KEYWORDS: Visualization, Image segmentation, Tissues, 3D image processing, Tumors, Open source software, Surgery, 3D modeling, Image visualization, Information visualization
PURPOSE: There are several interstitial (needle based) image-guided ablation planning systems available, but most of them are closed or unsupported. We propose an open source software platform for the planning of image-guided interstitial ablation procedures, providing generic functionality and support for specialized plug-ins. METHODS: The patient’s image data is loaded or streamed into the system and the relevant structures are segmented. The user places fiducial points as ablation needle entries and tips, sets the ablation times, and the thermal dose is calculated by a dose engine. The thermal dose is then visualized on the 2D image slices and 3D rendering using a combination of isodose lines and surfaces. Quantitative feedback is provided by dose volume histograms. The treatment plan can be iteratively edited until satisfactory dose distribution is achieved. We performed a usability study with eight novice users in which they were asked to create a satisfactory treatment plan. RESULTS: Interventionists can use the proposed system to create and visualize thermal ablation plans. Researchers can use the platform to create a wide range of specialized applications by adding plug-ins for various types of ablation methods, thermal models, and dose calculation engines. Existing extensions of the platform can provide real-time imaging and tracked or robotic navigation to aid the user in optimal needle placement. From our usability study, the users found the visual information well represented and the platform intuitive to use. The users averaged 4.4 recalculation attempts before finding an optimal treatment, which was evaluated as 100% necrosis of the tumor. CONCLUSION: The developed platform fulfills a demand for a universal and shared ablation planning system. While also being supported by the state-of-the-art development of specialized plug-ins, the open source system can adapt to the desired dose calculation or ablation procedure.
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