79 lines
3.1 KiB
Markdown
79 lines
3.1 KiB
Markdown
# Total Metabolic Tumor Volume
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## Introduction
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Total Metabolic Tumor Volume (TMTV) workflow mode enables quantitatively measurement of a tumor volume in a patient's body.
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This mode is accessible in any study that has a PT and CT image series as you can see below
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Note: If the study does not have a PT and CT image series, the TMTV workflow mode will not be available
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and will become grayed out.
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## Layout
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The designed layout for the viewports follows a predefined hanging protocol which will place
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10 viewports containing CT, PT, Fusion and Maximum Intensity Projection (MIP) PT scenes.
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The hanging protocol will match the CT and PT displaySets based on series description. In terms
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of PT displaySets, the hanging protocol will match the PT displaySet that has attenuated
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corrected PET image data.
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As seen in the image below, the first row contains CT volume in 3 different views of Axial,
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Sagittal and Coronal. The second row contains PT volume in the same views as the first row.
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The last row contains the fusion volume and the viewport to the right is a MIP of the PT
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Volume in the Sagittal view.
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## Synchronization
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The viewports in the 3 rows are synchronized both for the Camera and WindowLevel.
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It means that when you interact with the CT viewport (pan, zoom, scroll),
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the PT and Fusion viewports will be synchronized to the same view. In addition
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to camera synchronization, the window level of the CT viewport will be synchronized
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with the fusion viewport.
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### MIP
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The tools that are activated on each viewport is unique to its data. For instance,
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the mouse scroll tool for PT, CT and Fusion viewports are scrolling through the image data
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(in different directions); however, the mouse scroll tool for the MIP viewport will
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rotate the camera to match the usecase for the MIP.
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## Panels
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There are two panels that are available in the TMTV workflow mode and we will
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discuss them in detail below.
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### SUV Panel
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This panel shows the PT metadata derived from the matched PT displaySet. The user
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can edit/change the metadata if needed, and by reloading the data the new
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metadata will be applied to the PT volume.
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## ROI Threshold Panel
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The ROI Threshold panel is a panel that allows the user to use the `RectangleROIStartEnd`
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tool from Cornerstone to define and edit a region of interest. Then, the user can
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apply a threshold to the pixels in the ROI and save the result as a segmentation volume.
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By applying each threshold to the ROI, the Total Metabolic Tumor Volume (TMTV), and
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the SUV Peak values will get calculated for the labelmap segments and shown in the
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panel.
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## Export Report
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Finally, the results can be saved in the CSV format. The RectangleROI annotations
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can also be extracted as a dicom RT Structure Set and saved as a DICOM file.
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## Video Tutorial
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Below you can see a video tutorial on how to use the TMTV workflow mode.
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https://user-images.githubusercontent.com/7490180/171065443-35369fba-e955-48ac-94da-d262e0fccb6b.mp4
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