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Saad F, Frysch R, Saalfeld S, Kellnberger S, Schulz J, Fahrig R, Bhadra K, Nürnberger A, Rose G. Deformable 3D/3D CT-to-digital-tomosynthesis image registration in image-guided bronchoscopy interventions. Comput Biol Med 2024; 171:108199. [PMID: 38394801 DOI: 10.1016/j.compbiomed.2024.108199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/30/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
Traditional navigational bronchoscopy procedures rely on preprocedural computed tomography (CT) and intraoperative chest radiography and cone-beam CT (CBCT) to biopsy peripheral lung lesions. This navigational approach is challenging due to the projective nature of radiography, and the high radiation dose, long imaging time, and large footprints of CBCT. Digital tomosynthesis (DTS) is considered an attractive alternative combining the advantages of radiography and CBCT. Only the depth resolution cannot match a full CBCT image due to the limited angle acquisition. To address this issue, preoperative CT is a good auxiliary in guiding bronchoscopy interventions. Nevertheless, CT-to-body divergence caused by anatomic changes and respiratory motion, hinders the effective use of CT imaging. To mitigate CT-to-body divergence, we propose a novel deformable 3D/3D CT-to-DTS registration algorithm employing a multistage, multiresolution approach and using affine and elastic B-spline transformation models with bone and lung mask images. A multiresolution strategy with a Gaussian image pyramid and a multigrid strategy within the B-spline model are applied. The normalized correlation coefficient is included in the cost function for the affine model and a multimetric weighted cost function is used for the B-spline model, with weights determined heuristically. Tested on simulated and real patient bronchoscopy data, the algorithm yields promising results. Assessed qualitatively by visual inspection and quantitatively by computing the Dice coefficient (DC) and the average symmetric surface distance (ASSD), the algorithm achieves mean DC of 0.82±0.05 and 0.74±0.05, and mean ASSD of 0.65±0.29mm and 0.93±0.43mm for simulated and real data, respectively. This algorithm lays the groundwork for CT-aided intraoperative DTS imaging in image-guided bronchoscopy interventions with future studies focusing on automated metric weight setting.
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Affiliation(s)
- Fatima Saad
- Institute for Medical Engineering, Otto-von-Guericke University, Magdeburg, Germany; Forschungscampus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany.
| | - Robert Frysch
- Institute for Medical Engineering, Otto-von-Guericke University, Magdeburg, Germany; Forschungscampus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
| | - Sylvia Saalfeld
- Forschungscampus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany; Department of Simulation and Graphics, Otto-von-Guericke University, Magdeburg, Germany
| | | | - Jessica Schulz
- Forschungscampus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany; Siemens Healthcare GmbH, Forchheim, Germany
| | | | - Krish Bhadra
- CHI Memorial Rees Skillern Cancer Institute, Chattanooga, USA
| | - Andreas Nürnberger
- Data and Knowledge Engineering Group, Faculty of Computer Science, Otto-von-Guericke University, Magdeburg, Germany
| | - Georg Rose
- Institute for Medical Engineering, Otto-von-Guericke University, Magdeburg, Germany; Forschungscampus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
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Wu W, Xia W, Jun Z, Saghatchi S, Lavasani SN, Mohagheghi S, Ahmadian A, Gao X. Coordinate-based fast lightweight path search algorithm for electromagnetic navigation bronchoscopy. Med Biol Eng Comput 2023; 61:699-708. [PMID: 36585561 DOI: 10.1007/s11517-022-02740-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023]
Abstract
Electromagnetic navigation bronchoscopy (ENB) uses electromagnetic positioning technology to guide the bronchoscope to accurately and quickly reach the lesion along the planned path. However, enormous data in high-resolution lung computed tomography (CT) and the complex structure of multilevel branching bronchial tree make fast path search challenging for path planning. We propose a coordinate-based fast lightweight path search (CPS) algorithm for ENB. First, the centerline is extracted from the bronchial tree by applying topological thinning. Then, Euclidean-distance-based coordinate search is applied. The centerline points are represented by their coordinates, and adjacent points along the navigation path are selected considering the shortest Euclidean distance to the target on the centerline nearest the lesion. From the top of the trachea centerline, search is repeated until reaching the target. In 50 high-resolution lung CT images acquired from five scanners, the CPS algorithm achieves accuracy, average search time, and average memory consumption of 100%, 88.5 ms, and 166.0 MB, respectively, reducing search time by 74.3% and 73.1% and memory consumption by 83.3% and 83.0% compared with Dijkstra and A* algorithms, respectively. CPS algorithm is suitable for path search in multilevel branching bronchial tree navigation based on high-resolution lung CT images.
