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Computed tomography-based bronchial tree three-dimensional reconstruction and airway resistance evaluation in adolescent idiopathic scoliosis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:1981-1992. [PMID: 32219596 DOI: 10.1007/s00586-020-06383-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 02/02/2020] [Accepted: 03/15/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To investigate airway development and airway resistance by computed tomographic three-dimensional (3D) reconstruction of the bronchial tree in patients with adolescent idiopathic scoliosis (AIS). We evaluated factors predicting postoperative respiratory complications to provide timely treatment, prevent complications, and improve operative and anesthetic safety. METHODS From August 2015 to August 2017, 53 AIS patients with a mean age of 15.4 years (range 10-20 years) were included in this study. Scoliotic parameters on radiographs were analyzed. Airway resistance was obtained by pulmonary function testing. All patients' pulmonary bronchial trees were 3D-reconstructed via chest thin layer computed tomography to explore the correlation between the spinal-thoracic deformity parameters and airway resistance. RESULTS Correlations between scoliotic parameters and airway development parameters were not statistically significant (P > 0.05). The scoliotic parameters such as Cobb angle, apical vertebral translation, rotation angle to sagittal plane, rotation angle to middle line, and apical vertebral body-rib ratio (AVB-R) were positively correlated with tracheal bifurcation angle (R2: 0.429, 0.374, 0.430, 0.504, and 0.414, respectively; P < 0.05). Cobb angle, rib hump, and apical vertebral body-rib ratio (AVB-R) were positively correlated with left principal bronchus length to right principal bronchus length (PBL-R) (R2: 0.373, 0.503, and 0.377, respectively; P < 0.05). Superficial area of bronchial tree (SABT) and narrow cross section of trachea (NCT) were negatively correlated with plethysmography Pre-Ref resistance ratio (Pre/Ref) (R2: - 0.365 and - 0.452, respectively; P < 0.05). SABT and NCT were negatively correlated with respiratory impedance (Zrs) (R2: - 0.327 and - 0.436, respectively; P < 0.05). CONCLUSIONS Pulmonary bronchial development in patients with AIS is affected by spinal-thoracic deformity. Comprehensive assessment of preoperative pulmonary function, especially airway resistance, is necessary in patients with AIS whether the thoracic scoliosis is severe or mild-to-moderate. These slides can be retrieved under Electronic Supplementary Material.
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Luo X, Kitasaka T, Mori K. Externally navigated bronchoscopy using 2-D motion sensors: dynamic phantom validation. IEEE TRANSACTIONS ON MEDICAL IMAGING 2013; 32:1745-1764. [PMID: 23686944 DOI: 10.1109/tmi.2013.2263152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The paper presents a new endoscope motion tracking method that is based on a novel external endoscope tracking device and our modified stochastic optimization method for boosting endoscopy navigation. We designed a novel tracking prototype where a 2-D motion sensor was introduced to directly measure the insertion-retreat linear motion and also the rotation of the endoscope. With our developed stochastic optimization method, which embeds traceable particle swarm optimization in the Condensation algorithm, a full six degrees-of-freedom endoscope pose (position and orientation) can be recovered from 2-D motion sensor measurements. Experiments were performed on a dynamic bronchial phantom with maximal simulated respiratory motion around 24.0 mm. The experimental results demonstrate that our proposed method provides a promising endoscope motion tracking approach with more effective and robust performance than several current available tracking techniques. The average tracking accuracy of the position improved from 6.5 to 3.3 mm, which further approaches the clinical requirement of 2.0 mm in practice.
