Medical image segmentation should be performed through software that is validated and integrated into clinical practice. We used Philips Intellispace Portal V11.1 (3D modeling application) and GE AW Server 3.2, both with direct access to the picture archiving and communication system (PACS).
Aw server 3
Manufactured by GE Healthcare
Sourced in United States
The AW Server 3.2 is a high-performance medical imaging server designed for use in healthcare environments. It is responsible for managing and processing medical imaging data from various modalities, including CT, MRI, and PET scanners. The server provides storage, archiving, and distribution capabilities for medical images and associated patient data.
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Lab products found in correlation
9 protocols using aw server 3
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Medical Image Segmentation Protocols
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Hepatic Vein Volume Mapping for Liver Transplantation
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Preoperatively, the proportion of volume of each hepatic vein branch was measured using the Volume viewer application in the AW server 3.2 (GE Healthcare). The veins included were right hepatic vein, inferior hepatic vein, and V5 and V8 branches draining into the middle hepatic vein. Both the volume (cm3) and proportion (%) of the territory compared to right hemi-liver were calculated (Fig. 1 ). Whether to reconstruct the middle hepatic vein territories or not was decided by the surgeons based on the mapping data and the graft’s finding during perfusion. Cryopreserved iliac vessels were used for reconstruction of the middle hepatic vein branches. When available, iliac vein grafts with proper size and length were preferred. However, iliac artery grafts were frequently used due to shortage of proper cryopreserved grafts.
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PET-Guided Nivolumab in Stage IV NSCLC
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All patients who were treated with Nivolumab as second- or third-line treatment for stage IV NSCLC at the Rouen University Hospital between February 2015 and July 2017 were screened. Patients who underwent 18-FDG PET-scan within the 3 months prior to Nivolumab treatment onset were selected for further analysis. Clinical data, imaging, pathology results and molecular analysis were collected from the electronic medical record. 18-FDG PET-scan were reviewed and Metabolic tumor volume was determined using PET VCAR semi-automatic software of AW server 3.2 (General Electric®, Milwaukee, USA) for segmentation. Non malignant FDG avidity areas were not included in this analysis. MTV cut-off to segregate low versus high MTV patients was determined using ROC curve analysis for overall survival.
The protocol received approval from our Institutional Review Board (CHB review board for non-interventional research, agreement #1809B). All research was performed in accordance with relevant guidelines/regulations, namely the European Directive 2014/536/EU and the French law 2012-300 regulating biomedical research.
The protocol received approval from our Institutional Review Board (CHB review board for non-interventional research, agreement #1809B). All research was performed in accordance with relevant guidelines/regulations, namely the European Directive 2014/536/EU and the French law 2012-300 regulating biomedical research.
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Quantifying Pulmonary Emphysema Using CT
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Replacement of normal lung parenchyma with an attenuation of approx. -850 HU on inspiratory CT scans by air-filled spaces with lower attenuation is characteristic for emphysematous lung destruction. The density masque technique has emerged as an objective and quantitative method to determine the degree of pulmonary emphysema. Most commonly, a threshold of − 950 HU is used to separate emphysematous from normal lung parenchyma22 (link),23 (link). After automatic identification of the lung and airway segmentation voxels within the lung below − 950 HU are automatically identified for calculating the emphysema score. The emphysema score is defined as the number of voxels below − 950 HU divided by the total number of voxels of the lung. The quantitative emphysema score is therefore referred to as %LAA-950 (low-attenuation areas less than − 950 Hounsfield Units) from here onwards. Parameters of the CT scans used in this study for quantitative emphysema analysis were as follows: 120 kV, automatic dose modulation (range 100–500 mA), standard kernel, ≤ 1.25 mm slice thickness and acquisition in inspiration. Several software packages are now available for this analysis; in this study, we used the software package from General Electrics (AW Server 3.2, Ext. 1.2, 2016).
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Diffusion Tensor Imaging of Lumbar Nerve Roots
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A 3.0 T superconductive MRI machine (GE Healthcare DISCOVERY MR750W with GEM Suite, Milwaukee, U.S.) was used with an 8-channel spine coil, gradient field of 40 mT/m, and a gradient switching rate 150 mT/m·s. An axial DTI scan (28 directional) was conducted for 6 min and 16 s with a single-shot spin-echo planar imaging sequence with the following parameters: TR/TE=10,000/72.3 ms; B value, 600 s mm-2; Slice thickness, 3.0 mm; layer spacing, 0; number of layers, 39; matrix, 128 x 128; FOV, 24 x 24 cm; and NEX 1.0, diffusion - sensitive gradient direction. Then, a senior radiologist analyzed the images using GE AW Server 3.2 The region of interest (ROI) was placed on the images and copied to all the images of series including DTI and then measured the ADC and FA. Three continuous scan planes were used to position the ROI. Nerve roots at the intraspinal (IS), intraforaminal (IF), and extraforaminal (EF) intervertebral foramina - were separately measured on the affected and contralateral normal sides, as demonstrated in Fig. 1(A) , 1(B) . The size of ROI was 20 -40 mm2. ADC and FA values of the bilateral nerve roots in L3 -L4, L4 -L5, and L5 -S1 were measured in subjects.
