3D Slicer AI-assisted planning guides safe transvenous mediastinal biopsy

3D Slicer planning with AI segmentation ranked six candidate transvenous mediastinal biopsy trajectories in a woman with superior vena cava syndrome; biopsy under fluoroscopy succeeded with no procedural complications.

• Single-patient technical note in a woman in her 60s with a large mediastinal tumor and superior vena cava syndrome; a transpulmonary approach was avoided due to pneumothorax and hemorrhage risk.
• Critical organs were segmented with AI-based tools, the tumor was manually segmented, and six candidate puncture trajectories were generated and compared using three-dimensional distance-based metrics.
• A composite risk score ranked trajectories as a heuristic within-case decision-support tool, not a validated predictor.

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