CT Bronchoscopic Simulation for Guiding Transbronchial Needle Aspiration of Extramural Mediastinal and Hilar Lesions: Initial Clinical Results

Weiner, Guido M.; Schulze, Karsten; Geiger, Bernhard; Ebhardt, Harald; Kj, Wolf; Albrecht, Thomas

doi:10.1148/radiol.2503072185

Cited by 13 publications

(7 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Planning endoscopic biopsy of either the peripheral parts of the lungs [12] or the lymph nodes and other masses adjacent to the bronchi [13–15] is one of the important applications for VBCT potential regarding the assessment of bronchial branching. In addition, it is suggested by many authors that the virtual bronchoscopy viewed before bronchofiberoscopy is not sufficient to guide the fiberscope to the proper location for sampling the lesion in the peripheral parts of the lungs.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

Adamczyk

Tomaszewski²,

Naumczyk³

et al. 2013

Pol J Radiol

View full text Add to dashboard Cite

SummaryBackground:Since introduction of multislice CT scanners into clinical practice, virtual brochoscopy has gained a lot of quality and diagnostic potential. Nevertheless it does not have established place in diagnostics of tracheal and bronchi disorders and its potential has not been examined enough. Nowadays a majority of bronchial tree variants and lesions are revealed by bronchofiberoscopy, which is an objective and a relatively safe method, but has side effects, especially in higher-risk subjects. Therefore noninvasive techniques enabling evaluation of airways should be consistently developed and updated.Material/Methods:Material consisted of 100 adults (45 female, 55 male) aged between 18 and 65 years (mean 40 years, median 40.5 years, SD 14.02), who underwent chest CT examination by means of a 16-slice scanner. Every patient had normal appearance of chest organs, with the exception of minor abnormalities that did not alter airways route.Divisions of bronchial tree to segmental level were evaluated and assigned to particular types by means of virtual bronchoscopy projection. In case of difficulties MPR or MinIP projection was used.Results:The frequency of lobar bronchi divisions other than the typical ones was in: right upper lobar bronchi 45%, left 55%; middle lobar bronchi 21%, lingula 26%; right lower lobar bronchi 28%, left 29%. Subsuperior bronchus or bronchi were found on the right side in 44% and on the left side in 37%. No dependency between types of bronchial divisions on different levels was found.

show abstract

Section: Discussionmentioning

confidence: 99%

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

Adamczyk

Tomaszewski²,

Naumczyk³

et al. 2013

Pol J Radiol

View full text Add to dashboard Cite

show abstract

“…[23][24][25][26][27][28] Virtual bronchoscopy is useful for the assessment of airway stenosis, guidance of transbronchial biopsies, evaluation of aspirated foreign bodies, confirmation of anatomic airway abnormalities, and screening for TBM. 8,23,25,27,[29][30][31] Furthermore, MDCT of the airways with virtual bronchoscopy may obviate the need for invasive bronchoscopy in certain circumstances, particularly in those patients in whom conventional bronchoscopy may not be clinically feasible or desirable, such as young children (Fig. 9) and frail elderly patients.…”

Section: Two-dimensional Multiplanar Reformation Imagesmentioning

confidence: 99%

“…When compared with axial CT image guidance, virtual bronchoscopy has been shown to improve the guidance of transbronchial needle aspiration of bronchoscopically occult mediastinal and hilar lesions and to significantly increase the target hit rate. 31 As opposed to virtual techniques, real-time, active guidance of transbronchial biopsies can be achieved with CT fluoroscopy. With CT fluoroscopy, the position of the biopsy needle can be easily confirmed or simply adjusted.…”

Section: Mdct Imaging: Complementary Role For Bronchoscopymentioning

confidence: 99%

Update on Multidetector Computed Tomography Imaging of the Airways

Lee

Boiselle

2010

Journal of Thoracic Imaging

View full text Add to dashboard Cite

Recent advances in multidetector computed tomography (MDCT) technology have transformed the imaging evaluation of the trachea and bronchi. Multiplanar 2-dimensional and 3-dimensional volume reconstruction techniques, including external rendering and virtual bronchoscopy, can be generated in mere minutes, thereby complementing conventional axial CT imaging in the depiction of various central airway disease processes including airway stenoses, central airway neoplasms, and congenital airway disorders. Paired inspiratory and dynamic expiratory MDCT imaging, along with newer cine CT imaging methods, have enhanced the assessment of tracheobronchomalacia in both adults and the pediatric population. In addition, MDCT imaging plays an essential complementary role to conventional bronchoscopy, facilitating planning and guidance of bronchoscopic interventions, and providing a noninvasive method for postprocedural surveillance.

show abstract

“…Virtual bronchoscopy (VB) has shown considerable promise for assisting guided bronchoscopic navigation [13]–[21]. VB, a form of virtual endoscopy specific to the chest, involves graphical rendering of the airway endoluminal surfaces, as captured in a 3D MDCT scan [22], [23].…”

Section: Introductionmentioning

confidence: 99%

“…VB only bronchoscopy-guidance systems, on the other hand, do not require expensive sensor hardware or excessive set-up prior to bronchoscopy [6], [20], [21]. In addition, since the physician navigates the bronchoscope itself toward a target, VB only systems enable direct vision along the entire airway route.…”

Section: Introductionmentioning

confidence: 99%

Interactive CT-Video Registration for the Continuous Guidance of Bronchoscopy

Merritt¹,

Khare

Bascom

et al. 2013

IEEE Trans. Med. Imaging

View full text Add to dashboard Cite

Bronchoscopy is a major step in lung cancer staging. To perform bronchoscopy, the physician uses a procedure plan, derived from a patient’s 3D computed-tomography (CT) chest scan, to navigate the bronchoscope through the lung airways. Unfortunately, physicians vary greatly in their ability to perform bronchoscopy. As a result, image-guided bronchoscopy systems, drawing upon the concept of CT-based virtual bronchoscopy (VB), have been proposed. These systems attempt to register the bronchoscope’s live position within the chest to a CT-based virtual chest space. Recent methods, which register the bronchoscopic video to CT-based endoluminal airway renderings, show promise but do not enable continuous real-time guidance. We present a CT-video registration method inspired by computer-vision innovations in the fields of image alignment and image-based rendering. In particular, motivated by the Lucas–Kanade algorithm, we propose an inverse-compositional framework built around a gradient-based optimization procedure. We next propose an implementation of the framework suitable for image-guided bronchoscopy. Laboratory tests, involving both single frames and continuous video sequences, demonstrate the robustness and accuracy of the method. Benchmark timing tests indicate that the method can run continuously at 300 frames/s, well beyond the real-time bronchoscopic video rate of 30 frames/s. This compares extremely favorably to the ≥1 s/frame speeds of other methods and indicates the method’s potential for real-time continuous registration. A human phantom study confirms the method’s efficacy for real-time guidance in a controlled setting, and, hence, points the way toward the first interactive CT-video registration approach for image-guided bronchoscopy. Along this line, we demonstrate the method’s efficacy in a complete guidance system by presenting a clinical study involving lung cancer patients.

show abstract

CT Bronchoscopic Simulation for Guiding Transbronchial Needle Aspiration of Extramural Mediastinal and Hilar Lesions: Initial Clinical Results

Abstract: http://radiology.rsnajnls.org/cgi/content/full/250/3/923/DC1.

Cited by 13 publications

References 40 publications

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

Update on Multidetector Computed Tomography Imaging of the Airways

Interactive CT-Video Registration for the Continuous Guidance of Bronchoscopy

Contact Info

Product

Resources

About