Localizing the bronchoscope in real time is essential for ensuring intervention quality. However, most existing vision-based methods struggle to balance between speed and generalization. To address these challenges, we present BronchoTrack, an innovative real-time framework for accurate branch-level localization, encompassing lumen detection, tracking, and airway association. To achieve real-time performance, we employ benchmark light weight detector for efficient lumen detection. We firstly introduce multi-object tracking to bronchoscopic localization, mitigating temporal confusion in lumen identification caused by rapid bronchoscope movement and complex airway structures. To ensure generalization across patient cases, we propose a training-free detection-airway association method based on a semantic airway graph that encodes the hierarchy of bronchial tree structures. Experiments on 11 patient datasets demonstrate BronchoTrack's localization accuracy of 81.72%, while accessing up to the 6th generation of airways. Furthermore, we tested BronchoTrack in an in-vivo animal study using a porcine model, where it localized the bronchoscope into the 8th generation airway successfully. Experimental evaluation underscores BronchoTrack's real-time performance in both satisfying accuracy and generalization, demonstrating its potential for clinical applications.
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