VOIs:
Quantitative VOIs (Volumes of  Interest) can be generated for the SPECT 2D (quasi) trans-Axial plane views (corresponding to the MRI planes). Once created, these VOIs are persistent - they are saved and stored with the MRI study and will be automatically restored and quantitatively updated on any subsequent viewing of any SPECT + MRI image fusion study of the same patient. They are saved and stored with the MRI study.

Building VOIs from ROIs:
For each of the 2D plane views, a VOI is built by drawing a set of overlapping ROIs (Regions of Interest) on adjacent slice planes. Click the left mouse button repeatedly outlining the region of interest (ROI) on the first slice plane of interest. As each new ROI is drawn, an automatic search is  performed  to determine, based on the overlap criteria,  whether or not the new ROI should be added to an existing VOI or should instead be the start of a new VOI.

After the first click, a cross will appear at the lower right of the mouse pointer indicating that a ROI is being created. The last point clicked will always have a pair of cross-hairs over it - to provide orientation as to where the next line segment will be generated. To remove the last point clicked and line segment created in the new ROI, click-once the right mouse button.

If, while generating  the ROI,  the mouse pointer is moved to a location where a line segment is not allowed because it would cross another segment, then the mouse pointer cross will change into a no- entry sign.

When you are ready to complete the ROI, position the mouse pointer at the ROI's beginning, and the mouse pointer cross will be replaced with a checkmark. Left-click once to close the ROI, An automatic search will be made to determine if the newly created ROI should be added to any existing VOIs, based on the overlap criteria, or be the start of a new VOI. The proper VOI number is assigned to the ROI.

The VOI statistics will be (re)computed and updated.

Deleting ROIs and VOIs:
Position the mouse pointer inside a ROI belonging to the VOI and right-click. A prompt will pop-up requesting confirmation before deleting the target ROI.

Exporting VOI Data:
The VOI data can be exported to a text file in a format that can be imported by Matlab, MS Excel, and other mathematical software packages for further analysis. Once one or more VOIs have been generated, position the mouse cursor on the viewer image and press the Shift and Enter key. A Save VOIs to Text File window will pop-up. Press Save in this window to export and save the VOI data.

Dynamic SPECT Imaging: The VOIs generated for a particular patient MRI + SPECT image fusion study are persistent across all the patient SPECT studies. Thus the VOIs can be used to 1) monitor changes in a patient rCBF (regional Cerebral Blood Flow) over time or to 2) generate single dynamic scanning session TACs (Time Activity Curves). The procedure is as follows:

• 1) Load and process a single MRI study of the patient.
• 2) Load and process each of the dynamic SPECT studies, one at a time.  
• 3) Open the 2D MRI + SPECT image fusion viewer for the first of the SPECT studies, create the desired VOIs, and export the VOI data to a new text file.  
• 4) For each of the remaining SPECT studies, open the 2D MRI + SPECT image fusion  viewer (at which point the VOIs created in the previous step will be loaded and re-computed for this study), and export the VOI data to the same text file created in Step 3.

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