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Hattingen E, Blasel S, Dumesnil R, Vatter H, Zanella FE, Weidauer S. MR angiography in patients with subarachnoid hemorrhage: adequate to evaluate vasospasm-induced vascular narrowing? Neurosurg Rev 2010; 33:431-9. [PMID: 20532584 DOI: 10.1007/s10143-010-0267-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 03/16/2010] [Accepted: 04/25/2010] [Indexed: 10/19/2022]
Abstract
The diagnosis of cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) is still challenging. We evaluate the accuracy of time of flight MR angiography (TOF-MRA) to assess the arterial diameters of the circle of Willis in SAH patients with suspected CVS. MR examinations (1.5 Tesla) including 3D TOF-MRA with maximum intensity projections (MIP) and digital subtraction angiography (DSA) were performed within 24 h in 21 patients with acute aneurysmal SAH and suspicion of CVS. Arterial diameters of the circle of Willis including the distal internal carotid artery (ICA) were measured as ratios to the extradural ICA in standard projections. The diagnosis of CVS was established by comparing the luminal size of baseline and follow-up DSA. The correlation between the arterial ratios measured on MIP angiograms and on follow-up DSA was assessed with Pearson's linear regression analysis. Arterial ratios on MIP angiograms were categorized as correct, overestimated, and underestimated compared to the ratios on follow-up DSA. Pearson's correlation coefficient between the ratios of MIP angiograms and DSA was r = 0.5799 and the regression coefficient was b = 0.4775. Highest correlation was found for the category of severe CVS (r = 0.8201). Of all MIP angiograms, 34.9% showed consistent results compared to the DSA, while 44.2% of MIP images overestimated the vascular narrowing. Standard MIP angiograms from TOF-MRA are not accurate to assess vascular narrowing in patients with suspected CVS after aneurysmal SAH. The multifocal arterial stenoses in CVS may induce severe changes in blood flow dynamics, which compromise the diagnostic accuracy of the TOF-MRA.
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Affiliation(s)
- Elke Hattingen
- Institute of Neuroradiology, Goethe University Frankfurt, Frankfurt/M, Germany.
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Vincze K, Zádori P, Magyaródi Z, Horváth G. [Spontaneous thoracic hernias--report of two cases, surgically treated]. Magy Seb 2010; 63:80-83. [PMID: 20400399 DOI: 10.1556/maseb.63.2010.2.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The authors present two cases of atraumatic (spontaneous) thoracic lung hernias, which are extreme rarities in the international literature, too. Risk factors and clinical pictures discussed and operative treatments are demonstrated. The spontaneous thoracic (intercostal) hernias were provoked by intractable cough caused by chronic obstructive pulmonary disease (COPD) in both cases. Multi-slice spiral CT (MSCT) scan as well as the secondary 3D 'volume rendering' (VRT) reconstructions unequivocally suggested this rare condition. Provided with the exact diagnosis, the surgical correction of the thoracic wall resulted in full recovery of the two patients. Finally, the authors briefly discuss data of thoracic hernias published in the Hungarian and the international literature. They conclude that the awareness of this extremely rare condition is important due to the high prevalence of COPD as a risk factor. Diagnostic imaging demonstrated can provide significant help in the correct diagnosis of similar cases.
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Affiliation(s)
- Károly Vincze
- Kaposi Mór Oktató Kórház Altalános-, Mellkas- és Ersebészeti Osztály Kaposvár
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Yu KC, Gibbs JD, Graham MW, Higgins WE. Image-based reporting for bronchoscopy. J Digit Imaging 2008; 23:39-50. [PMID: 19050956 DOI: 10.1007/s10278-008-9170-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 10/12/2008] [Accepted: 10/26/2008] [Indexed: 11/30/2022] Open
Abstract
Bronchoscopy is often performed for staging lung cancer. The recent development of multidetector computed tomography (MDCT) scanners and ultrathin bronchoscopes now enable the bronchoscopic biopsy and treatment of peripheral diagnostic regions of interest (ROIs). Because these ROIs are often located several generations within the airway tree, careful planning and interpretation of the bronchoscopic route is required prior to a procedure. The current practice for planning bronchoscopic procedures, however, is difficult, error prone, and time consuming. To alleviate these issues, we propose a method for producing and previewing reports for bronchoscopic procedures using patient-specific MDCT chest scans. The reports provide quantitative data about the bronchoscopic routes and both static and dynamic previews of the proper airway route. The previews consist of virtual bronchoscopic endoluminal renderings along the route and three-dimensional cues for a final biopsy site. The reports require little storage space and computational resources, enabling physicians to view the reports on a portable tablet PC. To evaluate the efficacy of the reporting system, we have generated reports for 22 patients in a human lung cancer patient pilot study. For 17 of these patients, we used the reports in conjunction with live image-based bronchoscopic guidance to direct physicians to central chest and peripheral ROIs for subsequent diagnostic evaluation. Our experience shows that the tool enabled useful procedure preview and an effective means for planning strategy prior to a live bronchoscopy.
