Three-Dimensional Volume Rendering of Pelvic Floor Anatomy with Focus on Fibroids in Relation to the Lower Urogenital Tract Based on Cross-Sectional MRI Images.

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.

CT imaging of dogs with perineal hernia reveals large prostates with morphological and spatial abnormalities.

The etiology of canine perineal hernia (PH) remains unclear, although as a disease of older male dogs, it is likely to be hormonal. The role of the prostate in the formation of PH has been questioned; however, prospective and systematic evaluation of prostates in these dogs is absent in the literature. In this prospective case-control study, CT imaging was used to assess prostatic changes in dogs with PH (n = 46) and compare these findings with those of intact age-matched male dogs (n = 23). Using the OsiriX® DICOM viewer, we measured prostatic volume and correlated it with the size of the dog by using the length of the sixth lumbar vertebra. In addition, we recorded spatial and morphological changes of the prostate, such as heterogenicity, intra- and paraprostatic cysts, and mineralizations, as well as prostatic location and rotation. We found that dogs with PH had larger prostates (P < .001) that more often contained cysts (P < .001) and had larger cyst diameters (P = .013) than age-matched controls. Prostates of PH dogs also contained paraprostatic cysts (17.4%) and focal mineralizations (32.6%), which were absent in the control group. Abnormal rotation and location of the prostate were common in dogs with PH. In conclusion, these findings support the use of CT as an adjunct diagnostic imaging modality for the evaluation of the prostate in dogs with PH. Further studies are needed to evaluate nonprostatic CT findings in the pelvic cavity of PH dogs.

3D-Volume Rendering of the Pelvis with Emphasis on Paraurethral Structures Based on MRI Scans and Comparisons between 3D Slicer and OsiriX®.

The feasibility of rendering three dimensional (3D) pelvic models of vaginal, urethral and paraurethral lesions from 2D MRI has been demonstrated previously. To quantitatively compare 3D models using two different image processing applications: 3D Slicer and OsiriX. Secondary analysis and processing of five MRI scan based image sets from female patients aged 29-43 years old with vaginal or paraurethral lesions. Cross sectional image sets were used to create 3D models of the pelvic structures with 3D Slicer and OsiriX image processing applications. The linear dimensions of the models created using the two different methods were compared using Bland-Altman plots. The comparisons demonstrated good agreement between measurements from the two applications. The two data sets obtained from different image processing methods demonstrated good agreement. Both 3D Slicer and OsiriX can be used interchangeably and produce almost similar results. The clinical role of this investigation modality remains to be further evaluated.

MRI perfusion analysis using freeware, standard imaging software.

BACKGROUND: Perfusion-weighted imaging is only scarcely used in veterinary medicine. The exact reasons are unclear. One reason might be the typically high costs of the software packages for image analysis. In addition, a great variability concerning available programs makes it hard to compare results between different studies. Moreover, these algorithms are tuned for their usage in human medicine and often difficult to adapt to veterinary studies. In order to address these issues, our aim is to deliver a free open source package for calculating quantitative perfusion parameters. We develop an "R package" calculating mean transit time, cerebral blood flow and cerebral blood volume from data obtained with freely imaging software (OsiriX Light®). We hope that the free availability, in combination with the fact that the underlying algorithm is open and adaptable, makes it easier for scientists in veterinary medicine to use, compare and adapt perfusion-weighted imaging analysis. In order to demonstrate the usage of our software package, we reviewed previously acquired perfusion-weighted images from a group of eight purpose-breed healthy beagle dogs and twelve client-owned dogs with idiopathic epilepsy. In order to obtain the data needed for our algorithm, the following steps were performed: First, regions of interest (ROI) were drawn around different, previously reported, brain regions and the middle cerebral artery. Second, a ROI enhancement curve was generated for each ROI using a freely available PlugIn. Third, the signal intensity curves were exported as a comma-separated-value file. These files constitute the input to our software package, which then calculates the PWI parameters. RESULTS: We used our software package to re-assess perfusion weighted images from two previous studies. The clinical results were similar, showing a significant increase in the mean transit time and a significant decrease in cerebral blood flow for diseased dogs. CONCLUSION: We provide an "R package" for computing the main perfusion parameters from measurements taken with standard imaging software and describe in detail how to obtain these measurements. We hope that our contribution enables users in veterinary medicine to easily obtain perfusion parameters using standard Open Source software in a standard, adaptable and comparable way.

