2 University of University of Iowa Iowa Iowa City, IA Iowa City, IA 52246 52246 William E. Higgins William E. Higgins 1,2 1,2 Anthony J. Sherbondy Anthony J. Sherbondy 1 James P. Helferty James P. Helferty 1 Atilla P. Kiraly Atilla P. Kiraly 1 Geoffrey McLennan Geoffrey McLennan 2 Eric A. Hoffman Eric A. Hoffman 2 Janice Z Turlington Janice Z Turlington 1 RSNA 2000 RSNA 2000 Chicago, IL Chicago, IL 26 November 2000 26 November 2000 1 Penn State Penn State University University University University Park, PA Park, PA 16802 16802
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2 University of Iowa Iowa City, IA 52246 2 University of Iowa Iowa City, IA 52246 William E. Higgins 1,2 Anthony J. Sherbondy 1 James P. Helferty 1 Atilla.
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22University of University of Iowa Iowa
Iowa City, IA Iowa City, IA 5224652246
22University of University of Iowa Iowa
Iowa City, IA Iowa City, IA 5224652246
William E. HigginsWilliam E. Higgins1,21,2 Anthony J. SherbondyAnthony J. Sherbondy11
James P. HelfertyJames P. Helferty11 Atilla P. KiralyAtilla P. Kiraly11
Geoffrey McLennanGeoffrey McLennan22 Eric A. HoffmanEric A. Hoffman22
Janice Z TurlingtonJanice Z Turlington11
William E. HigginsWilliam E. Higgins1,21,2 Anthony J. SherbondyAnthony J. Sherbondy11
James P. HelfertyJames P. Helferty11 Atilla P. KiralyAtilla P. Kiraly11
Geoffrey McLennanGeoffrey McLennan22 Eric A. HoffmanEric A. Hoffman22
Janice Z TurlingtonJanice Z Turlington11
RSNA 2000RSNA 2000Chicago, ILChicago, IL
26 November 200026 November 2000
RSNA 2000RSNA 2000Chicago, ILChicago, IL
26 November 200026 November 2000
11Penn State Penn State University University University University
Park, PA Park, PA 1680216802
11Penn State Penn State University University University University
Park, PA Park, PA 1680216802
1.1. Introduce the feasibility of PC-based Introduce the feasibility of PC-based virtual endoscopy for both 3D CT virtual endoscopy for both 3D CT assessment and live bronchoscopy.assessment and live bronchoscopy.
2.2. Demonstrate the concept of a multimedia Demonstrate the concept of a multimedia case study for CT-based report case study for CT-based report generation and bronchoscopic guidance.generation and bronchoscopic guidance.
3.3. Describe a method for linking 3D CT Describe a method for linking 3D CT data to live bronchoscopic video.data to live bronchoscopic video.
1.1. Introduce the feasibility of PC-based Introduce the feasibility of PC-based virtual endoscopy for both 3D CT virtual endoscopy for both 3D CT assessment and live bronchoscopy.assessment and live bronchoscopy.
2.2. Demonstrate the concept of a multimedia Demonstrate the concept of a multimedia case study for CT-based report case study for CT-based report generation and bronchoscopic guidance.generation and bronchoscopic guidance.
3.3. Describe a method for linking 3D CT Describe a method for linking 3D CT data to live bronchoscopic video.data to live bronchoscopic video.
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1.1. Overview of virtual bronchoscopy and our Overview of virtual bronchoscopy and our system (Virtual Navigator)system (Virtual Navigator)
2.2. Stage-1 CT-only Analysis: Stage-1 CT-only Analysis: Human caseHuman case
3.3. Stage-2 Bronchoscopy examples:Stage-2 Bronchoscopy examples:a.a. Human caseHuman caseb.b. Phantom and animal studiesPhantom and animal studies
1.1. Overview of virtual bronchoscopy and our Overview of virtual bronchoscopy and our system (Virtual Navigator)system (Virtual Navigator)
2.2. Stage-1 CT-only Analysis: Stage-1 CT-only Analysis: Human caseHuman case
3.3. Stage-2 Bronchoscopy examples:Stage-2 Bronchoscopy examples:a.a. Human caseHuman caseb.b. Phantom and animal studiesPhantom and animal studies
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virtual copy of chest anatomyvirtual copy of chest anatomy virtual copy of chest anatomyvirtual copy of chest anatomy
Input:Input:Input:Input:high-resolution 3D radiologic chest imagehigh-resolution 3D radiologic chest imagehigh-resolution 3D radiologic chest imagehigh-resolution 3D radiologic chest image
permits unlimited permits unlimited
“exploration”“exploration” no risk to patientno risk to patient
permits unlimited permits unlimited
“exploration”“exploration” no risk to patientno risk to patient
Explore:Explore:Explore:Explore:the virtual anatomy using computerthe virtual anatomy using computerthe virtual anatomy using computerthe virtual anatomy using computer
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Permit CT-only analysisPermit CT-only analysis
• No link to No link to follow-onfollow-on live bronchoscopy live bronchoscopy
Limited quantitative path planning to interesting sites Limited quantitative path planning to interesting sites
Do not provide complete examination packageDo not provide complete examination package
Often require expensive computersOften require expensive computers
Permit CT-only analysisPermit CT-only analysis
• No link to No link to follow-onfollow-on live bronchoscopy live bronchoscopy
Limited quantitative path planning to interesting sites Limited quantitative path planning to interesting sites
Do not provide complete examination packageDo not provide complete examination package
Often require expensive computersOften require expensive computers
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Complete CT Complete CT examination examination
Guide live Guide live bronchoscopybronchoscopy
Automate Automate steps in CT steps in CT assessment assessment
Inexpensive, Inexpensive, PC-basedPC-based
Complete CT Complete CT examination examination
Guide live Guide live bronchoscopybronchoscopy
Automate Automate steps in CT steps in CT assessment assessment
Inexpensive, Inexpensive, PC-basedPC-based
Build with Graphics/Processing ToolsBuild with Graphics/Processing Tools Build with Graphics/Processing ToolsBuild with Graphics/Processing Tools
3D CT assessment3D CT assessment3D CT assessment3D CT assessment
Guide bronchoscopyGuide bronchoscopyGuide bronchoscopyGuide bronchoscopy Supplemental plan Supplemental plan Supplemental plan Supplemental plan
1.1.Create new Case Study.Create new Case Study.2.2.Compute guidance data.Compute guidance data.3.3.Build complete Case Study. Build complete Case Study.
