Resident Researcher | Shriners for Children Medical Center | Pasadena, CA Heiberg, “Figure 2”, Researchgate, Available online at, Annotated-screen-shot-of-the-main-user-interface-of-Segment-The-circles-indicate_fig1_4090686, Jan.“High-Resolution Cardiac Imaging”, Biomedial Physics Research Group, Available Online at, Mar.“Discover OsiriX MD The World Famous Medical Imaging Viewer”, OsiriX, Available Online at, Apr.Resident Researcher | Motion Analysis Laboratory | Children's Hospital Los Angeles | Los Angeles, CAĬollaborated with team of biomedical engineers, physical therapists and orthopedic surgeons to evaluate predictors of walking activity in children with spina bifida and the effect of a novel SPLATT technique on the range of motion and walking kinematics in children with cerebral palsyĪccepted to present multiple oral and poster presentations at national gait analysis and movement disorder conferences 2010.Horos (LGPL 3.0 GNU Lesser General Public License, Version 3) is a free, open-source medical image viewer with a user-friendly interface and three-dimensional (3D) volumetric rendering capabilities. ![]() ![]() We present the use of Horos software as a postoperative tool for residual tumor volume analysis in children with high-grade gliomas (HGG). This is a case series of two pediatric patients with histologically confirmed high-grade gliomas who underwent tumor resection as definitive treatment from June 2011 to June 2019. Horos software provides increased accuracy and confidence in determining the postoperative volume and is useful in assessing the impact of residual volume on outcomes in patients with high-grade gliomas. Horos software is a highly effective means of volumetric analysis for the postoperative analysis of residual volume after maximal safe resection of high-grade gliomas in pediatric patients. Preoperative and postoperative tumor volumetric analyses were performed per patient. Volumetric data and extent of resection were obtained via region of interest-based 3D analysis using Horos image-processing software. The image data utilized were digital imaging and communications in medicine (DICOM) files that were imported into the Horos program by CDs provided by the neuroradiology department. Horos version 3.3.6 (macOS 10.11+) was utilized (free download: /download-horos/). The interface of the program includes the database with the DICOM data in “Albums.” Once a sequence is selected, the 2D viewer allows viewing of the imaging series and editing functions with the dropdown tools. The region of interest (ROI) segmentation function can be selected as demonstrated in Video 1. In the ROI dropdown, “Closed Polygon Tool” should be selected, which will allow the user to outline the tumor on each image in the sequence. To outline the tumor using the “Closed Polygon Tool,” an ROI point can be placed by right-clicking the mouse at any point along the circumference of the tumor. The outline is completed by repeating this process and placing ROI points along the tumor in a clockwise or counterclockwise direction. Once outlined throughout most images in the series, the user can use the “Generate Missing ROIs” function to capture the entirety of the tumor within the MRI series and fill in any ROIs that were not manually placed. After this is complete, the user must rename all ROIs to the same name. This can be performed using the ROI dropdown menu and selecting “ROI Rename”. Once the rename box appears, the user can select the second button “All ROIs in this series” and rename appropriately. The “Compute Volume” function can be used to render a 3D image of the tumor with an accurate volume measurement. ![]() To visualize the tumor within the cranium in a 3D model, utilize the “3D window” dropdown menu and select "3D MIP." This will produce a 3D image of the patient’s cranium with the 3D tumor highlighted. Preoperative and postoperative tumor volumes were analyzed to yield the percent extent of resection and residual volume.
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