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Affiliation(s)
- Kun-Chang Yu
- Endographics Imaging Systems, State College, PA 16801, USA
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Seemann MD, Heuschmid M, Vollmar J, Küttner A, Schober W, Schäfer JF, Bitzer M, Claussen CD. Virtual bronchoscopy: comparison of different surface rendering models. Technol Cancer Res Treat 2003; 2:273-9. [PMID: 12779357 DOI: 10.1177/153303460300200310] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to compare different representation models of surface-rendered virtual bronchoscopy. 10 consecutive patients with inoperable primary lung tumors underwent thin-section spiral computed tomography. The structures of interest, the tracheobronchial system and anatomical and pathological thoracic structures were segmented using an interactive threshold interval volume-growing segmentation algorithm and visualized with the aid of a color-coded surface rendering method. For virtual bronchoscopy, the tracheobronchial system was visualized using a triangle-surface rendering model, a shaded-surface rendering model and a transparent shaded-surface rendering model. The triangle-surface rendering model allowed optimum detailed spatial representation of the dimensions of extraluminal anatomical and pathological mediastinal structures. As the lumen of the tracheobronchial system was less well defined, the rendering model was of limited use for depiction of the airway surface. The shaded-surface rendering model facilitated an optimum assessment of the airway surface, but the mediastinal structures could not be depicted. The transparent shaded-surface rendering model provides simultaneous adequate to optimum visualization and assessment of the intraluminal airway surface and the extraluminal mediastinal structures as well as a quantitative assessment of the spatial relationship between these structures. Fast data acquisition with a multi-slice detector spiral computed tomography scanner and the use of virtual bronchoscopy with the transparent shaded-surface rendering model obviate the need for time consuming detailed analysis and presentation of axial source images by providing improved the diagnostic imaging of endotracheal and endobronchial diseases and offering a useful alternative to fiberoptic bronchoscopy.
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Affiliation(s)
- Marcus D Seemann
- Department of Diagnostic Radiology, Eberhard-Karls University of Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany.
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Liu J, Udupa JK, Odhnera D, McDonough JM, Arens R. System for upper airway segmentation and measurement with MR imaging and fuzzy connectedness. Acad Radiol 2003; 10:13-24. [PMID: 12529024 DOI: 10.1016/s1076-6332(03)80783-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to evaluate whether a computerized system developed to help delineate the upper airway and surrounding structures with magnetic resonance (MR) imaging was effective for aiding in the diagnosis of upper airway disorders in children. MATERIALS AND METHODS The authors performed axial T2-weighted MR imaging to gather information about different aspects of the airway and its surrounding soft-tissue structures, including the adenoid and palatine tonsils, tongue, and soft palate. Images were processed and segmented to compute the architectural parameters of the airway (eg, surface description, volume, central [medial] line, and cross-sectional areas at planes perpendicular to the central line). The authors built a software package for the visualization, segmentation, registration, prefiltering, interpolation, standardization, and quantitative analysis of the airway and tonsils. RESULTS The system was tested with 40 patient studies. For every study, the system segmented and displayed a smooth three-dimensional rendition of the airway and its central line and a plot of the cross-sectional area of the airway orthogonal to the central line as a function of the distance from one end of the central line. The precision and accuracy for segmentation was 97%. The mean time taken per study was about 4 minutes and included the operator interaction time and processing time. CONCLUSION This method provides a robust and fast means of assessing the airway size, shape, and level of restriction, as well as a structural data set suitable for use in modeling studies of airflow and mechanics.
