The use of osirix for surgical planning using cranial measures and region of interest tools: Technical note

Abstract

Background: During the surgery for intrinsic brain lesions, it is important to plan the proper site of the craniotomy and to identify the relations with the gyri and superficial veins. This might be a challenge, especially in small subcortical lesions and when there is a distortion of the cortical anatomy. Materials and Methods: Using the free computer software Osirix, we have created a 3-dimensional reconstruction of the head and cerebral showing the gyri and superficial veins. With the aid of some tools, it is possible to create a colored image of the lesion and also to calculate the distance between the areas of interest and some easily identifiable structure, making it easier to plan the site of the craniotomy identify the topography of the lesion. Results: The reconstructions were compared to the intraoperative view. We found this technique to be useful to help identify the gyri and cortical veins and use them to find the lesions. The use of a region of interest to show better the lesion under the cortical surface and in the three-dimensional reconstruction of the head was also helpful. Conclusions: This is a low-cost and easy technique that can be quickly learned and performed before every surgery. It helps the surgeon to plan a safe craniotomy and lesionectomy.

Simulation of surgery for supratentorial gliomas in virtual reality using a 3D volume rendering technique: a poor man's neuronavigation

“…21 With the advancement in MRI and CT technology, it is now possible to easily reconstruct the standard 2D MR and CT images (available in DICOM format) into virtual 3D images. [21][22][23] In this case series, we report our experience and different applications of this technique in the surgical management of supratentorial gliomas, focusing mainly on the advantages of using RadiAnt software, different MRI sequences required for the virtual 3D visualization of LGGs and HGGs, and clinical utility of this technique in both surfacing and deep-seated gliomas. A host of commercial as well as open-source 3D VR software programs is available online.…”

“…Though OsiriX Lite (a tailored-down version of OsiriX MD), free software, is also available, it has limited basic functionality. Unlike previous studies that have mainly used OsiriX, 22,23,[31][32][33][34] ours is the first study demonstrating the VR technique in the image-guided management of gliomas using RadiAnt software. In our experience, apart from the fact that it is free, Radi-Ant (unlike OsiriX and Horos) has a very user-friendly and intuitive operator interface.…”

“…21 This technique is now readily available as a tool in several DICOM viewer software programs available online, namely, OsiriX (www.osirix-viewer.com), Horos (www.horosproject.org), and RadiAnt (Medixant). [19][20][21][22][23][24][25] The different aspects of the ABBREVIATIONS HGG = high-grade glioma; LGG = low-grade glioma; VR = volume rendering.…”

“…21,[27][28][29][30][31] Authors of most of these articles have used OsiriX as the software for VR of the standard MR images. 22,23,27,[31][32][33][34] Despite their clinical value and easy availability, many of these software programs are still not popular among neurosurgeons because of the complex user interface and a long learning curve. 32 Hence, these software programs continue to be used mainly by radiologists for diagnostic purposes.…”

Editorial. Neurosurgical planning in a low-resource setting using free open-source three-dimensional volume-rendering software

“…For tumor cases, combining ROI formation and cortical topography recreation can assist in planning resection trajectories by establishing tumor boundaries or identifying sulci for corticectomy. 13 An additional advantage conferred by the use of Horos is that it allows senior consultants to facilitate training in a remote manner such as through "virtual planning sessions," during which they can discuss the conduct of the surgery through videoconferencing. The use of Horos can also mitigate the decrease in opportunities to perform or assist in surgery, and hasten the acquisition of skills when learning how to perform new operations.…”