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Affiliation(s)
- Wenbin Wu
- School of Biomedical Engineering (Suzhou), Division of Life Science and Medicine, University of Science and Technology of China, Hefei, 230026, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88, Keling Road, Suzhou New District, Suzhou, 215163, China
| | - Wei Xia
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88, Keling Road, Suzhou New District, Suzhou, 215163, China
- Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, Jinan, 250109, Shandong, China
| | - Zhong Jun
- Gaochun District, Nanjing Zhongao Jingzhong Medical Technology Co., LTD., No. 205, Shuanggao Road, Nanjing, 211300, China
| | - Samaneh Saghatchi
- Image Guided Surgery Lab, Research Centre of Biomedical Technology and Robotics, RCBTR, Tehran University of Medical Sciences, Tehran, 1416753955, Iran
| | - Saeedeh Navaei Lavasani
- Image Guided Surgery Lab, Research Centre of Biomedical Technology and Robotics, RCBTR, Tehran University of Medical Sciences, Tehran, 1416753955, Iran
| | - Saeed Mohagheghi
- Image Guided Surgery Lab, Research Centre of Biomedical Technology and Robotics, RCBTR, Tehran University of Medical Sciences, Tehran, 1416753955, Iran
| | - Alireza Ahmadian
- Department of Medical Physics & Biomedical Engineering & Research Centre for Biomedical Technology and Robotics, RCBTR, Tehran University of Medical Sciences, TUMS, Tehran, 1416753955, Iran
| | - Xin Gao
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, No. 88, Keling Road, Suzhou New District, Suzhou, 215163, China.
- Jinan Guoke Medical Engineering and Technology Development Co., Ltd., Pharmaceutical Valley New Drug Creation Platform, Jinan, 250109, Shandong, China.
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Uejo AA, Snyder MG, Rakowski JT. Breathing-Adapted Imaging Techniques for Rapid 4-Dimensional Lung Tomosynthesis. Adv Radiat Oncol 2023; 8:101173. [PMID: 36852404 PMCID: PMC9958353 DOI: 10.1016/j.adro.2023.101173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 12/29/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose This article presents enhancements to a 4-dimensional (4D) lung digital tomosynthesis (DTS) model introduced in a 2018 paper. That model was proposed as an adjunct to 4D computed tomography (4DCT) to improve tumor localization through artifact reduction achieved by imaging the entire lung in all projections, reducing the projection collection time duration for each phase compared with 4DCT, and requiring only a single-breath cycle to capture all phases. This is applicable to SABR treatment planning. Enhancements comprise customized patient 4D-DTS x-ray scanning parameters. Methods and Materials Imaging parameters derived with the 4D-DTS model were arc duration, frames per second, pulse duration, and tube current normalized to single-chest radiographic milliampere-seconds (mA/mAsAEC). Optimized phase-specific DTS projections imaging parameters were derived for volunteer respiration-tracking surrogate waveforms and for sinusoidal waveforms. These parameters are temporally matched to the respiratory surrogate waveform and presented as continuous data plots during a period of 20 seconds. Comparison is made between surrogate excursions during a single-phase CT and 4D-DTS reconstructions. Results 4D-DTS imaging techniques were customized to volunteer respiratory waveforms and sinusoidal waveforms. Technique settings at the highest velocity portions of the volunteer waveforms were arc duration 0.066 seconds, frame rate 921 Hz, pulse duration 1.076 ms, and normalized tube current 76.2 s-1. Technique settings at the highest velocity portions of the sinusoidal waveforms were arc duration 0.029 seconds, frame rate 2074 Hz, pulse duration 0.472 ms, and normalized tube current 173.6 s-1. Sinusoidal surrogate excursion distance at the highest velocity portion of the waveform during a CT rotation of 0.5 seconds ranged from 2.68 to 21.09 mm, all greater than the limiting excursion distance chosen in the 4D-DTS model. Conclusions 4D-DTS image technique settings can be customized to individual patient breathing patterns so that captured range of motion satisfies an operator-selected value.
