Search

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]

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]

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.

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]

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.

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]

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

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]

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]

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]

Abstract Background Irregular hematoma is considered as a risk sign of hematoma expansion. The aim of this study was to quantify hematoma irregularity with computed tomography based on 3D Slicer. Methods Patients with spontaneous intracerebral hemorrhage who underwent an initial and subsequent non-contrast computed tomography (CT) at a single medical center between January 2019 to January 2020 were retrospectively identified. The Digital Imaging and Communication in Medicine (DICOM) standard images were loaded into the 3D Slicer, and the surface area (S) and volume (V) of hematoma were calculated. The hematoma irregularity index (HII) was defined as $$\frac{\sqrt{S/\pi}}2/\sqrt[3]{3V/4\pi}\times100$$ S / π 2 / 3 V / 4 π 3 × 100 . Logistic regression analyses and receiver operating characteristic (ROC) curve analysis were performed to assess predictive performance of HII. Results The enrolled patients were divided into those with hematoma enlargement (n = 36) and those without the enlargement (n = 57). HII in hematoma expansion group was 130.4 (125.1–140.0), and the index in non-enlarged hematoma group was 118.6 (113.5-122.3). There was significant difference in HII between the two groups (P

Simple Summary: This study is the first to evaluate the impact of contouring differences on radiomics analysis in preclinical CBCT scans. We found that the variation in quantitative image readouts was greater between segmentation tools than between observers. Radiomics image analysis has the potential to uncover disease characteristics for the development of predictive signatures and personalised radiotherapy treatment. Inter-observer and inter-software delineation variabilities are known to have downstream effects on radiomics features, reducing the reliability of the analysis. The purpose of this study was to investigate the impact of these variabilities on radiomics outputs from preclinical cone-beam computed tomography (CBCT) scans. Inter-observer variabilities were assessed using manual and semi-automated contours of mouse lungs (n = 16). Inter-software variabilities were determined between two tools (3D Slicer and ITK-SNAP). The contours were compared using Dice similarity coefficient (DSC) scores and the 95th percentile of the Hausdorff distance (HD95p) metrics. The good reliability of the radiomics outputs was defined using intraclass correlation coefficients (ICC) and their 95% confidence intervals. The median DSC scores were high (0.82–0.94), and the HD95p metrics were within the submillimetre range for all comparisons. the shape and NGTDM features were impacted the most. Manual contours had the most reliable features (73%), followed by semi-automated (66%) and inter-software (51%) variabilities. From a total of 842 features, 314 robust features overlapped across all contouring methodologies. In addition, our results have a 70% overlap with features identified from clinical inter-observer studies. [ABSTRACT FROM AUTHOR]

Background and Objectives: Aneurysmal subarachnoid hemorrhage is strongly associated with symptomatic cerebral vasospasm. This study aims to investigate whether a quantitative measure of aneurysmal subarachnoid hematoma by 3D Slicer is more valuable for vasospasm risk prediction compared with modified Fisher scale and the new scale by Eagles. Materials and Methods: We performed a retrospective research of Digital Imaging and Communications in Medicine format (DICOM) in aneurysmal patients treated at our institution from 2019 to 2020. Association between vasospasm and hematoma volume by 3D Slicer was explored by univariate and multivariate analyses. Value of risk prediction was compared through area under the receiver operator characteristic curve (AUC) among the modified Fisher scale, the new scale by Eagles, and hematoma volume by 3D Slicer. Results: Hematoma volume by 3D Slicer had a significant relationship with vasospasm both by one‑way analysis of variance (ANOVA; F = 19.37, P < 0.001) and a binary logistic regression analysis (odds ratio [OR] = 1.05, P = 0.016). Hematoma volume by 3D Slicer had a significantly higher AUC (0.708; 95% confidence interval [CI]: 0.618–0.798, P < 0.001) than the modified Fisher scale and the new scale by Eagles. The optimal diagnostic threshold for hematoma volume by 3D Slicer was 15.98 ml, and the sensitivity and specificity were 73.5% and 58.6%, respectively. Conclusions: Volume of aneurysmal subarachnoid hematoma measured quantitatively by 3D Slicer can improve the predictive value for symptomatic cerebral vasospasm. [ABSTRACT FROM AUTHOR]

Abstract Pancreatoscopy plays a significant role in the diagnosis and treatment of pancreatic diseases. However, the risk of pancreatoscopy is remarkably greater than that of other endoscopic procedures, such as gastroscopy and bronchoscopy, owing to its severe invasiveness. In comparison, virtual pancreatoscopy (VP) has shown notable advantages. However, because of the low resolution of current computed tomography (CT) technology and the small diameter of the pancreatic duct, VP has limited clinical use. In this study, an optimal path algorithm and super-resolution technique are investigated for the development of an open-source software platform for VP based on 3D Slicer. The proposed segmentation of the pancreatic duct from the abdominal CT images reached an average Dice coefficient of 0.85 with a standard deviation of 0.04. Owing to the excellent segmentation performance, a fly-through visualization of both the inside and outside of the duct was successfully reconstructed, thereby demonstrating the feasibility of VP. In addition, a quantitative analysis of the wall thickness and topology of the duct provides more insight into pancreatic diseases than a fly-through visualization. The entire VP system developed in this study is available at https://github.com/gaoyi/VirtualEndoscopy.git .

