Image-guided EBUS bronchoscopy system for lung-cancer staging
The staging of the central-chest lymph nodes is a major step in the management of lung-cancer patients. For this purpose, the physician uses a device that integrates videobronchoscopy and an endobronchial ultrasound (EBUS) probe. To biopsy a lymph node, the physician first uses videobronchoscopy to...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
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| Series: | Informatics in Medicine Unlocked |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352914821001507 |
| _version_ | 1819116253125541888 |
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| author | Xiaonan Zang Ronnarit Cheirsilp Patrick D. Byrnes Trevor K. Kuhlengel Catherine Abendroth Thomas Allen Rickhesvar Mahraj Jennifer Toth Rebecca Bascom William E. Higgins |
| author_facet | Xiaonan Zang Ronnarit Cheirsilp Patrick D. Byrnes Trevor K. Kuhlengel Catherine Abendroth Thomas Allen Rickhesvar Mahraj Jennifer Toth Rebecca Bascom William E. Higgins |
| author_sort | Xiaonan Zang |
| collection | DOAJ |
| description | The staging of the central-chest lymph nodes is a major step in the management of lung-cancer patients. For this purpose, the physician uses a device that integrates videobronchoscopy and an endobronchial ultrasound (EBUS) probe. To biopsy a lymph node, the physician first uses videobronchoscopy to navigate through the airways and then invokes EBUS to localize and biopsy the node. Unfortunately, this process proves difficult for many physicians, with the choice of biopsy site found by trial and error. We present a complete image-guided EBUS bronchoscopy system tailored to lymph-node staging. The system accepts a patient’s 3D chest CT scan, an optional PET scan, and the EBUS bronchoscope’s video sources as inputs. System workflow follows two phases: (1) procedure planning and (2) image-guided EBUS bronchoscopy. Procedure planning derives airway guidance routes that facilitate optimal EBUS scanning and nodal biopsy. During the live procedure, the system’s graphical display suggests a series of device maneuvers to perform and provides multimodal visual cues for locating suitable biopsy sites. To this end, the system exploits data fusion to drive a multimodal virtual bronchoscope and other visualization tools that lead the physician through the process of device navigation and localization. A retrospective lung-cancer patient study and follow-on prospective patient study, performed within the standard clinical workflow, demonstrate the system’s feasibility and functionality. For the prospective study, 60/60 selected lymph nodes (100%) were correctly localized using the system, and 30/33 biopsied nodes (91%) gave adequate tissue samples. Also, the mean procedure time including all user interactions was 6 min 43 s All of these measures improve upon benchmarks reported for other state-of-the-art systems and current practice. Overall, the system enabled safe, efficient EBUS-based localization and biopsy of lymph nodes. |
| first_indexed | 2024-12-22T05:14:09Z |
| format | Article |
| id | doaj.art-b7d712271dc64f43804a0fdb4794fa35 |
| institution | Directory Open Access Journal |
| issn | 2352-9148 |
| language | English |
| last_indexed | 2024-12-22T05:14:09Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Informatics in Medicine Unlocked |
| spelling | doaj.art-b7d712271dc64f43804a0fdb4794fa352022-12-21T18:37:54ZengElsevierInformatics in Medicine Unlocked2352-91482021-01-0125100665Image-guided EBUS bronchoscopy system for lung-cancer stagingXiaonan Zang0Ronnarit Cheirsilp1Patrick D. Byrnes2Trevor K. Kuhlengel3Catherine Abendroth4Thomas Allen5Rickhesvar Mahraj6Jennifer Toth7Rebecca Bascom8William E. Higgins9School of Electrical Engineering and Computer Science, Penn State University, University Park, PA, United States; EDDA Technologies, Princeton, NJ 08540, United StatesSchool of Electrical Engineering and Computer Science, Penn State University, University Park, PA, United States; Broncus Medical, San Jose, CA, United StatesSchool of Electrical Engineering and Computer Science, Penn State University, University Park, PA, United States; University of Wisconsin, Platteville, WI 53818, United StatesSchool of Electrical Engineering and Computer Science, Penn State University, University Park, PA, United StatesPenn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA, United StatesPenn State Milton S. Hershey Medical Center, Penn State University, Hershey, PA, United StatesSchool of Electrical Engineering and Computer Science, Penn State University, University Park, PA, United States; Corresponding author.The staging of the central-chest lymph nodes is a major step in the management of lung-cancer patients. For this purpose, the physician uses a device that integrates videobronchoscopy and an endobronchial ultrasound (EBUS) probe. To biopsy a lymph node, the physician first uses videobronchoscopy to navigate through the airways and then invokes EBUS to localize and biopsy the node. Unfortunately, this process proves difficult for many physicians, with the choice of biopsy site found by trial and error. We present a complete image-guided EBUS bronchoscopy system tailored to lymph-node staging. The system accepts a patient’s 3D chest CT scan, an optional PET scan, and the EBUS bronchoscope’s video sources as inputs. System workflow follows two phases: (1) procedure planning and (2) image-guided EBUS bronchoscopy. Procedure planning derives airway guidance routes that facilitate optimal EBUS scanning and nodal biopsy. During the live procedure, the system’s graphical display suggests a series of device maneuvers to perform and provides multimodal visual cues for locating suitable biopsy sites. To this end, the system exploits data fusion to drive a multimodal virtual bronchoscope and other visualization tools that lead the physician through the process of device navigation and localization. A retrospective lung-cancer patient study and follow-on prospective patient study, performed within the standard clinical workflow, demonstrate the system’s feasibility and functionality. For the prospective study, 60/60 selected lymph nodes (100%) were correctly localized using the system, and 30/33 biopsied nodes (91%) gave adequate tissue samples. Also, the mean procedure time including all user interactions was 6 min 43 s All of these measures improve upon benchmarks reported for other state-of-the-art systems and current practice. Overall, the system enabled safe, efficient EBUS-based localization and biopsy of lymph nodes.http://www.sciencedirect.com/science/article/pii/S2352914821001507BronchoscopyLung cancer stagingEndobronchial ultrasoundImage-guided surgery systemsMultimodal imagingLymph nodes |
| spellingShingle | Xiaonan Zang Ronnarit Cheirsilp Patrick D. Byrnes Trevor K. Kuhlengel Catherine Abendroth Thomas Allen Rickhesvar Mahraj Jennifer Toth Rebecca Bascom William E. Higgins Image-guided EBUS bronchoscopy system for lung-cancer staging Informatics in Medicine Unlocked Bronchoscopy Lung cancer staging Endobronchial ultrasound Image-guided surgery systems Multimodal imaging Lymph nodes |
| title | Image-guided EBUS bronchoscopy system for lung-cancer staging |
| title_full | Image-guided EBUS bronchoscopy system for lung-cancer staging |
| title_fullStr | Image-guided EBUS bronchoscopy system for lung-cancer staging |
| title_full_unstemmed | Image-guided EBUS bronchoscopy system for lung-cancer staging |
| title_short | Image-guided EBUS bronchoscopy system for lung-cancer staging |
| title_sort | image guided ebus bronchoscopy system for lung cancer staging |
| topic | Bronchoscopy Lung cancer staging Endobronchial ultrasound Image-guided surgery systems Multimodal imaging Lymph nodes |
| url | http://www.sciencedirect.com/science/article/pii/S2352914821001507 |
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