Comprehensive review of 3D segmentation software tools for MRI usable for pelvic surgery planning
Résumé
Background: Patient specific 3D modeling is the first step towards image-guided
surgery, the actual revolution in surgical care. Pediatric and adolescent patients with
rare tumors and malformations should highly benefit from these latest technological
innovations, allowing personalized tailored surgery. This study focused on the pelvic
region, located at the crossroads of the urinary, digestive and genital channels with
important vascular and nervous structures. 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.
Methods: 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 software tools were rated accordingly 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).
Results: A ranking of software tools for 3D modeling of MRI medical images, according
to the set of predefined criteria, was given. This ranking allowed us to elaborate
guidelines for the choice of software tools for pelvic surgical planning in pediatric
patients. 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.
Conclusion: 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.