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Affiliation(s)
- Jianguo Liu
- Medical Image Processing Group, Department of Radiology, University of Pennsylvania, 4th Floor, Blockley Hall, 423 Guardian Dr, Philadelphia, PA 19104-6021, USA
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Abstract
Lung disease is a leading cause of morbidity and mortality. HRCT, currently the best test to assess lung involvement in emphysema and interstitial lung disease, relies on abnormalities being detected when there is sufficient morphologic distortion to result in visually identified changes that, for the most part, correlate poorly with conventional lung function tests and outcome. QIA offers a technique to assess both structure and function on a regional and global basis. With the advent of user-friendly software packages, this approach is finding application in clinical practice and in clinical studies of new treatment alternatives for diffuse lung disease
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Affiliation(s)
- Jonathan G Goldin
- Department of Radiological Sciences, University of California at Los Angeles Medical Center, 90095-1721, USA.
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Salvolini L, Bichi Secchi E, Costarelli L, De Nicola M. Clinical applications of 2D and 3D CT imaging of the airways--a review. Eur J Radiol 2000; 34:9-25. [PMID: 10802203 DOI: 10.1016/s0720-048x(00)00155-8] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hardware and software evolution has broadened the possibilities of 2D and 3D reformatting of spiral CT and MR data set. In the study of the thorax, intrinsic benefits of volumetric CT scanning and better quality of reconstructed images offer us the possibility to apply additional rendering techniques to everyday clinical practice. Considering the large number and redundancy of possible post-processing imaging techniques that we can apply to raw CT sections data, it is necessary to precisely set a well-defined number of clinical applications of each of them, by careful evaluation of their benefits and possible pitfalls in each clinical setting. In diagnostic evaluation of pathological processes affecting the airways, a huge number of thin sections is necessary for detailed appraisal and has to be evaluated, and information must then be transferred to referring clinicians. By additional rendering it is possible to make image evaluation and data transfer easier, faster, and more effective. In the study of central airways, additional rendering can be of interest for precise evaluation of the length, morphology, and degree of stenoses. It may help in depicting exactly the locoregional extent of central tumours by better display of relations with bronchovascular interfaces and can increase CT/bronchoscopy sinergy. It may allow closer radiotherapy planning and better depiction of air collections, and, finally, it could ease panoramic evaluation of the results of dynamic or functional studies, that are made possible by increased speed of spiral scanning. When applied to the evaluation of peripheral airways, as a completion to conventional HRCT scans, High-Resolution Volumetric CT, by projection slabs applied to target areas of interest, can better depict the profusion and extension of affected bronchial segments in bronchiectasis, influence the choice of different approaches for tissue sampling by better evaluation of the relations of lung nodules with the airways, or help to detect otherwise overlooked slight pathological findings. In the exploration of the air-spaces of the head and neck, targeted multiplanar study can now be performed without additional scanning by retro-reconstructed sections from original transverse CT slices. Additional rendering can help in surgical planning, by simulation of surgical approaches, and allows better integration with functional paranasal sinuses endoscopic surgery, by endoscopic perspective rendering. Whichever application we perform, the clinical value of 2D and 3D rendering techniques lies in the possibility of overcoming perceptual difficulties and 'slice pollution', by easing more efficient data transfer without loss of information. 3D imaging should not be considered, in the large majority of cases, as a diagnostic tool: looking at reformatted images may increase diagnostic accuracy in only very few cases, but an increase in diagnostic confidence could be not negligible. The purpose of the radiologist skilled in post-processing techniques should be that of modifying patient management, by more confident diagnostic evaluation, in a small number of patients, and, in a larger number of cases, by simplifying communication with referring physicians and surgeons. We will display in detail possible clinical applications of the different 2D and 3D imaging techniques, in the study of the tracheobronchial tree, larynx, nasal cavities and paranasal sinuses by Helical CT, review relating bibliography, and briefly discuss pitfalls and perspectives of CT rendering techniques for each field.