Advantages and Disadvantages in Image Processing with Free Software in Radiology.

Currently, there are sophisticated applications that make it possible to visualize medical images and even to manipulate them. These software applications are of great interest, both from a teaching and a radiological perspective. In addition, some of these applications are known as Free Open Source Software because they are free and the source code is freely available, and therefore it can be easily obtained even on personal computers. Two examples of free open source software are Osirix Lite® and 3D Slicer®. However, this last group of free applications have limitations in its use. For the radiological field, manipulating and post-processing images is increasingly important. Consequently, sophisticated computing tools that combine software and hardware to process medical images are needed. In radiology, graphic workstations allow their users to process, review, analyse, communicate and exchange multidimensional digital images acquired with different image-capturing radiological devices. These radiological devices are basically CT (Computerised Tomography), MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), etc. Nevertheless, the programs included in these workstations have a high cost which always depends on the software provider and is always subject to its norms and requirements. With this study, we aim to present the advantages and disadvantages of these radiological image visualization systems in the advanced management of radiological studies. We will compare the features of the VITREA2® and AW VolumeShare 5® radiology workstation with free open source software applications like OsiriX® and 3D Slicer®, with examples from specific studies.

Quantitative chest computed tomography is associated with two prediction models of mortality in interstitial lung disease related to systemic sclerosis.

Objective: In this multicentre study, we aimed to evaluate the capacity of a computer-assisted automated QCT method to identify patients with SSc-associated interstitial lung disease (SSc-ILD) with high mortality risk according to validated composite clinical indexes (ILD-Gender, Age, Physiology index and du Bois index). Methods: Chest CT, anamnestic data and pulmonary function tests of 146 patients with SSc were retrospectively collected, and the ILD-Gender, Age, Physiology score and DuBois index were calculated. Each chest CT underwent an operator-independent quantitative assessment performed with a free medical image viewer (Horos). The correlation between clinical prediction models and QCT parameters was tested. A value of P < 0.05 was considered statistically significant. Results: Most QCT parameters had a statistically different distribution in patients with diverging mortality risk according to both clinical prediction models (P < 0.01). The cut-offs of QCT parameters were calculated by receiver operating characteristic curve analysis, and most of them could discriminate patients with different mortality risk according to clinical prediction models. Conclusion: QCT assessment of SSc-ILD can discriminate between well-defined different mortality risk categories, supporting its prognostic value. These findings, together with the operator independence, strengthen the validity and clinical usefulness of QCT for assessment of SSc-ILD.

Enlarged uterine corpus volume in women with endometriosis: Assessment using three-dimensional reconstruction of pelvic magnetic resonance images.

AIM: To assess and compare the uterine volume and endometrium length between women with and without endometriosis, using pelvic magnetic resonance imaging scans. METHODS: In this case-control study, a total of 75 nulligravid women (aged 20-45 years) with regular menstrual cycles whose uterus were free of any surgically confirmed lesions were enrolled. The endometriosis group underwent surgery for endometrioma (n = 39), and the control group underwent surgery for non-endometrioma ovarian cysts (n = 36). The primary outcome was uterine corpus volume, which was assessed using three-dimensional reconstructions of preoperative pelvic magnetic resonance imaging scans. RESULTS: The mean uterine volume was significantly larger in the endometriosis group than in the control group (mean ± standard deviation, 50.9 ± 14.4 cm3 vs 41.7 ± 14.3 cm3 ; P < 0.01). The longitudinal length and transverse diameter of the corpus and the longitudinal length of the endometrium were also significantly greater in the endometriosis group (all, P < 0.01). CONCLUSIONS: An increase in uterine volume and endometrium length was observed in women with endometriosis.

