OSIRIX MD STANFORD TRIAL
OsiriX provides a 32-bit free trial “Lite” version, which runs up to 4.4 times slower than the 64-bit version. OsiriX was initially marketed as an open-source project with conversion to a closed-source imaging viewer and analytic tool in 2015, which eventually prompted many users to switch to the easily attainable Horos project. Preoperative and postoperative tumor volumes were analyzed to yield the percent extent of resection and residual volume. 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. The “Compute Volume” function can be used to render a 3D image of the tumor with an accurate volume measurement. Once the rename box appears, the user can select the second button “All ROIs in this series” and rename appropriately. This can be performed using the ROI dropdown menu and selecting “ROI Rename”. After this is complete, the user must rename all ROIs to the same name.
OSIRIX MD STANFORD SERIES
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. The outline is completed by repeating this process and placing ROI points along the tumor in a clockwise or counterclockwise direction. 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. 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. The region of interest (ROI) segmentation function can be selected as demonstrated in Video 1. 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. Horos version 3.3.6 (macOS 10.11+) was utilized (free download: /download-horos/). 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. Volumetric data and extent of resection were obtained via region of interest-based 3D analysis using Horos image-processing software. Preoperative and postoperative tumor volumetric analyses were performed per patient.
OSIRIX MD STANFORD SOFTWARE
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. 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. 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. We present the use of Horos software as a postoperative tool for residual tumor volume analysis in children with high-grade gliomas (HGG). 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.
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