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Affiliation(s)
- L Salvolini
- Radiology Department, University of Ancona, Umberto 1/Torrette Hospital, I-60020 Torrette, Ancona, Italy.
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Calhoun PS, Kuszyk BS, Heath DG, Carley JC, Fishman EK. Three-dimensional volume rendering of spiral CT data: theory and method. Radiographics 1999; 19:745-64. [PMID: 10336201 DOI: 10.1148/radiographics.19.3.g99ma14745] [Citation(s) in RCA: 315] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Three-dimensional (3D) medical images of computed tomographic (CT) data sets can be generated with a variety of computer algorithms. The three most commonly used techniques are shaded surface display, maximum intensity projection, and, more recently, 3D volume rendering. Implementation of 3D volume rendering involves volume data management, which relates to operations including acquisition, resampling, and editing of the data set; rendering parameters including window width and level, opacity, brightness, and percentage classification; and image display, which comprises techniques such as "fly-through" and "fly-around," multiple-view display, obscured structure and shading depth cues, and kinetic and stereo depth cues. An understanding of both the theory and method of 3D volume rendering is essential for accurate evaluation of the resulting images. Three-dimensional volume rendering is useful in a wide variety of applications but is just now being incorporated into commercially available software packages for medical imaging. Although further research is needed to determine the efficacy of 3D volume rendering in clinical applications, with wider availability and improved cost-to-performance ratios in computing, 3D volume rendering is likely to enjoy widespread acceptance in the medical community.
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Affiliation(s)
- P S Calhoun
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD 21287, USA
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11
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Abstract
Three-dimensional endoluminal tracheobronchial simulations can be derived successfully from thoracic helical CT scans, and can reproduce the appearances of major endobronchial abnormalities confirmed during FB. The prospects of ever-faster CT scanners (capable of submillimeter resolution) merged with greater computer power make it likely that current versions of virtual bronchoscopy images will seem primitive in the future. Initial descriptive reports suggest great potential, but the startling visual appeal of these 3-D portrayals of a patient's airway and mediastinal anatomy and the prospects of exploring this information in real time do not establish its clinical role. Such virtual bronchoscopy findings are generally predictable on the basis of currently available axial CT images alone. The extent to which these 3-D endobronchial renderings improve the already high predictive values of CT requires critical study. In their patients with lung cancer Cicero et al observed that neither the staging nor diagnosis was modified substantially, but virtual bronchoscopy contributed to enhanced understanding of the pathology of the neoplastic process. Whether this added perspective translates to tangible benefits for patients is an intriguing possibility that has yet to be proved. The unique 3-D endobronchial view may offer particular advantages in some individuals and contribute to the patient's noninvasive evaluation. Because of the already high yield of conventional CT, diagnostic yield alone is not likely to be the sole best measure of this evolving technology. Accordingly, future multidisciplinary research investigations will also need to prospectively address nuances of decision-making and measure appropriate patient outcomes. In these efforts the active dialogue between chest clinician and radiologist will remain essential to defining and realizing the true potential of virtual bronchoscopy.