INTRAOPERATIVE IMAGE NAVIGATION: EXPERIMENTAL STUDY OF THE FEASIBILITY AND SURGEON PREFERENCE BETWEEN A STERILE ENCASED NINTENDO WIITM REMOTE AND STANDARD WIRELESS COMPUTER MOUSE.

Diagnostic imaging plays an important role in the operating room, providing surgeons with a reference and surgical plan. Surgeon autonomy in the operating room has been suggested to decrease errors that stem from communication mistakes. A standard computer mouse was compared to a wireless remote-control style controller for computer game consoles (Wiimote) for the navigation of diagnostic imaging studies by sterile personnel in this prospective survey study. Participants were recruited from a cohort of residents and faculty that use the surgical suites at our institution. Outcome assessments were based on survey data completed by study participants following each use of either the mouse or Wiimote, and compared using an analysis of variance. The mouse was significantly preferred by the study participants in the categories of handling, accuracy and efficiency, and overall satisfaction (P <0.05). The mouse was preferred to both the Wiimote and to no device, when participants were asked to rank options for image navigation. This indicates the need for the implementation of intraoperative image navigation devices, to increase surgeon autonomy in the operating room.

Operator-independent quantitative chest computed tomography versus standard assessment of interstitial lung disease related to systemic sclerosis: A multi-centric study.

PURPOSE: Interstitial lung disease (ILD) related to systemic sclerosis (SSc) is assessed with pulmonary functional tests (PFTs) and semi-quantitative scores based on extent of ILD detectable on chest computed tomography (CT). CT quantitative indexes (QCTIs) are promising tools to assess extent of ILD. This study's aim is to evaluate the validity of QCTI compared with that of chest CT standard evaluation and PFTs. Moreover, QCTI differences between patients' subgroups according to prognostic stratifications were investigated. METHODS: ILD-SSc of patients from six rheumatological clinics was routinely assessed with chest CT and PFTs. Patients were clustered according to prognosis based on functional and/or radiological examinations. Finally, chest CTs were processed with OsiriX in order to obtain QCTI. RESULTS: Two hundred fifty-seven SSc patients were enrolled. QCTI correlation between extent of ILD and PFTs range from - 0.60 to 0.58 and from - 0.54 to 0.52, respectively. The majority of QCTI have a different distribution in patients' subgroups based on prognosis. Most of QCTI discriminate patients with an ILD severity leading to a poor prognosis. CONCLUSIONS: QCTI assessment of ILD-SSc is comparable to the evaluation based on chest CT and/or PFTs. QCTI values corresponding to severe ILD were identified. QCTIs are excellent candidates for a new and more reliable SSc-ILD assessment.

Volumetric trends associated with MRI-guided laser-induced thermal therapy (LITT) for intracranial tumors.

BACKGROUND: MR-guided Laser Induced Thermal Therapy (LITT) is a procedure for intracranial tumors. Minimal data exists regarding post-procedure lesion volume changes. OBJECTIVES: We aim to analyze changes in lesion volume during the post-LITT period using polygonal tracing with fusion. Additionally, we investigated the role of lesion histopathology on LITT parameters and volume dynamics. METHODS: Sixteen patients with intracranial neoplasms received LITT. Using OsiriX DICOM Viewer, three raters computed lesion volumes at the following: pre-ablation (PreA), immediate post-ablation (IPA), 24 hours post-ablation (24PA), and first follow-up post-ablation (FPA), which ranged from 4 to 11 weeks post-ablation. Statistical analyses for volume changes between time points and inter-rater reliability were performed. Additionally, comparisons were made between metastatic versus non-metastatic and small versus large lesions in terms of operative parameters and volume changes. RESULTS: There was an acute increase in volume at IPA with a decrease in size by 24PA. ANOVA among inter-rater datasets showed no significant difference at any time point (highest F(1,15) = 0.225, P > 0.80, for IPA). GLM repeated measures, for Intra-Rater analysis, demonstrated statistically significant differences across time points (lowest F(1,15) = 13.297, P = 0.003). IPA volumes were larger than those at PreA, 24PA, and FPA (average volume increase [95% CI]: 281% [157-404%], 167% [134-201%], 187% [154-219%], respectively; all P < 0.004). Correlation analysis showed lower inter-rater reliability at IPA versus other time points (all P < 0.03). Larger lesions (>2.5 cm³ ) versus smaller (<2.5 cm³ ) did not demonstrate a difference in percent volume increase. Operative parameters and volume dynamics were not different between metastatic and non-metastatic groups. CONCLUSIONS: The response of intracranial lesions to LITT demonstrates a peak in volume at the IPA time point with decreased IPA inter-rater reliability. We recommend that conclusions about intracranial lesion size post-LITT be made at least 24 hours post-LITT rather than immediately after LITT.

