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Standard and Advanced Tumor Response Analysis using 3D Slicer Title change? Images & Acknowledgements…

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Presentation on theme: "Standard and Advanced Tumor Response Analysis using 3D Slicer Title change? Images & Acknowledgements…"— Presentation transcript:

1 Standard and Advanced Tumor Response Analysis using 3D Slicer Title change? Images & Acknowledgements…

2 RECIST and Advanced Tumor Response Analysis in 3D Slicer Clinical relevance: (jeff) Tutorial description: (jeff desc. how addresses clinical needs)

3 RECIST and Advanced Tumor Response Analysis in 3D Slicer The tutorial has 3 parts: 1. Volumetric analysis using structural MR 2. Perfusion analysis using DCE-MRI 3. Functional image analysis for PET/CT

4 Part 1: Volumetric Analysis using Structural MR (image)

5 Overview Part I: Volumetric Analysis using structural MR In Part I, you will learn how to perform volumetric analysis of tumors using both existing and developing tools using 3D Slicer. Standard Response Evaluation Criteria in Solid Tumors (RECIST) analysis, and Advanced analyses and visualization of tumor response to therapy using Slicers ChangeTracker Module. Approximate time to complete: 60 minutes??

6 Learning objective Following Part I of this tutorial, youll be able to…

7 Part I: Volumetric Analysis using structural MR Description of Tutorial Data: Pre-treatment: Post-treatment: Acknowledgement for the data?

8 Volumetric Analysis: Measurement WorkFlow 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Standard volumetric measurements

9 Volumetric Analysis: Loading data 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section …shows a DICOM browser from which data can be loaded into Slicer…

10 Volumetric Analysis: Loading data 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Post-TX T1 shown in Four-up Layout (Axial, Saggital, Coronal, & 3D Views)

11 Volumetric Analysis: Displaying data 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Volumes Module GUIPre-TX study Post-TX study

12 Volumetric Analysis: Changing layouts 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout & Display Pre-TX volume 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Layout Options

13 Volumetric Analysis: Linear measurement 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Fiducials Module: Create Fiducial List Create two fiducials Click & drag fiducials to endpoints of longest diameter Record distance readout Linear Measurement: D1 pre =48.7073mm

14 Volumetric Analysis: Linear measurement 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Fiducials Module: Click & drag fiducials to endpoints of orthogonal diameter Record distance readout Linear Measurement: D2 pre =48.6839 mm

15 Volumetric Analysis: Linear measurement 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Or: Make only Axial Slice visible in 3D Viewer Select Four-Up Layout Use Measurements Module to turn on Ruler Widget; click & drag line & endpoints. (Currently being extended to work in Slice Viewers too)

16 Volumetric Analysis: Linear measurement Linear Measurement on Post-TX volume: D1 post =26.123mm 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor (scar) cross section 5.Compare region size of largest tumor cross section

17 Volumetric Analysis: Linear measurement Linear Measurement on Post-TX volume: D2 post =17.8873mm 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor (scar) cross section 5.Compare region size of largest tumor cross section

18 Volumetric Analysis: ROI comparison Editor Module: Use Threshold Paint Tool, configured to capture the grayscale range within tumor. Paint in a few strokes 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section

19 Volumetric Analysis: ROI comparison Editor Module: Rapidly define ROI (more accurate than ellipsoid) Refine if desired: Dilate, Erode, Remove islands, Erase unwanted labels, etc. 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section View ROI: as semi-transparent or opaque overlay, or… …as outline at voxel boundaries.

20 Volumetric Analysis: ROI comparison Statistics Module: Specify: Pre-TX Volume Label Map Apply Save output to file Volume Measurement: V pre = 7877.268 mm 3 (computed for single slice) 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section

21 Volumetric Analysis: ROI comparison Similar workflow applied to Post-TX volume: Volume Measurement: V post = 38.192 mm 3 (computed for single slice) 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section

22 Volumetric Analysis: Final volumetric comparisons Pre- and Post-Treatment Comparisons: 1.Load pre- and post-treatment T1s (or Pre/Post GAD) study 2.Adjust display of both studies in Volumes Module 3.Switch to Axial (Red) Slice Layout 4.Compare opposing diameters of largest tumor cross section 5.Compare region size of largest tumor cross section Post-TX Pre-TX VD2D1 38.192 mm 3 7877.268 mm 3 17.8873mm26.123mm 48.6839 mm 48.7073mm

23 Volumetric Analysis: Advanced volume change analysis 1.Create left breast volume of interest (for both pre- and post-TX) 2.Mask out background using Editor Tools: 3.Run MRI bias field correction (10 iterations): 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings Step B. Perform Change Tracking Analysis on registered datasets 6.Use ChangeTracker Wizard Advanced analysis, appropriate for assessing small tumor changes. Step A. Prepare data for registration & register pre- and post-TX

24 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest for pre- and post-TX datasets 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTXbiascorr, ref = postTXbiascorr 5.Run manual, then affine registration with default settings Wizards->ChangeTracker Module: Select pre- and post-TX datasets; Specify ROI (pre- and post-TX subvolumes should contain anatomy in good correspondence. Oversample pre-Tx by a factor of 2 (low resolution dataset)