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Affiliation(s)
- E F Haponik
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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12
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Rapp-Bernhardt U, Welte T, Budinger M, Bernhardt TM. Comparison of three-dimensional virtual endoscopy with bronchoscopy in patients with oesophageal carcinoma infiltrating the tracheobronchial tree. Br J Radiol 1998; 71:1271-8. [PMID: 10319000 DOI: 10.1259/bjr.71.852.10319000] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Virtual endoscopy (VE) is a technique for performing simulated bronchoscopy using helical CT data of the tracheobronchial tree. In order to evaluate a virtual three-dimensional (3D) endoluminal procedure for the tracheobronchial tree, comparison was made between bronchoscopy, axial CT images and minimal intensity projections (MIP). 21 patients were referred for helical CT because of oesophageal carcinoma shown by bronchoscopy to infiltrate into the trachea or bronchi. Axial CT images obtained on a helical scanner were transferred to a Sparc20 workstation. VE was compared with the axial CT images and the MIP concerning additional information on the location and degree of stenosis gained after 3D reconstruction of the inner surface of the tracheobronchial tree. The accuracy of this VE system was compared with bronchoscopy. Follow-up was performed in two patients to evaluate the tracheobronchial system after stent implantation. All stenoses were identified by VE with no statistically significant difference in detection of location or grading of the stenosis to real time bronchoscopy. Passage of subtotal stenosis was only possible with VE. VE is suitable for following up stent implantation. Submucosal lesions of the tracheobronchial tree could not be detected by VE. There was no statistically significant difference regarding the location of the stenoses between VE, axial CT slices, MIP and bronchoscopy. The VE showed only a statistically significant difference with regard to the degree of stenosis which was underrated on axial CT slices and MIPs. Pitfalls including mucus plugs and wall defects due to the wrong threshold value were a limitation of VE. VE is presently too time-consuming to use in every patient with an infiltrating tumour into the tracheobronchial tree. In conclusion, while VE cannot replace endoscopy of the tracheobronchial tree or the oesophagus, it is an accurate and non-invasive method for identifying endoluminal tumours, grading stenoses and visualizing the tracheobronchial tree beyond stenoses in a small number of patients who are not amenable to endoscopy.
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Affiliation(s)
- U Rapp-Bernhardt
- Department of Diagnostic Radiology, Otto-von-Guericke-University, University Hospital, Magdeburg, Germany
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13
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Abstract
The basic tasks of spiral CT acquisition, image processing, and image display are the foundations underlying CT angiography regardless of the anatomic region of interest. Volume rendering is a rapidly emerging image processing technique for creating three-dimensional (3D) images from CT datasets, which has important advantages over other 3D rendering techniques including maximum intensity projection and surface rendering. This articles reviews the techniques that are commonly used in CT angiography and key considerations for optimization.
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Affiliation(s)
- B S Kuszyk
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD, USA
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14
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Kozuka T, Minaguchi K, Yamaguchi R, Yamaguchi M, Taniguchi Y. Three dimensional imaging of tracheobronchial system using spiral CT. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 1998; 57:133-138. [PMID: 9804010 DOI: 10.1016/s0169-2607(98)00053-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The purpose of this study was to evaluate the clinical efficacy of 3D reconstruction of the tracheobronchial system using spiral CT. A total of 25 patients with tracheobronchial abnormalities, stenosis (n = 21) and fistula with esophagus (n = 4), underwent a single breathhold spiral CT (5 mm collision, 5 mm)/s increment). With respect to localization, extent and degree of stenosis and size of fistula were compared with findings at bronchoscopy. The CT location and extent of stenoses were consistent with bronchoscopic findings in all 21 patients. The diameter and shape of the lesions were not evaluated in five patients with severe stenoses. In patients with fistula, 3D CT image demonstrates the location and size of fistula in all four patients. Spiral CT serves to demonstrate accurate and useful 3D reconstruction images for planning and monitoring therapy.
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Affiliation(s)
- T Kozuka
- Department of Radiology, Osaka Prefectural Habikino Hospital, Japan.
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15
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Park W, Hoffman EA, Sonka M. Segmentation of intrathoracic airway trees: a fuzzy logic approach. IEEE TRANSACTIONS ON MEDICAL IMAGING 1998; 17:489-497. [PMID: 9845305 DOI: 10.1109/42.730394] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Three-dimensional (3-D) analysis of airway trees extracted from computed tomography (CT) image data can provide objective information about lung structure and function. However, manual analysis of 3-D lung CT images is tedious, time consuming and, thus, impractical for routine clinical care. We have previously reported an automated rule-based method for extraction of airway trees from 3-D CT images using a priori knowledge about airway-tree anatomy. Although the method's sensitivity was quite good, its specificity suffered from a large number of falsely detected airways. We present a new approach to airway-tree detection based on fuzzy logic that increases the method's specificity without compromising its sensitivity. The method was validated in 32 CT image slices randomly selected from five volumetric canine electron-beam CT data sets. The fuzzy-logic method significantly outperformed the previously reported rule-based method (p < 0.002).
