--- a
+++ b/src/antsGetItem.cxx
@@ -0,0 +1,78 @@
+#include <nanobind/nanobind.h>
+#include <nanobind/stl/vector.h>
+#include <nanobind/stl/string.h>
+#include <nanobind/stl/tuple.h>
+#include <nanobind/stl/list.h>
+#include <nanobind/ndarray.h>
+#include <nanobind/stl/shared_ptr.h>
+
+#include "itkImage.h"
+#include <itkExtractImageFilter.h>
+
+#include "antsImage.h"
+
+namespace nb = nanobind;
+using namespace nb::literals;
+
+template <typename ImageType, class PixelType, unsigned int ndim>
+AntsImage<itk::Image<PixelType, ndim>> getItem( AntsImage<ImageType> & antsImage, 
+                              std::vector<unsigned long> starts, 
+                              std::vector<unsigned long> sizes )
+{
+    typename ImageType::Pointer image = antsImage.ptr;
+
+    using OutImageType = itk::Image<PixelType, ndim>;
+
+    typename ImageType::IndexType desiredStart;
+    typename ImageType::SizeType desiredSize;
+
+    for( int i = 0 ; i < starts.size(); ++i )
+    {
+        desiredStart[i] = starts[i];
+        desiredSize[i] = sizes[i];
+    }
+
+    typename ImageType::RegionType desiredRegion(desiredStart, desiredSize);
+
+    using FilterType = itk::ExtractImageFilter<ImageType, OutImageType>;
+    typename FilterType::Pointer filter = FilterType::New();
+    filter->SetExtractionRegion(desiredRegion);
+    filter->SetInput(image);
+    filter->SetDirectionCollapseToIdentity(); // This is required.
+    filter->Update();
+
+    FixNonZeroIndex<OutImageType>( filter->GetOutput() );
+    AntsImage<OutImageType> outImage = { filter->GetOutput() };
+    return outImage;
+}
+
+
+void local_antsGetItem(nb::module_ &m) {
+    m.def("getItem2",   &getItem<itk::Image<float,2>, float, 2>);
+    m.def("getItem2",   &getItem<itk::Image<float,3>, float, 2>);  
+    m.def("getItem2",   &getItem<itk::Image<float,4>, float, 2>);  
+    m.def("getItem3",   &getItem<itk::Image<float,3>, float, 3>);  
+    m.def("getItem3",   &getItem<itk::Image<float,4>, float, 3>);  
+    m.def("getItem4",   &getItem<itk::Image<float,4>, float, 4>);  
+    
+    m.def("getItem2",   &getItem<itk::Image<unsigned char,2>, unsigned char, 2>);
+    m.def("getItem2",   &getItem<itk::Image<unsigned char,3>, unsigned char, 2>);
+    m.def("getItem2",   &getItem<itk::Image<unsigned char,4>, unsigned char, 2>);
+    m.def("getItem3",   &getItem<itk::Image<unsigned char,3>, unsigned char, 3>);
+    m.def("getItem3",   &getItem<itk::Image<unsigned char,4>, unsigned char, 3>);
+    m.def("getItem4",   &getItem<itk::Image<unsigned char,4>, unsigned char, 4>);
+
+    m.def("getItem2",   &getItem<itk::Image<unsigned int,2>, unsigned int, 2>);
+    m.def("getItem2",   &getItem<itk::Image<unsigned int,3>, unsigned int, 2>);
+    m.def("getItem2",   &getItem<itk::Image<unsigned int,4>, unsigned int, 2>);
+    m.def("getItem3",   &getItem<itk::Image<unsigned int,3>, unsigned int, 3>);
+    m.def("getItem3",   &getItem<itk::Image<unsigned int,4>, unsigned int, 3>);
+    m.def("getItem4",   &getItem<itk::Image<unsigned int,4>, unsigned int, 4>);
+
+    m.def("getItem2",   &getItem<itk::Image<double,2>, double, 2>);
+    m.def("getItem2",   &getItem<itk::Image<double,3>, double, 2>);
+    m.def("getItem2",   &getItem<itk::Image<double,4>, double, 2>);
+    m.def("getItem3",   &getItem<itk::Image<double,3>, double, 3>);
+    m.def("getItem3",   &getItem<itk::Image<double,4>, double, 3>);
+    m.def("getItem4",   &getItem<itk::Image<double,4>, double, 4>);
+}
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