The Effectiveness of OsiriX and the Anatomage Virtual Dissection Table in Enhancing Neuroanatomy and Neuroradiology Teaching.

Introduction: In recent years with the advent of technology in medical education, teaching methodology has shifted towards heavy use of online-learning modalities. This has been especially the case for anatomy and radiology courses since they require students to visualize structures of the human body. Several studies indicated that Anatomage and OsiriX can be effective at enhancing students' learning experiences in anatomy and radiology. Purpose: This aim of this study is to assess the effectiveness of online case-based learning modules in teaching medical students about the anatomy and radiology of different types of brain tumors. Methods: Two online case-based learning modules were designed using Anatomage Table® and OsiriX DICOM viewer®, consisting of a clinical case and CT and MRI images. We recruited 36 fourth-year medical students that completed two 10-question quizzes (one on glioblastoma multiforme and one on pituitary adenomas). Participants were randomly assigned to either a study group that completed both modules prior to completing the quizzes, or a control group that completed the quizzes without access to the modules. The performance of both groups was compared to assess the effectiveness of the modules. Participants in the study group also completed a feedback survey to assess the quality and convenience of using the modules. Results: Students who used the case-based learning modules performed significantly better than those who did not (Quiz 1: mean = 6.56 vs 3.28, p<0.01. Quiz 2: mean = 6.67 vs 3.06, p<0.01). Students who completed the modules would like to see similar modules used in teaching anatomy and radiology in the future (64%). They found them easy to navigate (72%), useful in teaching anatomy and radiology (72%), and helpful in improving understanding of anatomical and radiological clinical correlations (77%). Conclusion: Online case-based learning modules created using Anatomage and OsiriX can be used effectively in teaching medical students about the anatomy and radiology of different types of brain tumors.

Effect of postoperative radiotherapy for free flap volume changing after tongue reconstruction.

OBJECTIVE: The purpose of this study was to evaluate the effect of postoperative radiotherapy (RT) on temporal volume changes with a cutaneous free flap (CF) and a myocutaneous free flap (MCF). METHODS: The subjects were 24 men and 11 women (mean age, 50.5 ± 15.5 years) with tongue or floor of mouth cancer. Twenty-seven cases of CF and eight cases of MCF were selected. The flap volume change of the reconstructed tongue was calculated using computed tomography (CT) images taken immediately and at one year postoperatively using the DICOM image processing software OsiriX®. RESULTS: The reduction rate in flap volume at one year postoperatively was 82.0 ± 15% in CF without RT, 70.3 ± 26.1% in CF with RT, 88.5 ± 14.7% in MCF without RT, and 99.5 ± 16% in MCF with RT. The MCF volume was significantly higher compared to the CF volume. Although postoperative RT reduced the CF volume by 30%, there was only a slight reduction in the MCF volume. CONCLUSIONS: We evaluated the effect of postoperative RT on volume reduction in 35 cases of the reconstructed tongue with CF and MCF using a computer-assisted volume rendering technique. In this study, the effect of RT on volume reduction was different between the CF and MCF.

Three-Dimensional Volumetric Assessment of Resected Gliomas Assisted by Horos Imaging Software: Video Case Series of Postoperative Tumor Analyses.