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Affiliation(s)
- W Park
- Department of Electrical and Computer Engineering, The University of Iowa, Iowa City 52242, USA
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16
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Abstract
The data set of the thorax acquired by spiral CT is volumetric. Such data can be processed so that conventional axial sections are supplemented by reconstructed images, in an attempt to answer specific clinical questions. This review considers three reconstruction techniques: multiplanar reformation, three-dimensional rendering and sliding-thin slab reconstruction. Their relative benefits and limitations are considered, as are the implications of image processing in general.
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17
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Hoffman EA, McLennan G. Assessment of the pulmonary structure-function relationship and clinical outcomes measures: quantitative volumetric CT of the lung. Acad Radiol 1997; 4:758-76. [PMID: 9365756 DOI: 10.1016/s1076-6332(97)80080-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- E A Hoffman
- Department of Radiology, University of Iowa, College of Medicine, Iowa City 52240, USA
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Buthiau D, Antoine E, Piette JC, Nizri D, Baldeyrou P, Khayat D. Virtual tracheo-bronchial endoscopy: educational and diagnostic value. Surg Radiol Anat 1996; 18:125-31. [PMID: 8782318 DOI: 10.1007/bf01795231] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The use of Helical CT significantly improves image quality of examinations in a number of clinical settings. It is particularly suited to the study of the tracheo-bronchial tree as a result of new ways of image processing (developed by GEMS research) which can produce virtual endoscopic images without the use of an endoscope. We present our initial anatamo-radiological findings and their educational value as well as our thoughts on potential future clinical applications.
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Affiliation(s)
- D Buthiau
- Centre d'Imagerie Scanner Paris, France
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Sonka M, Park W, Hoffman EA. Rule-based detection of intrathoracic airway trees. IEEE TRANSACTIONS ON MEDICAL IMAGING 1996; 15:314-326. [PMID: 18215912 DOI: 10.1109/42.500140] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
New sensitive and reliable methods for assessing alterations in regional lung structure and function are critically important for the investigation and treatment of pulmonary diseases. Accurate identification of the airway tree will provide an assessment of airway structure and will provide a means by which multiple volumetric images of the lung at the same lung volume over time can be used to assess regional parenchymal changes. The authors describe a novel rule-based method for the segmentation of airway trees from three-dimensional (3-D) sets of computed tomography (CT) images, and its validation. The presented method takes advantage of a priori anatomical knowledge about pulmonary airway and vascular trees and their interrelationships. The method is based on a combination of 3-D seeded region growing that is used to identify large airways, rule-based two-dimensional (2-D) segmentation of individual CT slices to identify probable locations of smaller diameter airways, and merging of airway regions across the 3-D set of slices resulting in a tree-like airway structure. The method was validated in 40 3-mm-thick CT sections from five data sets of canine lungs scanned via electron beam CT in vivo with lung volume held at a constant pressure. The method's performance was compared with that of the conventional 3-D region growing method. The method substantially outperformed an existing conventional approach to airway tree detection.
