while the total effective rate of the other three types of patients was 9/9 (100%). The average length of the craniotomy bone window of the supraorbital eyebrow arch keyhole is 3.77 ± 0.31 cm, and the average width is 2.53 ± 0.23 cm. The average postoperative hospital stay was 14.77 ± 6.59 days. The average clearance rate of hematoma by neuroendoscopy is 95.00% ± 1.51%. Our results indicate that endoscopic surgery through the supraorbital eyebrow arch keyhole approach is safe and effective for the treatment of anterior skull base lesions and cerebral hemorrhage. However, this retrospective study is a single center, small sample study, and the good surgical results do not exclude the subjective screening of suitable patients by clinical surgeons, which may have some bias. Although the clinical characteristics such as indications and contraindications of this surgical method still require further prospective and multicenter clinical research validation, our study still provides a new approach and choice for minimally invasive surgical treatment of anterior skull base lesions.

To explore the techniques, safety, and feasibility of minimally invasive neurosurgery through the supraorbital eyebrow arch keyhole approach by neuroendoscopy. Retrospective analysis of clinical data of patients with various cranial diseases treated by transcranial neuroendoscopic supraorbital eyebrow keyhole approach in our hospital from March 2021 to October 2023. A total of 39 complete cases were collected, including 21 cases of intracranial aneurysms, 9 cases of intracranial space occupying lesions, 5 cases of brain trauma, 3 cases of cerebrospinal fluid rhinorrhea, and 1 case of cerebral hemorrhage. All patients' surgeries were successful. The good prognosis rate of intracranial aneurysms was 17/21 (81%), and the symptom improvement rate of intracranial space occupying lesions was 8/9 (88.9%). Among them, the initial symptoms of one patient with no improvement were not related to space occupying, while the total effective rate of the other three types of patients was 9/9 (100%). The average length of the craniotomy bone window of the supraorbital eyebrow arch keyhole is 3.77 ± 0.31 cm, and the average width is 2.53 ± 0.23 cm. The average postoperative hospital stay was 14.77 ± 6.59 days. The average clearance rate of hematoma by neuroendoscopy is 95.00% ± 1.51%. Our results indicate that endoscopic surgery through the supraorbital eyebrow arch keyhole approach is safe and effective for the treatment of anterior skull base lesions and cerebral hemorrhage. However, this retrospective study is a single center, small sample study, and the good surgical results do not exclude the subjective screening of suitable patients by clinical surgeons, which may have some bias. Although the clinical characteristics such as indications and contraindications of this surgical method still require further prospective and multicenter clinical research validation, our study still provides a new approach and choice for minimally invasive surgical treatment of anterior skull base lesions. [ABSTRACT FROM AUTHOR]

Simple Summary: There are few available data on the venous anatomy of Choloepus didactylus, particularly in living subjects. This study highlights the unique venous anatomy of this species in a non-invasive, retrospective, and reproducible manner, to enhance our understanding of this understudied species. The venous anatomy of the two-toed sloth (Choloepus didactylus) remains poorly understood, particularly in living specimens due to the limitations of traditional cadaveric studies. This study aims to describe the unique venous structures of Choloepus didactylus using computed tomography, enhancing our understanding of this species in a live setting. Three living Choloepus didactylus underwent CT scans as part of routine clinical assessments. The images were reconstructed using 3D Slicer software (version 5.6.2), focusing on the caudal vena cava anatomy. The reconstructions confirmed the presence of a significant intravertebral vein, showing complex venous connections through the ventral sacral foramen and vertebral foramina. These findings highlight notable anatomical variations and challenge existing literature on the species' venous architecture. By employing modern imaging technologies, this research provides new insights into the venous anatomy of Choloepus didactylus, demonstrating the value of non-invasive techniques in studying the anatomical features of live animals, thereby offering a foundation for further comparative and evolutionary studies. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationship between temporomandibular joint (TMJ) effusion and TMJ pain, as well as jaw function limitation in patients via two-dimensional (2D) and three-dimensional (3D) magnetic resonance imaging (MRI) evaluation. Patients and Methods: 121 patients diagnosed with temporomandibular disorder (TMD) were included. TMJ effusion was assessed qualitatively using MRI and quantified with 3D Slicer software, then graded accordingly. In addition, a visual analogue scale (VAS) was employed for pain reporting and an 8-item Jaw Functional Limitations Scale (JFLS-8) was utilized to evaluate jaw function limitation. Statistical analyses were performed appropriately for group comparisons and association determination. A probability of p< 0.05 was considered statistically significant. Results: 2D qualitative and 3D quantitative strategies were in high agreement for TMJ effusion grades (κ = 0.766). No significant associations were found between joint effusion and TMJ pain, nor with disc displacement and JLFS-8 scores. Moreover, the binary logistic regression analysis showed significant association between sex and the presence of TMJ effusion, exhibiting an Odds Ratio of 5.168 for females (p = 0.008). Conclusion: 2D qualitative evaluation was as effective as 3D quantitative assessment for TMJ effusion diagnosis. No significant associations were found between TMJ effusion and TMJ pain, disc displacement or jaw function limitation. However, it was suggested that female patients suffering from TMD may be at a risk for TMJ effusion. Further prospective research is needed for validation. [ABSTRACT FROM AUTHOR]