Purpose: This study aimed to explore circular RNA (circRNA) hsa_circ_0000690 as a potential biomarker for diagnosis and prognosis of intracranial aneurysm (IA) and its relationship with clinical factors and complications of IA. Material/methods: 216 IA patients admitted to the neurosurgery department of our hospital from January 2019 to December 2020 were selected as the experimental group, and 186 healthy volunteers were selected as the control group. The expression of hsa_circ_0000690 in peripheral blood was detected by quantitative real‐time PCR, and its diagnostic value was assessed by receiver operating characteristic curve. Relationship between hsa_circ_0000690 and clinical factors of IA was assessed by chi‐square test. Nonparametric test was used in univariate analysis, and regression analysis was used in multivariate analysis. Multivariate Cox proportional hazards regression analysis was used to analyze the survival time. Results: CircRNA hsa_circ_0000690 of IA patients was relatively lower than that in the control group (p <.001). The AUC of hsa_circ_0000690 was 0.752, the specificity was 0.780, and sensitivity was 0.620, with diagnostic threshold of 0.0449. In addition, hsa_circ_0000690 expression was correlated with Glasgow Coma Scale, the volume of subarachnoid hemorrhage, modified Fisher scale, Hunt–Hess levels and surgical type. For hydrocephalus and delayed cerebral ischemia, hsa_circ_0000690 was significant in univariate analysis, but nonsignificant in multivariate analysis. For prognosis, hsa_circ_0000690 was significantly associated with modified Rankin Scales after surgery for 3 months, but not associated with survival time. Conclusions: The expression of hsa_circ_0000690 can act as a diagnostic marker for IA and predict the prognosis of 3 months after operation and is closely related to the volume of hemorrhage. [ABSTRACT FROM AUTHOR]

Background: As an integral part of computer-assisted surgery, virtual surgical planning (VSP) leads to significantly better surgery results, such as for oral and maxillofacial reconstruction with microvascular grafts of the fibula or iliac crest. It is performed on a 2D computer desktop screen (DS) based on preoperative medical imaging. However, in this environment, VSP is associated with shortcomings, such as a time-consuming planning process and the requirement of a learning process. Therefore, a virtual reality (VR)-based VSP application has great potential to reduce or even overcome these shortcomings due to the benefits of visuospatial vision, bimanual interaction, and full immersion. However, the efficacy of such a VR environment has not yet been investigated. Objective: This study aimed to demonstrate the possible advantages of a VR environment through a substep of VSP, specifically the segmentation of the fibula (calf bone) and os coxae (hip bone), by conducting a training course in both DS and VR environments and comparing the results. Methods: During the training course, 6 novices were taught how to use a software application in a DS environment (3D Slicer) and in a VR environment (Elucis) for the segmentation of the fibula and os coxae, and they were asked to carry out the maneuvers as accurately and quickly as possible. Overall, 13 fibula and 13 os coxae were segmented for each participant in both methods (VR and DS), resulting in 156 different models (78 fibula and 78 os coxae) per method (VR and DS) and 312 models in total. The individual learning processes in both environments were compared using objective criteria (time and segmentation performance) and self-reported questionnaires. The models resulting from the segmentation were compared mathematically (Hausdorff distance and Dice coefficient) and evaluated by 2 experienced radiologists in a blinded manner. Results: A much faster learning curve was observed for the VR environment than the DS environment (β=.86 vs β=.25). This nearly doubled the segmentation speed (cm3/min) by the end of training, leading to a shorter time (P<.001) to reach a qualitative result. However, there was no qualitative difference between the models for VR and DS (P=.99). The VR environment was perceived by participants as more intuitive and less exhausting, and was favored over the DS environment. Conclusions: The more rapid learning process and the ability to work faster in the VR environment could save time and reduce the VSP workload, providing certain advantages over the DS environment. [ABSTRACT FROM AUTHOR]