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Affiliation(s)
- Arielle A. Uejo
- Department of Oncology, Karmanos Cancer Institute, Flint, MI
| | | | - Joseph T. Rakowski
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI
- Corresponding author: Joseph T. Rakowski, PhD
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Vijayan R, Sheth N, Mekki L, Lu A, Uneri A, Sisniega A, Magaraggia J, Kleinszig G, Vogt S, Thiboutot J, Lee H, Yarmus L, Siewerdsen JH. 3D-2D image registration in the presence of soft-tissue deformation in image-guided transbronchial interventions. Phys Med Biol 2022; 68. [PMID: 36317269 DOI: 10.1088/1361-6560/ac9e3c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
Purpose. Target localization in pulmonary interventions (e.g. transbronchial biopsy of a lung nodule) is challenged by deformable motion and may benefit from fluoroscopic overlay of the target to provide accurate guidance. We present and evaluate a 3D-2D image registration method for fluoroscopic overlay in the presence of tissue deformation using a multi-resolution/multi-scale (MRMS) framework with an objective function that drives registration primarily by soft-tissue image gradients.Methods. The MRMS method registers 3D cone-beam CT to 2D fluoroscopy without gating of respiratory phase by coarse-to-fine resampling and global-to-local rescaling about target regions-of-interest. A variation of the gradient orientation (GO) similarity metric (denotedGO') was developed to downweight bone gradients and drive registration via soft-tissue gradients. Performance was evaluated in terms of projection distance error at isocenter (PDEiso). Phantom studies determined nominal algorithm parameters and capture range. Preclinical studies used a freshly deceased, ventilated porcine specimen to evaluate performance in the presence of real tissue deformation and a broad range of 3D-2D image mismatch.Results. Nominal algorithm parameters were identified that provided robust performance over a broad range of motion (0-20 mm), including an adaptive parameter selection technique to accommodate unknown mismatch in respiratory phase. TheGO'metric yielded median PDEiso= 1.2 mm, compared to 6.2 mm for conventionalGO.Preclinical studies with real lung deformation demonstrated median PDEiso= 1.3 mm with MRMS +GO'registration, compared to 2.2 mm with a conventional transform. Runtime was 26 s and can be reduced to 2.5 s given a prior registration within ∼5 mm as initialization.Conclusions. MRMS registration via soft-tissue gradients achieved accurate fluoroscopic overlay in the presence of deformable lung motion. By driving registration via soft-tissue image gradients, the method avoided false local minima presented by bones and was robust to a wide range of motion magnitude.
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Affiliation(s)
- R Vijayan
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - N Sheth
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - L Mekki
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Lu
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - A Sisniega
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | | | | | - S Vogt
- Siemens Healthineers, Erlangen, Germany
| | - J Thiboutot
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - H Lee
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - L Yarmus
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institution, Baltimore, MD, United States of America
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America.,Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States of America
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Advances in Bone Joint Imaging-Metal Artifact Reduction. Diagnostics (Basel) 2022; 12:diagnostics12123079. [PMID: 36553086 PMCID: PMC9776622 DOI: 10.3390/diagnostics12123079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
Numerous types of metal implants have been introduced in orthopedic surgery and are used in everyday practice. To precisely evaluate the postoperative condition of arthroplasty or trauma surgery, periprosthetic infection, and the loosening of implants, it is important to reduce artifacts induced by metal implants. In this review, we focused on technical advances in metal artifact reduction using digital tomosynthesis, computed tomography, and magnetic resonance imaging. We discussed new developments in diagnostic imaging methods and the continuous introduction of novel technologies to reduce metal artifacts; however, these innovations have not yet completely removed metal artifacts. Different algorithms need to be selected depending on the size, shape, material and implanted body parts of an implant. Future advances in metal artifact reduction algorithms and techniques and the development of new sequences may enable further reductions in metal artifacts even on original images taken previously. Moreover, the combination of different imaging modalities may contribute to further reductions in metal artifacts. Clinicians must constantly update their knowledge and work closely with radiologists to select the best diagnostic imaging method for each metal implant.
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Ishibashi K, Sasaki E, Wijaya E, Yamauchi S, Sasaki S, Kimura Y, Yamamoto Y, Shimbo T, Tamai K, Ishibashi Y. A Novel Quantitative Evaluation of Bone Formation After Opening Wedge High Tibial Osteotomy Using Tomosynthesis. J Digit Imaging 2022; 35:1373-1381. [PMID: 35419665 PMCID: PMC9582182 DOI: 10.1007/s10278-022-00630-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/17/2022] [Accepted: 04/03/2022] [Indexed: 11/24/2022] Open
Abstract
This study aimed to establish and validate a novel evaluation method using digital tomosynthesis to quantify bone formation in the gap after opening wedge high tibial osteotomy (OW-HTO). We retrospectively analyzed bone formation in the gap in 22 patients who underwent OW-HTO using digital tomosynthesis at 1, 2, 3, 6, 9, and 12 months postoperatively. Bone formation was semi-quantitatively assessed using the modified van Hemert's score and density measurements on digital tomosynthesis images. The gap filling value (GFV) was calculated as the ratio of the intensities of the opening gap and the tibial shaft. In addition, the relationship between the modified van Hemert's score and GFV was evaluated. The reproducibility of GFV had an interclass correlation coefficient (ICC [1,2]) of 0.958 for intraobserver reliability and an ICC (2,1) of 0.975 for interobserver reliability. The GFV increased in a time-dependent manner and was moderately correlated with the modified van Hemert's score (r = 0.630, p < 0.001). The GFV plateaued at 6 months postoperatively. In addition, the GFV was higher in patients with a modified van Hemert's score of 2 than in patients with a modified van Hemert's score of 3 (p = 0.008). The GFVs obtained using digital tomosynthesis can be used to assess postoperative bone formation in the opening gap after OW-HTO with high accuracy and reproducibility.