The minimally invasive surgery through transcranial endoscopic keyhole approach has become the main surgical method for treating cerebral hemorrhage. This method has the advantages of small trauma, short surgical time, low bleeding volume, and fast postoperative recovery. However, this method is not suitable for cases where cerebral hemorrhage occurs again after skull repair surgery. Our team used 3D Slicer reconstruction combined with virtual reality technology to find a suitable keyhole surgical approach and successfully completed a neuroendoscopic removal of basal ganglia hemorrhage through the eyebrow arch keyhole approach in a case of recurrent cerebral hemorrhage after cranioplasty.

Background and importance: Explore the techniques, advantages and disadvantages of 3D Slicer reconstruction combined with transcranial neuroendoscopy in cerebrospinal fluid rhinorrhea surgery. Clinical presentation: We collected complete clinical data of two patients with cerebrospinal fluid rhinorrhea who underwent minimally invasive surgery using 3D Slicer reconstruction combined with transcranial neuroendoscopy through the supraorbital eyebrow arch keyhole approach in our hospital from June 2022 to May 2023. The patients were one male and one female, aged 50 and 63 years old. At the same time, a retrospective summary of relevant literature at home and abroad in recent years was conducted. 1 case had spontaneous cerebrospinal fluid rhinorrhea with secondary cribriform plate lesion, and the other 1 case had traumatic cerebrospinal fluid rhinorrhea. Both 2 patients were ineffective after long-term conservative treatment, and ultimately recovered after detailed preoperative evaluation and preparation and surgical treatment. Conclusion: Cerebrospinal fluid rhinorrhea is a challenging disease in neurosurgery, and improper management can lead to serious complications such as meningitis. Our team used 3D Slicer reconstruction combined with transcranial endoscopic minimally invasive keyhole surgery to treat cerebrospinal fluid rhinorrhea, achieving good results, proving that this combined technology has certain advantages and is a new surgical technique worth promoting. However, the widespread application and promotion of this technology in anterior skull base surgery still require comprehensive and reliable prospective clinical studies to test.

Abstract Objective To explore the applicability of bone reamer and trephine for foraminoscopy in percutaneous endoscopic lumbar discectomy (PELD), and to provide a theoretical basis for foraminoplasty options in clinical practice. Methods This study was a prospective cohort study. Sixty-three consecutive patients who underwent PELD for lumbar disc herniation between May 2021 and July 2022 were analysed. Foraminoplasty were performed by bone reamer or trephine. The amount of bone removed and the foramen area enlarged during foraminoplasty by both tools were measured by 3D slicer and Digimizer software, and the numbers of fluoroscopic views were recorded. Results The bone reamer removed less bone in the Superior Articular Process (SAP) than the trephine (t = 17.507, P

The complex anatomy of the avian respiratory system makes it necessary to broaden our knowledge using modern imaging and reconstructional possibilities. The visualization of these structures can be used for clinical situations, in research or as teaching aids in veterinary education. For this we generated 3D models from diagnostic imaging data (computed tomography [CT] scans) of birds. We describe in detail a repeatable method of animal preparation for scanning, data handling and image analysis. CT scans with varying slice thickness and resolution were obtained in prone and supine body positions to analyse air sac morphology and volume changes relative to posture or sexual dimorphism in birds. The resulting data were prepared and analysed using a reconstructional software (3D Slicer) based on manual and semi‐automatic labelling and subsequent 3D models of the air sac system were created. The terminology employed has been referenced from the Nomina Anatomica Avium, Second Ed. [ABSTRACT FROM AUTHOR]

