Abstract
Virtual bronchoscopy (VB) is a non-invasive exploration tool for intervention planning and navigation of possible pulmonary lesions (PLs). A VB software involves the location of a PL and the calculation of a route, starting from the trachea, to reach it. The selection of a VB software might be a complex process, and there is no consensus in the community of medical software developers in which is the best-suited system to use or framework to choose. The authors present Bronchoscopy Exploration (BronchoX), a VB software to plan biopsy interventions that generate physician-readable instructions to reach the PLs. The authors’ solution is open source, multiplatform, and extensible for future functionalities, designed by their multidisciplinary research and development group. BronchoX is a compound of different algorithms for segmentation, visualisation, and navigation of the respiratory tract. Performed results are a focus on the test the effectiveness of their proposal as an exploration software, also to measure its accuracy as a guiding system to reach PLs. Then, 40 different virtual planning paths were created to guide physicians until distal bronchioles. These results provide a functional software for BronchoX and demonstrate how following simple instructions is possible to reach distal lesions from the trachea.
Highlights
Bronchoscopy is an endoscopic technique that allows visualising the inside of lung airways by inserting an instrument with a camera through the nose or mouth
The segmentation was applied to the 40 computed tomography (CT) scans data of the Medical Image Computing & Computer Assisted Intervention Conference Challenge EXACT’09 [23], acquired in different conditions including variable slice thickness (0.5–1.0 mm), in-plane voxel sizes (0.55–0.78 mm), and radiation dose (120/140 kVp, 10.0–411.5 mAs)
An exploration bronchoscopy software for biopsy intervention planning and navigation is introduced in this Letter
Summary
Bronchoscopy is an endoscopic technique that allows visualising the inside of lung airways by inserting an instrument with a camera (i.e. bronchoscope) through the nose or mouth. VB inspects lungs using a computed tomography (CT) volume of the patient, and it allows planning the procedure to be followed during the intervention Biopsy planning involves both the location of the peripheral pulmonary lesion (PL) and the identification of the path across airways to reach it. This path would be the best suited to perform the medical procedure using the available instrumentation. Using a framework involves considering the steep learning curve to develop applications, the portability for different platforms, the available documentation, and the extensibility to develop new features over it These aspects may create doubts in which is the adequate framework for a particular need or how to implement a particular algorithm in a chosen framework. This image-based approach allows the generation of instructions to be used during bronchoscopy as a roadmap
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