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---
layout: default
title: Needlefinder
pagetitle : Needle segmentation from volumetric data
tagline: Surgical Planning Laboratory
---
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<br/>
<h1>NeedleFinder</h1>

<p>NeedleFinder is an open-source extension available for <a href="https://www.slicer.org/">3D Slicer</a>  that provides fast and accurate segmentation of
needles from Magnetic Resonance Imaging (MRI) data.</p>

<h2>Gynecological cancers</h2>
<p>
    The worldwide gynecological cancer mortality rate including cervical, ovarian, vaginal and vulvar cancers is more
    than 20,000 per year in the US alone. In many countries, including the US, external beam radiotherapy followed by
    high dose rate brachytherapy is the standard of care, and the superior ability of MR to visualize soft tissue has
    led to an increase in its usage in brachytherapy treatment planning and delivery. One of the technical challenges
    associated with the use of MRI for brachytherapy, in contrast to that of CT imaging, is the visualization of
    catheters that are used to place radiation sources into cancerous tissue.
</p>

<h2>Guiding the physician to provide the best care to the patient</h2>
<p>
    We developped a precise, accurate method for achieving catheter segmentation and visualization. The algorithm, with the assistance of manually
    provided tip locations, performs segmentation using image-features, and is guided by a catheter-specific, estimated
    mechanical model. A final quality-control step removes outliers or conflicting catheter trajectories.


    <!--The mean and-->
    <!--median Hausdorff errors on a reference database of 760 catheters from 54 patients were 1.49 and 0.95 mm,-->
    <!--respectively; 51 of the outliers deviated more than two catheters widths (3.4 mm) from the gold standard,-->
    <!--corresponding to catheter identification accuracy of 93\%. In a multi-user simulation experiment for evaluating RMS-->
    <!--precision by simulated varying of the manually provided superior tip positions, maximum errors were 2.44 mm. The-->
    <!--average segmentation time for a single catheter was 3 seconds on a standard i7 3 GHz personal computer CPU core.-->
    <!--These results, in terms of segmentation time, accuracy and precision, are promising indicators of the value of this-->
    <!--method for clinical translation of MR-guidance in gynecologic brachytherapy and other catheter-based interventional-->
    <!--procedures.-->
</p>

<h2>Image-guided therapy in AMIGO</h2>
<p>
    Patients treated in <a href="http://www.brighamandwomens.org/Research/amigo/default.aspx">AMIGO</a> often have very large tumors that may have spread to surrounding structures. Image-guided
    interstitial catheter placement increases the likelihood that the catheters will be properly placed in the center of
    the tumor, thereby improving radiation dosimetry. The physician is able to see the tumor with much greater accuracy
    using MRI in <a href="http://www.brighamandwomens.org/Research/amigo/default.aspx">AMIGO</a> than is possible with other imaging modalities and it allows direct placement of an interstitial
    catheter into the tumor and away from the normal tissue, minimizing future toxicity to the patient. In the case of
    larger tumors that often require insertion of multiple catheters, each area of the tumor can be treated with the
    appropriate dose. <a href="http://www.brighamandwomens.org/Research/amigo/default.aspx">AMIGO</a>, with its unique integration of surgery, PET/CT, MRI, and brachytherapy, offers many
    possibilities for translational research with the potential for improving patient care for patients with gynecologic
    tumors. In terms of MRI, <a href="http://www.brighamandwomens.org/Research/amigo/default.aspx">AMIGO</a> facilitates assessment of potentially biologically active residual regions of tumors.
    In the laboratory, biopsied tissue obtained during <a href="http://www.brighamandwomens.org/Research/amigo/default.aspx">AMIGO</a> imaging allows correlation between imaging and pathology.
    The ultimate goal is to use these novel approaches to increase disease-free intervals and minimize long-term
    toxicities frequently associated with radiation treatment.
</p>