The multimodal and multidomain registration of medical images have gained increasing recognition in clinical practice as a powerful tool for fusing and leveraging useful information from different imaging techniques and in different medical fields such as cardiology and orthopedics. Image registration could be a challenging process, and it strongly depends on the correct tuning of registration parameters. In this paper, the robustness and accuracy of a landmarks-based approach have been presented for five cardiac multimodal image datasets. The study is based on 3D Slicer software and it is focused on the registration of a computed tomography (CT) and 3D ultrasound time-series of post-operative mitral valve repair. The accuracy of the method, as a function of the number of landmarks used, was performed by analysing root mean square error (RMSE) and fiducial registration error (FRE) metrics. The validation of the number of landmarks resulted in an optimal number of 10 landmarks. The mean RMSE and FRE values were 5.26 ± 3.17 and 2.98 ± 1.68 mm, respectively, showing comparable performances with respect to the literature. The developed registration process was also tested on a CT orthopaedic dataset to assess the possibility of reconstructing the damaged jaw portion for a pre-operative planning setting. Overall, the proposed work shows how 3D Slicer and registration by landmarks can provide a useful environment for multimodal/unimodal registration. [ABSTRACT FROM AUTHOR]

This study aimed to explore a novel, non-segmented based on inverted water outline, and rapid 3D rendering method for identifying the responsible blood vessels for hemifacial spasm. First, the software was developed using the free and open-source 3D Slicer to process magnetic resonance images. Outlines of the water region were extracted and rendered in a three-dimensional space. The traditional image re-slicing technique (IMRT) was used for the control group, while non-segmented inverted water outline rendering (NSIWR) was used to observe the relevant blood vessels in the root entry/exit zone (REZ) of patients with hemifacial spasm. The intraoperative exploration results were considered the gold standard for comparing the differences in identifying relevant blood vessels between the two methods. Twenty-five patients were included, and the reconstruction effect evaluation suggested that NSIWR could effectively reconstruct the responsible blood vessels of the cochlea, facial nerve, and REZ. Compared with IMRT, NSIWR effectively improved the diagnosis of the responsible blood vessels in the REZ, clarified their sources and directions, and was consistent with intraoperative results. This study introduced a novel rapid rendering method based on NSIWR, which was successfully applied for hemifacial spasm. The method enhances accuracy in identifying responsible blood vessels in the REZ without needing multi-modal techniques. It has the potential to improve surgical effectiveness and reduce exploration time in treating hemifacial spasm. [ABSTRACT FROM AUTHOR]

Artificial Intelligence (AI) has revolutionized medical imaging procedures, specifically with regard to image segmentation, reconstruction, interpretation, and research. 3D Slicer, an open-source medical image analysis platform, has become a valuable tool in medical imaging education due to its integration of various AI applications. Through its open-source architecture, students can gain practical experience with diverse medical images and the latest AI technology, reinforcing their understanding of anatomy and imaging technology while fostering independent learning and clinical reasoning skills. The implementation of this platform improves instruction quality and nurtures skilled professionals who can meet the demands of clinical practice, research institutions, and technology innovation enterprises. AI algorithms' application in medical image processing have facilitated their translation from the lab to practical clinical applications and education. [ABSTRACT FROM AUTHOR]

Objective: To explore the applicability of bone reamer and trephine for foraminoscopy in percutaneous endoscopic lumbar discectomy (PELD), and to provide a theoretical basis for foraminoplasty options in clinical practice. Methods: This study was a prospective cohort study. Sixty-three consecutive patients who underwent PELD for lumbar disc herniation between May 2021 and July 2022 were analysed. Foraminoplasty were performed by bone reamer or trephine. The amount of bone removed and the foramen area enlarged during foraminoplasty by both tools were measured by 3D slicer and Digimizer software, and the numbers of fluoroscopic views were recorded. Results: The bone reamer removed less bone in the Superior Articular Process (SAP) than the trephine (t = 17.507, P < 0.001), and the area enlarged by the bone reamer was smaller than that of the trephine (t = 10.042, P = 0.002). The overall numbers of fluoroscopic views were significantly more in the bone reamer group than in the trephine group (t = 19.003, P < 0.001). In the bone reamer group, when the area of preoperative (FPZ) was no less than 54.55 mm2, the mean number of fluoroscopic views significantly decreased (t = 14.443, P = 0.001). Conclusion: Bone reamer was safer and trephine was more efficient for foraminoscopy in PELD. An area of preoperative (FPZ) of 54.55 mm2 can be used as a critical value: bone reamer reduced the risk for cases above the value, while trephine improved the efficiency for cases less than the value. [ABSTRACT FROM AUTHOR]