25 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest for pre- and post-TX datasets 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings Wizards->ChangeTracker Module: Pre-Tx-supersampled subvolume: (subsequently renamed PreTreatSubvol for brevity) Post-Tx subvolume: (subsequently renamed PostTreatSubvol for brevity)

26 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 4.Run manual, then affine registration with default settings Editor Module: Tools to use: threshold, save island, dilation, island removal, erosion Perform for both pre- and post-TX volumes, to create: PreTreatSubvol-label and PostTreatSubvol-label

27 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings MRI Bias Field Correction Module: IN parameters = GADParameters Input Volume = PreTreatSubvol Mask Volume = PreTreatSubvol-label Create new volumes for Preview and Output. Set iterations = 10 Use default parameters for all other options. Pre-TX prior to bias field correction Pre-TX after bias field correction

28 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings Histogram Matching Module: Default parameters Input Volume = PreTreatSubvolBias10 Reference Volume = PostTreatSubvolBias10 Create new volumes for Output. Pre-TX prior to histogram matching Pre-TX after histogram matching

29 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings Transforms Module: Adjust display: Change color LUTs in Volumes Module to use Red/Green or Ocean/Desert, and adjust the FG/BG fade to display both layers simultaneously. Adjust Translations and Rotations manually to get best possible alignment.

30 Volumetric Analysis: Pre-processing data 1.Create left breast volume of interest 2.Mask out background using Editor Tools 3.Run MRI bias field correction 4.Run histogram matching: input = preTX, ref = post-TX 5.Run manual, then affine registration with default settings Registration-> Affine Registration Module: Use default registration parameters. Initial Transform = linear transform Fixed image = pre-Tx Moving image = post-Tx Create new transform for affine output Create new volume for output.

31 Volumetric Analysis: Analyzing changes Advanced volumetric analysis: ChangeTracker Module Wizards-> ChangeTracker Module: Use default registration parameters. Scan1 = pre-Tx Scan2 = post-Tx Create subvolume around pre-Tx tumor

32 Volumetric Analysis: Analyzing change Advanced volumetric analysis: ChangeTracker Module Wizards-> ChangeTracker Module: Select high resolution segmentation (label map) of pre-TX tumor (or specify an intensity threshold)

33 Volumetric Analysis: Analyzing change Advanced volumetric analysis: ChangeTracker Module Wizards-> ChangeTracker Module: Choose growth metric (intensity patterns) Choose not to align data since registration has already been performed.

34 Volumetric Analysis: Analyzing change Advanced volumetric analysis: Building 3D Models

35 Volumetric Analysis: Analyzing change Advanced volumetric analysis: Visualization

36 Volumetric Analysis: Analyzing change Advanced volumetric analysis: Computing Changes

37 Conclusion of Part I What is important to conclude?

38 Part 2: Perfusion Analysis using DCE-MRI (image)

39 Overview Part II: Perfusion Analysis using DCE-MRI In Part II, you will learn how to load, visualize and analyze perfusion sequences using the FourDImage and FourDAnalysis Modules in 3D Slicer. Load DICOM DCE-MRI perfusion dataset Visualize the timeseries data Create a simple ROI using thresholding Plot intensity profiles for both tumor and blood pool and perform curve fitting using Tofts Kinetic Model Approximate time to complete: 20 minutes??

40 Learning objective Following Part II of this tutorial, youll be able to…

41 Part II: Perfusion Analysis using DCE-MRI Description of Tutorial Data: Pre-treatment: Post-treatment: Acknowledgement for the data?

42 Conclusion of Part II What is important to conclude?

43 Part 3: Functional Image Analysis using PET/CT (image)

44 Overview Part III: Functional image analysis using PET/CT In Part II, you will learn how to load, visualize and analyze PET/CT studies using the PETCTFusion Module in 3D Slicer. Load DICOM and non-DICOM PET/CT datasets Visualize the Fused datasets Manually enter required nuclear medicine parameters and Compute the Standardized Uptake Value (SUV) Approximate time to complete: 20 minutes??

45 Learning objective Following Part III of this tutorial, youll be able to…

46 Part II: Functional Image Analysis using PET/CT Description of Tutorial Data: Pre-treatment: Post-treatment: Acknowledgement for the data?

47 Part II: Functional Image Analysis: Workflow 1.Load pre- and post-treatment CT, PET, and tumor segmentations 2.Adjust display of CT studies in Volumes Module 3.Switch to Four-Up Layout 4.Set up Display for PET (Volumes & VolumeRendering Modules) 5.Select pre-treatment CT, PET and label map in PETCTFusion Module 6.Retrieve values from DICOM or enter parameters manually 7.Perform analysis, record SUV max, SUV mean, SUV maxmean 8.Repeat for post-treatment CT, PET and label map

48 Conclusion of Part III What is important to conclude?

49 Acknowledgements Harvard CTSC NA-MIC NAC (what other?)

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