Our research focuses on pelvic malformations and tumors in children and adolescents.
OSIRIX LITE SEGMENTATION SOFTWARE
However, most of the available segmentation and 3D modeling software tools focus on CT images (e.g., segmentation of bones, liver, and vessels) or on brain MRI. We here refer to segmentation of a 3D image as the process of assigning a given label to each voxel of the image, such that voxels with the same label belong to the same anatomical structure. Hence, dedicated segmentation tools are mandatory to obtain a comprehensive, relevant, and useful 3D pelvic model. Secondly, simple automatic tools such as MIP (maximum intensity projection) or direct 3D volume rendering, only based on the intensity of the voxels, are ineffective for the pelvis due to the strong signal heterogeneity, especially in MRI. First, the involved structures are soft and deformable leading to a strong anatomical inter-patient variability. Imaging the pelvis for a 3D patient-specific model entails important difficulties. However, general surgeons, and even more pediatric surgeons, do not have access in routine to these tools. Thanks to the advances in medical imaging technologies, especially 3D visualization, the surgeon should better understand the patient’s anatomy, properly counsel the patient, predict possible complications, choose the surgical approach, and use image overlay to guide surgery. To conclude, this study proposed a comprehensive review of software tools for 3D modeling of the pelvis according to a set of eight criteria and delivered specific conclusions for pediatric and adolescent patients that can be directly applied to clinical practice.
The best-ranked software tools were Myrian Studio, ITK-SNAP, and 3D Slicer, the latter being especially appropriate if nerve fibers should be included in the 3D patient model. This ranking allowed us to elaborate guidelines for the choice of software tools for pelvic surgical planning in pediatric patients. A ranking of software tools for 3D modeling of MRI medical images, according to the set of predefined criteria, was given.
OSIRIX LITE SEGMENTATION REGISTRATION
The software tools were rated according to eight criteria, evaluated by three different users: automatization degree, segmentation time, usability, 3D visualization, presence of image registration tools, tractography tools, supported OS, and potential extension (i.e., plugins). Twelve software tools freely available on the Internet and two commercial software tools were evaluated using T2-w MRI and diffusion-weighted MRI images. The aim of this study was to evaluate the performances of different software tools to obtain patient-specific 3D models, through segmentation of magnetic resonance images (MRI), the reference for pediatric pelvis examination.
This study focused on the pelvic region, located at the crossroads of the urinary, digestive, and genital channels with important vascular and nervous structures. Pediatric and adolescent patients with rare tumors and malformations should highly benefit from these latest technological innovations, allowing personalized tailored surgery. Patient-specific 3D modeling is the first step towards image-guided surgery, the actual revolution in surgical care.
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