Image-guided endobronchial ultrasound

Higgins, William E.; Zang, Xiaonan; Cheirsilp, Ronnarit; Byrnes, Patrick; Kuhlengel, T.; Bascom, Rebecca; Toth, Jennifer

doi:10.1117/12.2208771

Cited by 3 publications

(2 citation statements)

References 19 publications

(20 reference statements)

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“…These data were then used to devise various system methods for multimodal procedure planning, EBUS segmentation, and virtual-to-real EBUS registration [ 12 , 39 , 47 ]. (Other methods were derived from our previous navigation-only image-guided bronchoscopy research [ 20 , 23 , 41 ].)…”

Section: Resultsmentioning

confidence: 99%

“…Next, the known CT-based ROI is registered to the segmented real EBUS ROI using an automatic multimodal registration method. The method invokes an optimization process that draws upon raw image intensity information and known ROI segmentation knowledge, as discussed in [ 47 ]. This precisely synchronizes the EBUS bronchoscope position in both the virtual and real spaces at the frozen real position.…”

Section: Methodsmentioning

confidence: 99%

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Image-guided EBUS bronchoscopy system for lung-cancer staging

Zang

Cheirsilp

Byrnes

et al. 2021

Informatics in Medicine Unlocked

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The staging of the central-chest lymph nodes is a major step in the management of lung-cancer patients. For this purpose, the physician uses a device that integrates videobronchoscopy and an endobronchial ultrasound (EBUS) probe. To biopsy a lymph node, the physician first uses videobronchoscopy to navigate through the airways and then invokes EBUS to localize and biopsy the node. Unfortunately, this process proves difficult for many physicians, with the choice of biopsy site found by trial and error. We present a complete image-guided EBUS bronchoscopy system tailored to lymph-node staging. The system accepts a patient’s 3D chest CT scan, an optional PET scan, and the EBUS bronchoscope’s video sources as inputs. System workflow follows two phases: (1) procedure planning and (2) image-guided EBUS bronchoscopy. Procedure planning derives airway guidance routes that facilitate optimal EBUS scanning and nodal biopsy. During the live procedure, the system’s graphical display suggests a series of device maneuvers to perform and provides multimodal visual cues for locating suitable biopsy sites. To this end, the system exploits data fusion to drive a multimodal virtual bronchoscope and other visualization tools that lead the physician through the process of device navigation and localization. A retrospective lung-cancer patient study and follow-on prospective patient study, performed within the standard clinical workflow, demonstrate the system’s feasibility and functionality. For the prospective study, 60/60 selected lymph nodes (100%) were correctly localized using the system, and 30/33 biopsied nodes (91%) gave adequate tissue samples. Also, the mean procedure time including all user interactions was 6 min 43 s All of these measures improve upon benchmarks reported for other state-of-the-art systems and current practice. Overall, the system enabled safe, efficient EBUS-based localization and biopsy of lymph nodes.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Image-guided EBUS bronchoscopy system for lung-cancer staging

Zang

Cheirsilp

Byrnes

et al. 2021

Informatics in Medicine Unlocked

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Optimal multimodal virtual bronchoscopy for convex-probe endobronchial ultrasound

Higgins

Zang

Cheirsilp

et al. 2018

Medical Imaging 2018: Image-Guided Procedures, Robotic Interventions, and Modeling

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A multimodal image guiding system for Navigated Ultrasound Bronchoscopy (EBUS): A human feasibility study

et al. 2017

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BackgroundEndobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is the endoscopic method of choice for confirming lung cancer metastasis to mediastinal lymph nodes. Precision is crucial for correct staging and clinical decision-making. Navigation and multimodal imaging can potentially improve EBUS-TBNA efficiency.AimsTo demonstrate the feasibility of a multimodal image guiding system using electromagnetic navigation for ultrasound bronchoschopy in humans.MethodsFour patients referred for lung cancer diagnosis and staging with EBUS-TBNA were enrolled in the study. Target lymph nodes were predefined from the preoperative computed tomography (CT) images. A prototype convex probe ultrasound bronchoscope with an attached sensor for position tracking was used for EBUS-TBNA. Electromagnetic tracking of the ultrasound bronchoscope and ultrasound images allowed fusion of preoperative CT and intraoperative ultrasound in the navigation software. Navigated EBUS-TBNA was used to guide target lymph node localization and sampling. Navigation system accuracy was calculated, measured by the deviation between lymph node position in ultrasound and CT in three planes. Procedure time, diagnostic yield and adverse events were recorded.ResultsPreoperative CT and real-time ultrasound images were successfully fused and displayed in the navigation software during the procedures. Overall navigation accuracy (11 measurements) was 10.0 ± 3.8 mm, maximum 17.6 mm, minimum 4.5 mm. An adequate sample was obtained in 6/6 (100%) of targeted lymph nodes. No adverse events were registered.ConclusionsElectromagnetic navigated EBUS-TBNA was feasible, safe and easy in this human pilot study. The clinical usefulness was clearly demonstrated. Fusion of real-time ultrasound, preoperative CT and electromagnetic navigational bronchoscopy provided a controlled guiding to level of target, intraoperative overview and procedure documentation.

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Image-guided endobronchial ultrasound

Cited by 3 publications

References 19 publications

Image-guided EBUS bronchoscopy system for lung-cancer staging

Image-guided EBUS bronchoscopy system for lung-cancer staging

Optimal multimodal virtual bronchoscopy for convex-probe endobronchial ultrasound

A multimodal image guiding system for Navigated Ultrasound Bronchoscopy (EBUS): A human feasibility study

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