Horos (LGPL 3.0; GNU Lesser General Public License, Version 3) is a free, open-source medical image viewer with a user-friendly interface and three-dimensional (3D) volumetric rendering capabilities. We present the use of Horos software as a postoperative tool for residual tumor volume analysis in children with high-grade gliomas (HGG). This is a case series of two pediatric patients with histologically confirmed high-grade gliomas who underwent tumor resection as definitive treatment from June 2011 to June 2019. Volumetric data and extent of resection were obtained via region of interest-based 3D analysis using Horos image-processing software. Horos software provides increased accuracy and confidence in determining the postoperative volume and is useful in assessing the impact of residual volume on outcomes in patients with high-grade gliomas. Horos software is a highly effective means of volumetric analysis for the postoperative analysis of residual volume after maximal safe resection of high-grade gliomas in pediatric patients.

Cardiac Radiographic Measurements in Ferrets Using the OsiriX MD Programme.

Objectives: To adapt the vertebral heart scale (VHS) for use in ferrets and identify new scales and tools that allow to establish the normal heart size by means of radiography more quickly and effectively. Methods: Forty healthy pet ferrets (Mustela putorius furo) were used in this prospective study. The measurements were made on right lateral, left lateral, ventrodorsal, and dorsoventral projections, using OsiriX MD medical imaging software, to evaluate sex effect and variance within the different heart scales. Cardiac measurements were also correlated to VHS and the cardiac dimension in the same projection. Results: Most of the cardiac measurements were significantly different between males and females. The results for the VHS were: right lateral VHS (RL-VHS): 5.52 ± 0.28 v (vertebrae units); left lateral (LL-VHS): 5.55 ± 0.28 v; and dorsoventral VHS (DV-VHS): 6.22 ± 0.34 v for males and RL-VHS: 5.24 ± 0.2 v; LL-VHS: 5.25 ± 0.20 v; and DV-VHS: 5.97 ± 0.35 v for females. Regarding the sternebral heart scale (SHS), the values were: RL-SHS: 5.10 ± 0.20 s (sternebrae units) and LL-SHS: 5.11 ± 0.20 s for males and RL-SHS: 4.67 ± 0.24 s and LL-SHS: 4.67 ± 0.28 s for females. The new measurements based on determining the cardiac area were also marked by clear sexual dimorphism, as shown for the cardiac area-axis (AREA-AXIS): RL-AREA-AXIS: 3.82 ± 0.45 cm2; LL-AREA-AXIS: 3.87 ± 0.41 cm2; ventrodorsal (VD)-AREA-AXIS: 4.59 ± 0.64 cm2; and DV-AREA-AXIS: 4.80 ± 0.50 cm2 for males and RL-AREA-AXIS: 2.39 ± 0.23 cm2; LL-AREA-AXIS: 2.41 ± 0.26 cm2; VD-AREA-AXIS: 3.08 ± 0.45 cm2; and DV-AREA-AXIS: 3.06 ± 0.47 cm2 for females. The cardiac area open polygon (AREA-POL) values were: RL-AREA-POL: 6.78 ± 0.65 cm2; LL-AREA-POL: 6.88 ± 0.68 cm2; VD-AREA-POL: 7.20 ± 0.91 cm2; and DV-AREA-POL: 7.57 ± 0.88 cm2 for males and RL-AREA-POL: 4.28 ± 0.30 cm2; LL-AREA-POL: 4.35 ± 0.35 cm2; VD-AREA-POL: 4.72 ± 0.65 cm2; and DV-AREA-POL: 4.79 ± 0.66 cm2 for females, with similar differences noted from various radiographic projections. A good correlation was noted between VHS and SHS, and a very strongly positive correlation existed between cardiac area measurements and cardiac dimensions. Conclusion: The VHS adapted to ferrets, the SHS, as well as the cardiac area measurements presented in our study are ideal tools for the assessment of cardiac size in ferrets.

Evaluation of bone erosion in rheumatoid arthritis patients by high-resolution peripheral quantitative computed tomography scans: Comparison between two semi-automated programs in a three-dimensional setting.

