Utilization of 3D segmentation for measurement of pediatric brain tumor outcomes after treatment: review of available free tools, step-by-step instructions, and applications to clinical practice

Volumetric measurements are known to provide more information when it comes to segmenting tumors, in comparison to one- and two-dimensional measurements, and thus can lead to better informed therapy. In this work, we review the free and easily accessible computer platforms available for conducting these 3D measurements, such as Horos and 3D Slicer and compare the segmentations to commercial Visage software. We compare the time for 3D segmentation of tumors and demonstrate how to use a novel plugin that we developed in 3D slicer for the efficient and accurate segmentation of the cystic component of a tumor.