Can a Free Open-Source Software Platform Serve as Minimal Ablation Confirmation Assessment Software in Real-Life...

Area of Science:

• Medical Imaging
• Image Processing Software
• Oncology

Background:

• Accurate evaluation of minimal ablative margins (MAM) is crucial for assessing treatment efficacy in liver tumors.
• Current methods for MAM assessment can be time-consuming and subjective.

Purpose of the Study:

• To evaluate the potential of the free, open-source image processing software, 3D Slicer, for assessing MAM in ablated liver tumors.
• To compare the consistency and time efficiency of 3D Slicer-based MAM assessment with traditional visual assessment.

Main Methods:

• 3D Slicer was retrospectively applied to pre- and post-procedural CT scans of ablated liver tumors.
• Two operators used 3D Slicer's segmentation, registration, and Model-to-Model tools to categorize MAM.
• A third operator performed visual assessment; inter-operator concordance (K Cohen) and processing time were evaluated.

Main Results:

• Substantial agreement (K Cohen 0.65-0.74) was observed between operators using 3D Slicer for MAM categorization (≤0 mm, >0-<5 mm, ≥5 mm).
• Slight or no agreement (K Cohen -0.30 to 0.11) was found between 3D Slicer and visual assessment.
• Mean calculation time for MAM was significantly longer with 3D Slicer compared to visual assessment.

Conclusions:

• 3D Slicer demonstrates strong inter-reader agreement for MAM evaluation, indicating its potential utility.
• The current workflow and time requirements of 3D Slicer hinder its widespread clinical adoption for MAM assessment.
• Development of task-specific software may be necessary to optimize MAM evaluation in clinical practice.