To propose an automated fast cochlear segmentation, length, and volume estimation method from clinical 3D multimodal images which has a potential role in the choice of cochlear implant type, surgery planning, and robotic surgeries. Methods: Two datasets from different countries were used. These datasets include 219 clinical 3D images of cochlea from 3 modalities: CT, CBCT, and MR. The datasets include different ages, genders, and types of cochlear implants. We propose an atlas–model-based method for cochlear segmentation and measurement based on high-resolution μCT model and A-value. The method was evaluated using 3D landmarks located by two experts. Results: The average error was $0.61 \pm 0.22$ 0.61 ± 0.22 mm and the average time required to process an image was $5.21 \pm 0.93$ 5.21 ± 0.93 seconds (P<0.001). The volume of the cochlea ranged from 73.96 mm $^3$ 3 to 106.97 mm $^3$ 3 , the cochlear length ranged from 36.69 to 45.91 mm at the lateral wall and from 29.12 to 39.05 mm at the organ of Corti. Discussion: We propose a method that produces nine different automated measurements of the cochlea: volume of scala tympani, volume of scala vestibuli, central lengths of the two scalae, the scala tympani lateral wall length, and the organ of Corti length in addition to three measurements related to A-value. Conclusion: This automatic cochlear image segmentation and analysis method can help clinician process multimodal cochlear images in approximately 5 seconds using a simple computer. The proposed method is publicly available for free download as an extension for 3D Slicer software. [ABSTRACT FROM AUTHOR]

To investigate the surgical method and efficacy of percutaneous endoscopic transforaminal discectomy (PETD) for the treatment of lumbar disc herniation (LDH) with different migration levels by introducing the strategy of foramenoplasty with the "distal nucleus pulposus as the core".Methods: Clinical data of LDH patients who underwent single-segment PETD surgery were retrospectively analyzed. Three groups were categorized according to the degree of nucleus pulposus migration in the sagittal position: no migration group, mild migration group, and high migration group. Different sites of foramenoplasty were used for LDH with different degrees of migration. All patients were followed up for at least 12 months. The clinical and follow-up data of the three groups were compared.Results: A total of 102 patients were included, of which 46 (45.1%) were in the no migration group, 36 (35.3%) in the mild migration group, and 20 (19.6%) in the high migration group. Encouraging treatment results were obtained in all three groups.Conclusion: PETD is effective in the treatment of LDH with different degrees of migration, and the foramenoplasty concept of "distal nucleus pulposus as the core" can effectively guide the molding site of foramenoplasty and facilitate the accurate placement of the working trocar. [ABSTRACT FROM AUTHOR]

Runqi Cheng,1 Tiansheng Wang,1 Yuankun Cai,1 Songshan Chai,1 Lei Shen,1 Dongyuan Xu,1 Jingyi Yang,1 Chuqiao Yue,1 Jianzhang Pu,2 Nanxiang Xiong1 1Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People’s Republic of China; 2Department of Neurosurgery, Beijing Shunyi District Hospital, Shunyi Teaching Hospital of Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Nanxiang Xiong, Email mozhuoxiong@163.comObjective: To predict the volume and shape of the balloon before PBC by reconstructing the Meckel’s cave (MC) and establishing a volumetric measurement model, supporting preoperative preparation and intraoperative decisions.Methods: The clinical data of 31 patients with good therapeutic effects who underwent PBC are retrospectively collected, including preoperative MRI, the volume of contrast agent injected into the balloon, and intraoperative lateral X-ray images. The MC on the affected side of the 31 patients is reconstructed based on MRI using 3D Slicer, while the volume of the MC is calculated to compare with the volume of contrast agent. The width (W) and length (L) of the model of the MC in lateral view are measured and used to classify the shape of the MC based on W/L. The consistency between the W/L of the model of the MC and the W/L of the intraoperative balloon is evaluated.Results: For volume, the mean value of the models of the MC (V1) in 31 patients is 399.77± 155.13 mm³, while the mean value of the contrast agent injected during PBC (V2) is 539.03± 111.93 mm³. The formula obtained by linear regression is V2= 392.1 + 0.3676×V1. Based on the value of W/L, the shape of the MC is classified into thin “pear” in 5 patients (16.13%), standard “pear” in 22 patients (70.97%), and square “pear” in 4 patients (12.90%). There is no significant difference in W/L between the models of the MC and the intraoperative balloons in 31 patients (P=0.221).Conclusion: In 31 patients with good efficacy, it is verified that the prediction of the MC before PBC by 3D Slicer is consistent with the actual situation of the intraoperative balloon. This method can provide certain basis for preoperative preparation and intraoperative judgment.Keywords: trigeminal neuralgia, percutaneous balloon compression, Meckel’s cave, 3D Slicer, reconstruction