Background: Irregular hematoma is considered as a risk sign of hematoma expansion. The aim of this study was to quantify hematoma irregularity with computed tomography based on 3D Slicer.Methods: Patients with spontaneous intracerebral hemorrhage who underwent an initial and subsequent non-contrast computed tomography (CT) at a single medical center between January 2019 to January 2020 were retrospectively identified. The Digital Imaging and Communication in Medicine (DICOM) standard images were loaded into the 3D Slicer, and the surface area (S) and volume (V) of hematoma were calculated. The hematoma irregularity index (HII) was defined as [Formula: see text]. Logistic regression analyses and receiver operating characteristic (ROC) curve analysis were performed to assess predictive performance of HII.Results: The enrolled patients were divided into those with hematoma enlargement (n = 36) and those without the enlargement (n = 57). HII in hematoma expansion group was 130.4 (125.1-140.0), and the index in non-enlarged hematoma group was 118.6 (113.5-122.3). There was significant difference in HII between the two groups (P < 0.01). Multivariate logistic regression analysis revealed that the HII was significantly associated with hematoma expansion before (odds ratio = 1.203, 95% confidence interval [CI], 1.115-1.298; P < 0.001) and after adjustment for age, hematoma volume, Glasgow Coma Scale score (odds ratio = 1.196, 95% CI, 1.102-1.298, P < 0.001). The area under the ROC curve was 0.86 (CI, 0.78-0.93, P < 0.01), and the best cutoff of HII for predicting hematoma growth was 123.8.Conclusion: As a quantitative indicator of irregular hematoma, HII can be calculated using the 3D Slicer. And the HII was independently correlated with hematoma expansion. [ABSTRACT FROM AUTHOR]

Purpose: Monte Carlo (MC) simulation is an important technique that can help design advanced and challenging experimental setups. GATE (Geant4 application for tomographic emission) is a useful simulation toolkit for applications in nuclear medicine. Transarterial radioembolization is a treatment for liver cancer, where microspheres embedded with yttrium‐90 (90Y) are administered intra‐arterially to the tumor. Personalized dosimetry for this treatment may provide higher dosimetry accuracy compared to the conventional partition model (PM) calculation. However, incorporation of three‐dimensional tomographic input data into MC simulation is an intricate process. In this article, 3D Slicer, free and open‐source software, was utilized for the incorporation of patient tomographic images into GATE to demonstrate the feasibility of personalized dosimetry in hepatic radioembolization with 90Y. Methods: In this article, the steps involved in importing, segmenting, and registering tomographic images using 3D Slicer were thoroughly described, before importing them into GATE for MC simulation. The absorbed doses estimated using GATE were then compared with that of PM. SlicerRT, a 3D Slicer extension, was then used to visualize the isodose from the MC simulation. Results: A workflow diagram consisting of all the steps taken in the utilization of 3D Slicer for personalized dosimetry in 90Y radioembolization has been presented in this article. In comparison to the MC simulation, the absorbed doses to the tumor and normal liver were overestimated by PM by 105.55% and 20.23%, respectively, whereas for lungs, the absorbed dose estimated by PM was underestimated by 25.32%. These values were supported by the isodose distribution obtained via SlicerRT, suggesting the presence of beta particles outside the volumes of interest. These findings demonstrate the importance of personalized dosimetry for a more accurate absorbed dose estimation compared to PM. Conclusion: The methodology provided in this study can assist users (especially students or researchers who are new to MC simulation) in navigating intricate steps required in the importation of tomographic data for MC simulation. These steps can also be utilized for other radiation therapy related applications, not necessarily limited to internal dosimetry. [ABSTRACT FROM AUTHOR]

Purpose: During cochlear implantation surgery, a range of complications may occur such as tip fold-over. We recently developed a method to estimate the insertion orientation of the electrode array. The aim of the study was to determine the optimal angle of orientation in a cohort of cochlear implanted patients. Methods: On eighty-five CT scans (80 uncomplicated insertions and 5 cases with tip fold-over), location of the electrode array's Insertion Guide (IG), Orientation marker (OM) and two easily identifiable landmarks (the round window (RW) and the incus short process (ISP)) were manually marked. The angle enclosed by ISP-RW line and the Cochlear™ Slim Modiolar electrode array's OM line determined the electrode array insertion angle. Results : The average insertion angle was 45.0–47.2° ± 10.4–12° SD and was validated with 98% confidence interval. Based on the measurements obtained, patients' sex and age had no impact on the size of this angle. Although the angles of the tip fold-over cases (44.9°, 46.9°, 34.2°, 54.3°, 55.9°) fell within this average range, the further it diverted from the average it increased the likelihood for tip fold-over. Conclusion: Electrode array insertion in the individually calculated angle relative to the visible incus short process provides a useful guide for the surgeon when aiming for the optimal angle, and potentially enhances good surgical outcomes. Our results show that factors other than the orientation angle may additionally contribute to failures in implantation when the Slim Modiolar electrode is used. [ABSTRACT FROM AUTHOR]

Copyright of China Medical Education Technology is the property of China Medical Education Technology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)