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Proceedings Paper

Fluoroscopic image-guided intervention system for transbronchial localization
Author(s): Lav Rai; Thomas M Keast; Henky Wibowo; Kun-Chang Yu; Jeffrey W. Draper; Jason D. Gibbs
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Paper Abstract

Reliable transbronchial access of peripheral lung lesions is desirable for the diagnosis and potential treatment of lung cancer. This procedure can be difficult, however, because accessory devices (e.g., needle or forceps) cannot be reliably localized while deployed. We present a fluoroscopic image-guided intervention (IGI) system for tracking such bronchoscopic accessories. Fluoroscopy, an imaging technology currently utilized by many bronchoscopists, has a fundamental shortcoming - many lung lesions are invisible in its images. Our IGI system aligns a digitally reconstructed radiograph (DRR) defined from a pre-operative computed tomography (CT) scan with live fluoroscopic images. Radiopaque accessory devices are readily apparent in fluoroscopic video, while lesions lacking a fluoroscopic signature but identifiable in the CT scan are superimposed in the scene. The IGI system processing steps consist of: (1) calibrating the fluoroscopic imaging system; (2) registering the CT anatomy with its depiction in the fluoroscopic scene; (3) optical tracking to continually update the DRR and target positions as the fluoroscope is moved about the patient. The end result is a continuous correlation of the DRR and projected targets with the anatomy depicted in the live fluoroscopic video feed. Because both targets and bronchoscopic devices are readily apparent in arbitrary fluoroscopic orientations, multiplane guidance is straightforward. The system tracks in real-time with no computational lag. We have measured a mean projected tracking accuracy of 1.0 mm in a phantom and present results from an in vivo animal study.

Paper Details

Date Published: 17 February 2012
PDF: 11 pages
Proc. SPIE 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling, 831624 (17 February 2012); doi: 10.1117/12.911476
Show Author Affiliations
Lav Rai, Broncus Technologies, Inc. (United States)
Thomas M Keast, Broncus Technologies, Inc. (United States)
Henky Wibowo, Broncus Technologies, Inc. (United States)
Kun-Chang Yu, Broncus Technologies, Inc. (United States)
Jeffrey W. Draper, Broncus Technologies, Inc. (United States)
Jason D. Gibbs, Broncus Technologies, Inc. (United States)

Published in SPIE Proceedings Vol. 8316:
Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling
David R. Holmes; Kenneth H. Wong, Editor(s)

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