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This paper presents a novel method for the interactive identification of contextual interest points within volumetric data by picking on a direct volume rendered image. In clinical diagnostics the points of interest are often located in the center of anatomical structures. In order to derive the volumetric position which allows a convenient examination of the intended structure, the system automatically extracts contextual meta information from the DICOM (Digital Imaging and Communications in Medicine) images and the setup of the medical workstation. Along a viewing ray for a volumetric picking, the ray profile is analyzed for structures which are similar to predefined templates from a knowledge base. We demonstrate with our results that the obtained position in 3D can be utilized to highlight a structure in 2D slice views, to interactively calculate centerlines of tubular objects, or to place labels at contextually-defined volumetric positions.