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Affiliation(s)
- Kyota Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
- Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Eiji Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | | | - Shohei Yamauchi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Shizuka Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yuka Kimura
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Yuji Yamamoto
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
| | - Takashi Shimbo
- Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
- StemRIM Institute of Regeneration-Inducing Medicine, Osaka University, Suita, Japan
| | - Katsuto Tamai
- Department of Stem Cell Therapy Science, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan
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Pritchett MA, Bhadra K, Mattingley JS. Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction: Three-dimensional Accuracy as Confirmed by Cone-Beam Computed Tomography. J Bronchology Interv Pulmonol 2021; 28:10-20. [PMID: 32412920 PMCID: PMC7742212 DOI: 10.1097/lbr.0000000000000687] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/23/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Electromagnetic navigation bronchoscopy (ENB) aids in lung lesion biopsy. However, anatomic divergence between the preprocedural computed tomography (CT) and the actual bronchial anatomy during the procedure can limit localization accuracy. An advanced ENB system has been designed to mitigate CT-to-body divergence using a tomosynthesis-based software algorithm that enhances nodule visibility and allows for intraprocedural local registration. MATERIALS AND METHODS A prospective, 2-center study was conducted in subjects with single peripheral lung lesions ≥10 mm to assess localization accuracy of the superDimension navigation system with fluoroscopic navigation technology. Three-dimensional accuracy was confirmed by cone-beam computed tomography. Complications were assessed through 7 days. RESULTS Fifty subjects were enrolled (25 per site). Lesions were <20 mm in 61.2% (30/49). A bronchus sign was present in 53.1% (26/49). Local registration was completed in 95.9% (47/49). Three-dimensional target overlap (primary endpoint) was achieved in 59.6% (28/47) and 83.0% (39/47) before and after location correction, respectively. Excluding subjects with unevaluable video files, target overlap was achieved 68.3% (28/41) and 95.1% (39/41), respectively. Malignant results were obtained in 53.1% (26/49) by rapid on-site evaluation and 61.2% (30/49) by final pathology of the ENB-aided sample. Diagnostic yield was not evaluated. Procedure-related complications were pneumothorax in 1 subject (no chest tube required) and scant hemoptysis in 3 subjects (no interventions required). CONCLUSION ENB with tomosynthesis-based fluoroscopic navigation improved the 3-dimensional convergence between the virtual target and actual lung lesion as confirmed by cone-beam computed tomography. Future studies are necessary to understand the impact of this technology on diagnostic yield.
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Affiliation(s)
| | - Krish Bhadra
- CHI Memorial Rees Skillern Cancer Institute, Chattanooga, TN
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Toyooka S, Masuda H, Nishihara N, Shimazaki N, Ando S, Kawano H, Nakagawa T. Tomosynthesis Is Equivalent to Computed Tomography for Evaluating Osseous Integration After Anterior Cruciate Ligament Reconstruction. Arthrosc Sports Med Rehabil 2020; 2:e105-e112. [PMID: 32368746 PMCID: PMC7190547 DOI: 10.1016/j.asmr.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/25/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To compare tomosynthesis and computed tomography (CT) for evaluating bone plug integration after anterior cruciate ligament (ACL) reconstruction with a bone–patellar tendon–bone (BPTB) graft. Methods Data of consecutive adult patients who underwent ACL reconstruction with BPTB were analyzed. Bone integration between the bone plug and bone tunnel was evaluated by tomosynthesis and CT, which were both performed 3 months postoperatively. The obtained data for both modalities were reconstructed with slice thickness of 2 mm. Evaluation of bone integration were separately performed using coronal- and sagittal-reconstructed images for the femur and tibia. The ratio of bone integration between the reconstructed slices in which bone grafting was involved, for both tomosynthesis and CT, was investigated by 2 blinded examiners. The equivalence of tomosynthesis to CT was tested by comparing the bone integration ratio for both modalities. The accuracy of diagnosing bone union using tomosynthesis and CT was also investigated. Results The diagnostic accuracy of tomosynthesis and CT exceeded 80%. Interobserver agreement of bone integration in the sagittal plane on the femoral side was 0.92 (intraclass correlation coefficient) for CT and 0.76 (intraclass correlation coefficient) for tomosynthesis. Conclusions Although it showed poor reliability, tomosynthesis was equivalent to CT in evaluating bone plug integration after ACL reconstruction with BPTB. Level of Evidence Level II, diagnostic study.