AIM: The aim of this study was to compare OsiriX software with the previous published Medical Image Analysis Framework (MIAF) method to assess the volume of erosion in patients with rheumatoid arthritis (RA). METHODS: Forty RA patients underwent high-resolution peripheral quantitative computed tomography scans of the second and third metacarpophalangeal joints, and thirty-four patients with any bone erosion were enrolled. Two techniques were applied to erosion evaluation: (a) semi-automated MIAF software, and (b) semi-automated segmentation by free open-source Digital Imaging and Communications in Medicine viewer, OsiriX software. MIAF has been published before, but this is the first time that OsiriX has been used in this way in rheumatology. Bland & Altman plots described agreement between methods. RESULTS: Forty-eight erosions from 34 patients were analyzed. Mean age was 40.74 ± 5.32 years and mean disease duration was 10.68 ± 4.96 years. Both methods demonstrated a strong correlation regarding erosion volume (r = 0.96, P < 0.001). Median (interquartile range) of erosion volume was 12.14 (4.5-36.07) when MIAF was considered, and 11.80 (3.45-29.42) when the OsiriX tool was used (P = 0.139). MIAF and OsiriX showed good agreement when the Bland & Altman plot was performed. Evaluation by MIAF took 22.69 ± 6.71 minutes, whereas OsiriX took only 2.62 ± 1.09 minutes (P < 0.001). CONCLUSION: The three-dimensional segmentation of bone erosions can be done by both MIAF and OsiriX software with good agreement. However, because OsiriX is a widespread tool and faster, its method seems to be more feasible for evaluating peripheral bone damage, especially bone erosions.

Intra- and Interobserver Reliability of Bone Volume Estimation Using OsiriX Software in Patients with Cleft Lip and Palate Using Cone Beam Computed Tomography.

The objective of the current study was to evaluate intra- and interobserver bone volume measurements and effect of orientation on the reliability of bone volume evaluation in as-acquired vis-à-vis oriented cone beam computed tomography scans using Osirix software and possible correlation between gender, age, and bone volume required. For this, 31 cone beam computed tomography (CBCT) scans of 14 girls and 17 boys (aged 9-13) with unilateral cleft lip and/or palate who met the inclusion criteria were analyzed. Efficacy and reliability of third party software Osirix for bone volume calculation was assessed using as acquired and oriented volumes by three specialists (a radiologist, an orthodontist, and an oral maxillofacial surgeon). The dataset and readings were anonymized to prevent any bias. Two-way mixed model analysis on as-acquired and oriented observations exhibited intra-class coefficient (ICC) values ≥ 0.90. Wilcoxon signed rank test (p = 0.10) and Kruskal-Wallis ANOVA (p = 0.46) indicated that although a clinical difference in volume assessment was seen between as-acquired and oriented observations (inter-observer and intra-observer), it was statistically insignificant. Spearman's bi-variate correlation analysis revealed a significant relation between the type (side) of cleft and bone volume required to fill the defect (p < 0.05). Although there was clinical difference in bone volume measurement by the three observers, it was insignificant statistically. Clefts on the left side in the patients had significantly more bone required than the right side, whereas age and gender had no relation with bone needed to fill the defect. OsiriX software provided good reliability in measurements of bone volume.

Does the Modified Arrhenius Model Reliably Predict Area of Tissue Ablation After Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Pediatric Lesional Epilepsy?

BACKGROUND: Commercial magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) systems utilize a generalized Arrhenius model to estimate the area of tissue damage based on the power and time of ablation. However, the reliability of these estimates in Vivo remains unclear. OBJECTIVE: To determine the accuracy and precision of the thermal damage estimate (TDE) calculated by commercially available MRgLITT systems using the generalized Arrhenius model. METHODS: A single-center retrospective review of pediatric patients undergoing MRgLITT for lesional epilepsy was performed. The area of each lesion was measured on both TDE and intraoperative postablation, postcontrast T1 magnetic resonance images using ImageJ. Lesions requiring multiple ablations were excluded. The strength of the correlation between TDE and postlesioning measurements was assessed via linear regression. RESULTS: A total of 32 lesions were identified in 19 patients. After exclusion, 13 pairs were available for analysis. Linear regression demonstrated a strong correlation between estimated and actual ablation areas (R2 = .97, P < .00001). The TDE underestimated the area of ablation by an average of 3.92% overall (standard error (SE) = 4.57%), but this varied depending on the type of pathologic tissue involved. TDE accuracy and precision were highest in tubers (n = 3), with average underestimation of 2.33% (SE = 0.33%). TDE underestimated the lesioning of the single hypothalamic hamartoma in our series by 52%. In periventricular nodular heterotopias, TDE overestimated ablation areas by an average of 13% (n = 2). CONCLUSION: TDE reliability is variably consistent across tissue types, particularly in smaller or periventricular lesions. Further investigation is needed to understand the accuracy of this emerging minimally invasive technique.

