Pall Jens Reynisson1, Erlend Fagertun Hofstad2, Håkon Olav Leira1,3, Christian Askeland2, Thomas Langø2, Hanne Sorger1,3, Frank Lindseth2,4, Tore Amundsen1,3, Toril Anita Nagelhus Hernes1,5. 1. a Department of Circulation and Medical Imaging, Faculty of Medicine , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway. 2. b Department of Medical Technology , SINTEF Technology and Society , Trondheim , Norway. 3. c Department Thoracic Medicine , St. Olavs Hospital , Trondheim , Norway. 4. d Department Computer and Information Science , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway. 5. e Department of Research , St. Olavs Hospital , Trondheim , Norway.
Abstract
OBJECTIVE: In flexible endoscopy techniques, such as bronchoscopy, there is often a challenge visualizing the path from start to target based on preoperative data and accessing these during the procedure. An example of this is visualizing only the inside of central airways in bronchoscopy. Virtual bronchoscopy (VB) does not meet the pulmonologist's need to detect, define and sample the frequent targets outside the bronchial wall. Our aim was to develop and study a new visualization technique for navigated bronchoscopy. MATERIAL AND METHODS: We extracted the shortest possible path from the top of the trachea to the target along the airway centerline and a corresponding auxiliary route in the opposite lung. A surface structure between the centerlines was developed and displayed. The new technique was tested on non-selective CT data from eight patients using artificial lung targets. RESULTS: The new display technique anchored to centerline curved surface (ACCuSurf) made it easy to detect and interpret anatomical features, targets and neighboring anatomy outside the airways, in all eight patients. CONCLUSIONS: ACCuSurf can simplify planning and performing navigated bronchoscopy, meets the challenge of improving orientation and register the direction of the moving endoscope, thus creating an optimal visualization for navigated bronchoscopy.
OBJECTIVE: In flexible endoscopy techniques, such as bronchoscopy, there is often a challenge visualizing the path from start to target based on preoperative data and accessing these during the procedure. An example of this is visualizing only the inside of central airways in bronchoscopy. Virtual bronchoscopy (VB) does not meet the pulmonologist's need to detect, define and sample the frequent targets outside the bronchial wall. Our aim was to develop and study a new visualization technique for navigated bronchoscopy. MATERIAL AND METHODS: We extracted the shortest possible path from the top of the trachea to the target along the airway centerline and a corresponding auxiliary route in the opposite lung. A surface structure between the centerlines was developed and displayed. The new technique was tested on non-selective CT data from eight patients using artificial lung targets. RESULTS: The new display technique anchored to centerline curved surface (ACCuSurf) made it easy to detect and interpret anatomical features, targets and neighboring anatomy outside the airways, in all eight patients. CONCLUSIONS: ACCuSurf can simplify planning and performing navigated bronchoscopy, meets the challenge of improving orientation and register the direction of the moving endoscope, thus creating an optimal visualization for navigated bronchoscopy.