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Affiliation(s)
- Seikai Toyooka
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Hironari Masuda
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Nobuhiro Nishihara
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Naoya Shimazaki
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Shuji Ando
- Department of Information and Computer Technology Faculty of Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Takumi Nakagawa
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
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Shaller BD, Gildea TR. What is the value of electromagnetic navigation in lung cancer and to what extent does it require improvement? Expert Rev Respir Med 2020; 14:655-669. [DOI: 10.1080/17476348.2020.1748012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Brian D. Shaller
- Interventional Pulmonology, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas R. Gildea
- Interventional Pulmonology, Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
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Pritchett MA, Bhadra K, Calcutt M, Folch E. Virtual or reality: divergence between preprocedural computed tomography scans and lung anatomy during guided bronchoscopy. J Thorac Dis 2020; 12:1595-1611. [PMID: 32395297 PMCID: PMC7212155 DOI: 10.21037/jtd.2020.01.35] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Guided bronchoscopy offers a minimally invasive and safe method for accessing indeterminate pulmonary nodules. However, all current guided bronchoscopy systems rely on a preprocedural computed tomography (CT) scan to create a virtual map of the patient's airways. Changes in lung anatomy between the preprocedural CT scan and the bronchoscopy procedure can lead to a divergence between the expected and actual location of the target lesion. Termed "CT-to-body divergence", this effect reduces diagnostic yield, adds time to the procedure, and can be challenging for the operator. The objective of this paper is to describe the concept of CT-to-body divergence, its contributing factors, and methods and technologies that might minimize its deleterious effects on diagnostic yield.
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Affiliation(s)
- Michael A Pritchett
- FirstHealth of the Carolinas and Pinehurst Medical Clinic, Pinehurst, NC, USA
| | - Krish Bhadra
- CHI Memorial Rees Skillern Cancer Institute, Chattanooga, TN, USA
| | - Mike Calcutt
- Clinical Education, Medtronic, Minneapolis, MN, USA
| | - Erik Folch
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Lerner AD, Feller-Kopman D. Is bronchoscopic treatment of lung cancer possible? Expert Rev Respir Med 2018; 13:1-3. [DOI: 10.1080/17476348.2019.1549493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Andrew D. Lerner
- Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David Feller-Kopman
- Interventional Pulmonology, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Krimsky WS, Pritchett MA, Lau KKW. Towards an optimization of bronchoscopic approaches to the diagnosis and treatment of the pulmonary nodules: a review. J Thorac Dis 2018; 10:S1637-S1644. [PMID: 30034829 DOI: 10.21037/jtd.2018.04.38] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The last several years have seen substantive improvements and innovation with respect to bronchoscopic approaches to the indeterminate pulmonary nodule both diagnostically and therapeutically. Indeed, these advances have only accelerated over the last year or two and extend across multiple domains and include improvements in imaging technologies and techniques, approaches and tools to access different areas of the lung, tools to acquire tissue as well as tools and methods to ablate tissue. Needless to say, there are a variety of different approaches in terms of how these issues are being solved along with differing levels of technology and infrastructure commitments necessary to utilize these various tools, with some of these approaches being farther along than others. This article reviews some of these recent advances in the domains of advanced imaging, approaches to accessing various parts of the lung, tools designed to acquire tissue, robotic endoscopy platforms, new approaches to tissue ablation as well as potential additions to these areas that are on the horizon.
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Affiliation(s)
- William S Krimsky
- Interventional Pulmonary Medicine, Medstar Franklin Square Medical Center, Baltimore, USA
| | - Michael A Pritchett
- Department of Pulmonary Medicine, Chest Center of the Carolinas, FirstHealth Moore Regional Hospital, Pinehurst Medical Clinic, Pinehurst, North Carolina, USA
| | - Kelvin K W Lau
- Department of Thoracic Surgery, St Bartholomew's Hospital, West Smithfield, London, UK
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