We aimed to assess the feasibility of developing three-dimensional (3D) models of pelvic organs using cross-sectional MRI images of patients with uterine fibroids and urinary symptoms and of obtaining anatomical information unavailable in 2D imaging modalities. We also aimed to compare two image processing applications. We performed a feasibility study analysing MRI scans from three women, aged 30 to 58 years old, with fibroids and urinary symptoms. Cross-sectional images were used to render 3D models of pelvic anatomy, including bladder, uterus and fibroids, using 3D Slicer and OsiriX. Dimensions, volumes and anatomical relationships of the pelvic organs were evaluated. Comparisons between anatomical landmarks and measurements obtained from the two image processing applications were undertaken. Rendered 3D pelvic models yielded detailed anatomical information and data on spatial relationships that were unobtainable from cross-sectional images. Models were rendered in sufficient resolution to aid understanding of spatial relationships between urinary bladder, uterus and fibroid(s). Measurements of fibroid volumes ranged from 5,336 to 418,012 mm3 and distances between the fibroid and urinary bladder ranged from 0.10 to 83.60 mm. Statistical analysis of measurements showed no significant differences in measurements between the two image processing applications. To date, limited data exist on the use of 3D volume reconstructions of routine MRI scans, to investigate pelvic pathologies such as fibroids in women with urinary symptoms. This study suggests that post-MRI image processing can provide additional information over standard MRI. Further studies are required to assess the role of these data in clinical practice, surgical planning and training. Three-dimensional reconstruction of routine two-dimensional magnetic resonance imaging provides additional anatomical information and may improve our understanding of anatomical relationships, their role in clinical presentations and possibly guide clinical and surgical management. [ABSTRACT FROM AUTHOR]

Aim: To evaluate various segmentation software for liver segmentation from MR images. Method: Three MR examinations were performed on seven healthy volunteers (average age 38.2 ± 5.5 years, BMI = 28.6 ± 8.3 kg/m²) without known liver or cholestatic diseases -- before initiating fasting, after 48 hours of fasting, and after subsequent twoday carbohydrate realimentation. The livers were segmented using seven (semi)automatic methods of software 3D Slicer, LiverLab, ITKSNAP, Myrian and MedSeg and compared to the reference manual segmentation. Results: All methods used for liver volume determination showed good accuracy. Intraclass coefficients of consistency and agreement were above 0.95. The TotalSegmentator module in the 3D Slicer program achieved the best coefficient of variation (CV), and also demonstrated the highest accuracy in the individual assessment of the dietary intervention effect, with an average CV below 10% (other methods ranged from 10-20%). Conclusion: 3D Slicer can be considered the best among all the tested segmentation software for liver segmentation from MR images in terms of program availability, accuracy, and speed. In basic tasks such as organ segmentation, it can compete with commercial software. It can accurately track liver volume changes during short-term dietary interventions. [ABSTRACT FROM AUTHOR]

Purpose: Up to date, there has been a lack of software infrastructure to connect 3D Slicer to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning. Methods: We developed an AR application in Unity that is wirelessly rendered onto Microsoft HoloLens 2 using Holographic Remoting. Simultaneously, Unity connects to 3D Slicer using the OpenIGTLink communication protocol. Geometrical transform and image messages are transferred between both platforms in real time. Through the AR glasses, a user visualizes a patient's computed tomography overlaid onto virtual 3D models showing anatomical structures. We technically evaluated the system by measuring message transference latency between the platforms. Its functionality was assessed in pedicle screw placement planning. Six volunteers planned pedicle screws' position and orientation with the AR system and on a 2D desktop planner. We compared the placement accuracy of each screw with both methods. Finally, we administered a questionnaire to all participants to assess their experience with the AR system. Results: The latency in message exchange is sufficiently low to enable real-time communication between the platforms. The AR method was non-inferior to the 2D desktop planner, with a mean error of 2.1 ± 1.4 mm. Moreover, 98% of the screw placements performed with the AR system were successful, according to the Gertzbein–Robbins scale. The average questionnaire outcomes were 4.5/5. Conclusions: Real-time communication between Microsoft HoloLens 2 and 3D Slicer is feasible and supports accurate planning for pedicle screw placement. [ABSTRACT FROM AUTHOR]