Optic disc Edema in patients with fibrous dysplasia/McCune-Albright syndrome: Craniomorphometric analysis and peripapillary retinal nerve fiber layer data.

This article reports quantitative measurements of intracranial volume, optic canal area, and peripapillary retinal nerve fiber layer (RNFL) for a cohort of 124 patients with craniofacial fibrous dysplasia/McCune-Albright Syndrome (FD/MAS), previously used to determine risks for developing optic disc edema [1]. Of these, 7 subjects were diagnosed with optic disc edema. OSIRIX imaging analysis software was used to collect intracranial volume and optic canal diameter for 107 patients, via 3D multiplanar reconstruction (MPR) of ≤5 mm axial CT slices. Spectral-domain Optical Coherence Tomography (OCT) was performed with the Cirrus-HD OCT (Carl Zeiss Meditec, Inc., Dublin, CA). The Optic Disc Cube 200 × 200 protocol was used for acquisition and analysis of the RNFL for 69 patients. The data can be used to assess typical ranges for intracranial volume, optic canal area, and RNFL in the craniofacial FD/MAS population and to assess ranges concerning for optic disc edema. [1] Raborn LN, Pan KS, FitzGibbon EJ, Collins MT, Boyce AM. Optic disc edema in fibrous dysplasia/McCune-Albright syndrome: Prevalence, etiologies, and clinical implications. Bone. 2021 Feb;143:115661. doi: 10.1016/j.bone.2020.115661. Epub 2020 Sep 24. PMID: 32979536.

Imaging in the Mobile Domain.

This article outlines the current state of imaging software with an emphasis on mobile sharing of images and mobile sharing of imaged data. The second portion focuses on the mobility of imaging design devices, highlighting the accessibility and the wider application of mobile devices.

A comparison of two different software packages for analysis of body composition using computed tomography images.

OBJECTIVES: The analysis of body composition from computed tomography (CT) imaging has become widespread. However, the methodology used is far from established. Two main software packages are commonly used for body composition analysis, with results used interchangeably. However, the equivalence of these has not been well established. The aim of this study was to compare the results of body composition analysis performed using the two software packages to assess their equivalence. METHODS: Triphasic abdominal CT scans from 50 patients were analyzed for a range of body composition measures at the third lumbar vertebral level using OsiriX (v7.5.1, Pixmeo, Switzerland) and SliceOmatic (v5.0, TomoVision, Montreal, Canada) software packages. Measures analyzed were skeletal muscle index (SMI), fat mass (FM), fat-free mass (FFM), and mean skeletal muscle Hounsfield Units (SMHU). RESULTS: The overall mean SMI calculated using the two software packages was significantly different (SliceOmatic 51.33 versus OsiriX 53.77, P < 0.0001), and this difference remained significant for non-contrast and arterial scans. When FM and FFM were considered, again the results were significantly different (SliceOmatic 33.7 versus OsiriX 33.1 kg, P < 0.0001; SliceOmatic 52.1 versus OsiriX 54.2 kg, P < 0.0001, respectively), and this difference remained for all phases of CT. Finally, when analyzed, mean SMHU was also significantly different (SliceOmatic 32.7 versus OsiriX 33.1 HU, P = 0.046). CONCLUSIONS: All four body composition measures were statistically significantly different by the software package used for analysis; however, the clinical significance of these differences is doubtful. Nevertheless, the same software package should be used if serial measurements are being performed.