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Affiliation(s)
- M Sonka
- Dept. of Electr. & Comput. Eng., Iowa Univ., Iowa City, IA
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20
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Padhani AR, Fishman EK, Heitmiller RF, Wang KP, Wheeler JH, Kuhlman JE. Multiplanar display of spiral CT data of the pulmonary hila in patients with lung cancer. Preliminary observations. Clin Imaging 1995; 19:252-7. [PMID: 8564869 DOI: 10.1016/0899-7071(94)00059-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Spiral or helical computed tomography (CT)-generated multiplanar reconstructions were used in the radiological assessment of the pulmonary hila in patients with central lung cancer. Twelve patients with non-small-cell lung cancer and hilar abnormalities were examined with contrast-enhanced spiral CT. Studies were performed on a Siemens Somatom S or Plus-S scanner using either a 24- or 32-second spiral. The study volume was from the arch of the aorta to the inferior pulmonary veins done in a single breath-hold, using 4-mm collimation, and reconstructed at 2-mm intervals. We assessed the quality of vascular enhancement and of multiplanar reconstructions. Bronchoscopic, surgical, and pathological findings were correlated. Excellent vascular opacification and good-quality reconstructions were obtained in all patients. No interscan motion was detected. No problems were encountered with the breathholding technique or in the reconstruction of images, even in patients with poor respiratory function. Multiplanar reconstructions were useful for the evaluation of mediastinal including vascular and airways invasion, for optimal definition of lymph node groups, for the planning of bronchoscopically guided biopsy, as well as for endobronchoscopic laser coagulation therapy and surgical treatment. Spiral CT-generated multiplanar reconstructions of the hila are helpful for staging, solving problems, guiding bronchoscopy, and planning surgery. Even patients with limited respiratory reserve can successfully complete the examination.
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Affiliation(s)
- A R Padhani
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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21
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Naidich DP. HELICAL COMPUTED TOMOGRAPHY OF THE THORAX. Radiol Clin North Am 1994. [DOI: 10.1016/s0033-8389(22)00407-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Kuhlman JE, Ney DR, Fishman EK. Two-dimensional and three-dimensional imaging of the in vivo lung: combining spiral computed tomography with multiplanar and volumetric rendering techniques. J Digit Imaging 1994; 7:42-7. [PMID: 8172978 DOI: 10.1007/bf03168478] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
We applied multiplanar techniques and a modified version of our volumetric rendering program for three-dimensional imaging to single-breath hold spiral computed tomography (CT) datasets to generate two- and three-dimensional (2-D and 3-D) images of the in vivo lung. We report details of the combined 2-D/3-D spiral CT technique along with three representative cases from our initial experience.
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Affiliation(s)
- J E Kuhlman
- Russell H. Morgan Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205
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23
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Bellon RJ, Horwitz SM. Three-dimensional computed tomography studies of the tendons of the foot and ankle. J Digit Imaging 1992; 5:46-9. [PMID: 1554757 DOI: 10.1007/bf03167822] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Three dimensional (3D) reconstruction techniques were applied to serial computed tomography scans of a cadaveric foot. Subsequent manipulations of the image data on a 3D imaging workstation facilitated differentiation of tendon from surrounding tissue. Through the use of free-rotation and density thresholding, detailed 3D images of the major tendons were produced and displayed. The value of the technique for education and its potential for diagnosis is discussed.
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Affiliation(s)
- R J Bellon
- Department of Radiology, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH 44109
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24
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Conley DM, Kastella KG, Sundsten JW, Rauschning W, Rosse C. Computer-generated three-dimensional reconstruction of the mediastinm correlated with sectional and radiological anatomy. Clin Anat 1992. [DOI: 10.1002/ca.980050303] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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25
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Kavuru M, Ney D, Fishman EK, Kuhlman JE, Hruban RH, Hutchins GM. Three-dimensional imaging of the lung in vivo: work in progress. J Digit Imaging 1991; 4:137-42. [PMID: 1911971 DOI: 10.1007/bf03168158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
It has previously been demonstrated that three-dimensional (3D) displays of the lung and bronchial tree can be generated from computed tomography (CT) scans of lung specimens. Subsequent refinement of the reconstruction algorithms has allowed high-resolution reconstructions of lungs in vivo. With the introduction of low-dose CT scan protocols, use of the technique may become more common in the radiologic community. The many potential clinical applications for 3D imaging of the lung include an aid to bronchoscopy and improved surgical planning. We present the technical details for 3D imaging of the lungs in vivo as well as three representative case studies.
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Affiliation(s)
- M Kavuru
- Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205
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