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. 2019 Feb 11;19(1):15.
doi: 10.1186/s12880-019-0316-6.

CoreSlicer: a web toolkit for analytic morphomics

Louis Mullie  1   2 , Jonathan Afilalo  3   4   5
Affiliations

CoreSlicer: a web toolkit for analytic morphomics

Louis Mullie et al. BMC Med Imaging. .

Abstract

Background: Analytic morphomics, or more simply, "morphomics," refers to the measurement of specific biomarkers of body composition from medical imaging, most commonly computed tomography (CT) images. An emerging body of literature supports the use of morphomic markers measured on single-slice CT images for risk prediction in a range of clinical populations. However, uptake by healthcare providers been limited due to the lack of clinician-friendly software to facilitate measurements. The objectives of this study were to describe the interface and functionality of CoreSlicer- a free and open-source web-based interface aiming to facilitate measurement of analytic morphomics by clinicians - and to validate muscle and fat measurements performed in CoreSlicer against reference software.

Results: Measurements of muscle and fat obtained in CoreSlicer show high agreement with established reference software. CoreSlicer features a full set of DICOM viewing tools and extensible plugin interface to facilitate rapid prototyping and validation of new morphomic markers by researchers. We present published studies illustrating the use of CoreSlicer by clinicians with no prior knowledge of medical image segmentation techniques and no formal training in radiology, where CoreSlicer was successfully used to predict operative risk in three distinct populations of cardiovascular patients.

Conclusions: CoreSlicer enables extraction of morphomic markers from CT images by non-technically skilled clinicians. Measurements were reproducible and accurate in relation to reference software.

Keywords: Analytic morphomics; Body composition analysis; Computed tomography; Medical image segmentation; Morphometric analysis; Obesity; Planimetric measurements; Sarcopenia.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Ethics Review Board of the Jewish General Hospital.

Consent for publication

Not applicable.

Competing interests

Louis Mullie and Jonathan Afilalo declare that they have no conflicts of interest. Louis Mullie and Jonathan Afilalo developed the CoreSlicer software but do not hold any financial incentives or patents related to its use.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Typical workflow for measurement of analytic morphomics
Fig. 2
Fig. 2
Program structure overview
Fig. 3
Fig. 3
Graphical user interface overview. Panel a shows the “Uploader” window, where DICOM archives can be imported. Panel b shows the “Level” window, using which an anatomical level can be selected. Panel c shows the “Region” window, using which regions of interest can be segmented
Fig. 4
Fig. 4
Plugin architecture overview. Panel a shows an example of a plugin served on a local endpoint. Panel b shows an example of a plugin served on a remote endpoint
Fig. 5
Fig. 5
Illustration of muscle and fat segmentation at L4 in CoreSlicer
Fig. 6
Fig. 6
Bland-Altman plot of difference in VFA, SFA and TLMA for manual measurements in CoreSlicer vs. Slice-O-Matic by Observer A
Fig. 7
Fig. 7
Bland-Altman plot of difference in VFA, SFA and TLMA for repeated manual measurements in CoreSlicer by Observer A
Fig. 8
Fig. 8
Bland-Altman plot of difference in VFA, SFA and TLMA for computed-assisted measurements in CoreSlicer by Observers A and B
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