Premise: Imaging technologies that capture three‐dimensional (3D) variation in floral morphology at micro‐ and nano‐resolutions are increasingly accessible. In herkogamous flowers, such as those of Theobroma cacao, structural barriers between anthers and stigmas represent bottlenecks that restrict pollinator size and access to reproductive organs. To study the unresolved pollination biology of cacao, we present a novel application of micro‐computed tomography (micro‐CT) using floral dimensions to quantify pollinator functional size limits. Methods: We generated micro‐CT data sets from field‐collected flowers and museum specimens of potential pollinators. To compare floral variation, we used 3D Slicer to place landmarks on the surface models and performed a geometric morphometric (GMM) analysis using geomorph R. We identified the petal side door (an opening between the petal hoods and filament) as the main bottleneck for pollinator access. We compared its mean dimensions with proposed pollinators to identify viable candidates. Results: We identified three levels of likelihood for putative pollinators based on the number of morphological (body) dimensions that fit through the petal side door. We also found floral reward microstructures whose presence and location were previously unclear. Discussion: Using micro‐CT and GMM to study the 3D pollination biology of cacao provides new evidence for predicting unknown pollinators. Incorporating geometry and floral rewards will strengthen plant–pollinator trait matching models for cacao and other species. [ABSTRACT FROM AUTHOR]

Aim: It was aimed to analyze the detailed morphometry of the pharyngeal recess (PR) using three-dimensional (3D) models reconstructed from multidetector computed tomography (MDCT) images. Material and Methods: This study was a retrospective analysis and performed on MDCT images of 97 patients (43 males, 54 females). 3D models of the PR were reconstructed using 3D Slicer software, enabling morphometric measurements according to established protocols. Measurements included PR depths, distances between the posterior nasal spine and torus levatorius (PNS-TL), distances between right and left TL (RTL-LTL) distances between the PNS and posterior wall of the nasopharynx (PNS-PWN), the angle (a) between the centerline of the PR and the sagittal plane. The morphologies of the PR classified into three types. Results: The average measurements for the parameters were as follows: PR depth - 10.42 mm, distance between PNS and TL - 10.40 mm, distance between RTL and LTL - 19.13 mm, distance between PNS and PWN - 19.92 mm, and the angle (a) - 53.65°. The prevalence of PR types was 20.62%, 47.42% and 31.96% for type 1, type 2 and type 3, respectively. Conclusion: Variations in reported measurements of the pharyngeal recess can be attributed to imaging techniques, patient positioning, anatomical differences, and sample sizes. The use of 3D models generated from MDCT datasets offers a high-resolution and comprehensive approach to understanding the PR's morphometry and spatial relationships, enabling accurate measurements and advancing our knowledge of this anatomical region. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the evolution of brain edema after minimally invasive surgery in deep spontaneous cerebral hemorrhage (DSICH) treatment and to analyze the differences in edema after different surgical methods. The clinical data of 105 patients with DSICH treated at Renmin Hospital of Wuhan University from January 2020 to June 2022 were analyzed retrospectively. Among them, 54 patients were treated with minimally invasive puncture and drainage surgery (MIPDS group), and 51 were treated with neuroendoscopic surgery (NES group). Continuous computed tomography images of patients in the hospital and 3D Slicer software were used to quantitatively calculate the edematous area to explore the changes in perihematomal edema volume in the two groups after the operation. The peak volume of postoperative edema (37.36±10.51 mL) in the MIPDS group was more extensive than that in the NES group, and its net increase in edema volume was 16.86±10.01 mL more than that in the NES group. The relative edema index (0.86±0.26) was lower in the NES group than in the MIPDS group (P < 0.05). The peak of postoperative edema in the MIPDS group was at 6–8 days after the operation, and that in the NES group was most often at 3–5 days after the operation. There are differences in perihematomal edema of DSICH treated by different minimally invasive methods. Compared with the MIPDS group, the NES group showed earlier peak of cerebral edema and lower degree of cerebral edema. The absolute regression volume of edema in the MIDPs group was greater than that in the NEs group, but there was no difference in the regression rate of edema between the two groups. [ABSTRACT FROM AUTHOR]