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Multimodal PET Imaging in Neuroendocrine Tumors
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Patients were divided according to histological grade [5 , 6 ] into three distinctive categories: G1, G2 and G3. The imaging classification was based upon the spatial distribution of the lesions and the relative uptake of the respective tracers. Anonymized PET image-sets were automatically co-registered anatomically, displayed simultaneously in transverse, sagittal and coronal planes and initially windowed with preset values for Standardized Uptake Value (SUV) of 0–15 for 68Ga-DOTATATE PET and SUV of 0–7 for 18F-FDG PET (AW Server 3.2, GE Healthcare). In both PETs, a lesion was considered as positive if tumoral uptake was superior to the local background. Patients were therefore divided into three distinct imaging categories: C1 (all lesions are 18F-FDG negative and 68Ga-DOTATATE positive, Figure 4 ), C2 (patients with one or more 18F-FDG positive lesions, all of them 68Ga-DOTATATE positive, Figure 5 ) and C3 (patients with one or more 18F-FDG positive lesions, at least one of them 68Ga-DOTATATE negative, Figure 6 ). Each pair of PETs was classified by two experienced nuclear medicine physicians into one of the three aforementioned categories (reporting was performed simultaneously). Radiological progression according to RECIST 1.1 was assessed without knowledge of the respective histological or imaging classification.
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Prostate Volumetric Analysis After TULSA Therapy
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NPVs were manually contoured using the contrast-enhanced T1w fs images (slice thickness = 3 mm, TR = 496 ms, TE = 8 ms, in-plane resolution = 0.75 × 0.75 mm). The non-enhancing prostatic and peri-prostatic tissue was designated as the NPV. Prostate volumes were manually contoured (AW Server 3.2, GE Healthcare, Chicago, Illinois, United States) using the axial T2w images with 3 mm slice thickness. Post-procedural peri-prostatic fibrosis, fluid-filled cavities, and cyst formation were excluded from the contoured areas in prostate volume and NPV measurements.
Subgroup analysis was also performed. The difference in NPV evolution between whole-gland and partial ablation for the radiorecurrent and primary PCa group was assessed. Additionally, the influence of the number of heating sweeps on residual NPV was analyzed for the BPH cohort.
Since this study was retrospective, only one clinical reader (P.M.) was used to segment the NPV for all images. The reader had over five years of experience in prostate MRI and TULSA therapy. For this reason, inter- and intra-reader reliability were not evaluated.
Subgroup analysis was also performed. The difference in NPV evolution between whole-gland and partial ablation for the radiorecurrent and primary PCa group was assessed. Additionally, the influence of the number of heating sweeps on residual NPV was analyzed for the BPH cohort.
Since this study was retrospective, only one clinical reader (P.M.) was used to segment the NPV for all images. The reader had over five years of experience in prostate MRI and TULSA therapy. For this reason, inter- and intra-reader reliability were not evaluated.
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FCH PET/CT Parathyroid Imaging Protocol
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All FCH PET/CT were performed at Godinot Institute (Reims, France) and followed the acquisition protocol used in clinical routine. Immediately after an intravenous administration of 2.5 MBq/kg of FCH, patients underwent a cervical dynamic acquisition (30 frames of 1 minute) followed by a late cervico-mediastinal acquisition at 60 minutes post-injection. Acquisitions were performed on a Discovery 710 Elite PET/CT system (General Electrics, Milwaukee, Wisconsin). Images retrospective analyses were conducted on a dedicated console (AW Server 3.2, General Electrics) by 2 experienced nuclear medicine physicians (more than 8 years of experience in parathyroid imaging). In case of discrepancy between the 2 observers, the final decision was reached by consensus. The cervical dynamic acquisition was reviewed in cine mode along with the late cervico-mediastinal acquisition. Criteria used to retain parathyroid target lesions were as follows: mandatory focal FCH uptake on dynamic and/or late acquisition; compatible target lesion on CT. The precise localization of target lesions was noted.
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Quantifying Epicardial Adipose Tissue via CT
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Epicardial adipose tissue measurements were performed using a semi-automatic software (AW Server 3.2, General Electric, Boston, New York) in axial 1.0 mm slices and interpolated to calculate volume and mean attenuation. Perivascular EAT was determined for the three major epicardial coronary arteries in a 5 mm radius from coronary centerline based on previous findings [10] (link). Overall EAT volume was caudally confined by the diaphragmal cardiac base, cranially by the origin of right pulmonary artery and laterally by the epicardial boarders. EAT volumes and attenuation levels were measured in total and separately for each coronary sulcus. The right coronary sulcus was defined as the coronary adjacent fat tissue between the right atrium and ventricle, measured from the coronary ostium to the distal bifurcation. The left circumflex artery was followed in the atrioventricular grove from the left main bifurcation to the laterobasal turning point. The left anterior sulcus was defined from the left main to the anterior turning point. Beyond the atrial/myocardial boarders, the selection was continued orthogonally to the epicardium. The attenuation range was defined at -195 to -5 HU based on previous evaluations of CT reports [5] (link). CT measurements are depicted in Fig. 1.
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