Fluoroscopic image-guided intervention system for transbronchial localization

Lav Rai; Thomas M Keast; Henky Wibowo; Kun-Chang Yu; Jeffrey W. Draper; Jason D. Gibbs

doi:10.1117/12.911476

17 February 2012 Fluoroscopic image-guided intervention system for transbronchial localization

Lav Rai, Thomas M Keast, Henky Wibowo, Kun-Chang Yu, Jeffrey W. Draper, Jason D. Gibbs

Proceedings Volume 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling; 831624 (2012) https://doi.org/10.1117/12.911476
Event: SPIE Medical Imaging, 2012, San Diego, California, United States

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.

Citation Download Citation

Lav Rai, Thomas M Keast, Henky Wibowo, Kun-Chang Yu, Jeffrey W. Draper, and Jason D. Gibbs "Fluoroscopic image-guided intervention system for transbronchial localization", Proc. SPIE 8316, Medical Imaging 2012: Image-Guided Procedures, Robotic Interventions, and Modeling, 831624 (17 February 2012); https://doi.org/10.1117/12.911476

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