1.1.Create new Case Study.Create new Case Study.2.2.Compute guidance data.Compute guidance data.3.3.Build complete Case Study. Build complete Case Study.
1.1.Load Case Study.Load Case Study.2.2.Set up graphical tools.Set up graphical tools.3.3.Perform virtual-guided bronchoscopy.Perform virtual-guided bronchoscopy.
1.1.Load Case Study.Load Case Study.2.2.Set up graphical tools.Set up graphical tools.3.3.Perform virtual-guided bronchoscopy.Perform virtual-guided bronchoscopy.
a.a. Build Case Study registry Build Case Study registry a.a. Build Case Study registry Build Case Study registry BB BB
Create CaseCreate Case Create CaseCreate Case
b.b. Set up for computing guidance data Set up for computing guidance data b.b. Set up for computing guidance data Set up for computing guidance data SS SS
Set upSet up Set upSet up
1.1. Create new Case Study.Create new Case Study.1.1. Create new Case Study.Create new Case Study.
Virtual Navigator showsVirtual Navigator shows•Characteristics of collapseCharacteristics of collapse•Condition of extended bronchial pathways Condition of extended bronchial pathways
Virtual Navigator showsVirtual Navigator shows•Characteristics of collapseCharacteristics of collapse•Condition of extended bronchial pathways Condition of extended bronchial pathways
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MPR MPR ViewsViewsIndicaIndica
teteGlobal Global
3D3Dpositiopositio
nn
MPR MPR ViewsViewsIndicaIndica
teteGlobal Global
3D3Dpositiopositio
nn
DepthDepth--
weighweightedtedSlab Slab
showsshowsgeomgeometryetry
DepthDepth--
weighweightedtedSlab Slab
showsshowsgeomgeometryetry
Same 3D site focused on by all Same 3D site focused on by all tools. tools. Same 3D site focused on by all Same 3D site focused on by all tools. tools.
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Selected 3D Selected 3D site (BLUE site (BLUE
DOT)DOT)Highlighted Highlighted
ononFive Five
different different tools at tools at once. once.
Selected 3D Selected 3D site (BLUE site (BLUE
DOT)DOT)Highlighted Highlighted
ononFive Five
different different tools at tools at once. once.
Bottom to top view of collapse
Site #99Site #99
Near carina, leaving collapse
Approaching collapse
Site #20
Site #47
Within tracheal collapse
Site #86Leaving trachea
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drop in areadrop in areadrop in areadrop in area
Approaching collapse
Site #20Site #20
Within tracheal collapse
Site #47Site #47
Plot clearly shows section Plot clearly shows section where blockage occurs where blockage occurs
Plot clearly shows section Plot clearly shows section where blockage occurs where blockage occurs
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Pathology documented by Pathology documented by captured Depth-Slab captured Depth-Slab
snapshots.snapshots.
Pathology documented by Pathology documented by captured Depth-Slab captured Depth-Slab
snapshots.snapshots.
Extent of collapse shown in Extent of collapse shown in rendered Airway tree.rendered Airway tree.
Extent of collapse shown in Extent of collapse shown in rendered Airway tree.rendered Airway tree.
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Virtual Navigator showsVirtual Navigator shows•Details of existing stentDetails of existing stent•Basis for intervention analysis Basis for intervention analysis (laser therapy was performed)(laser therapy was performed)
Virtual Navigator showsVirtual Navigator shows•Details of existing stentDetails of existing stent•Basis for intervention analysis Basis for intervention analysis (laser therapy was performed)(laser therapy was performed)
Stent Stent visiblevisibleIn this In this andandother other viewsviews
Stent Stent visiblevisibleIn this In this andandother other viewsviews
Same 3D site focused on by all Same 3D site focused on by all tools. tools. Same 3D site focused on by all Same 3D site focused on by all tools. tools.
Average biopsy error: 1.98 mm Average biopsy error: 1.98 mm
Average match time: 11.065 sec.Average match time: 11.065 sec.
Average biopsy error: 1.98 mm Average biopsy error: 1.98 mm
Average match time: 11.065 sec.Average match time: 11.065 sec.
AverageAverage
Std DevStd Dev
Distance and time measured to match each ROI target.Distance and time measured to match each ROI target.Distance measured from line extrapolated from the needle direction to metal bead edge.Distance measured from line extrapolated from the needle direction to metal bead edge.Note:Note:
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RegistereRegisteredd
virtual virtual shotshot
RegistereRegisteredd
virtual virtual shotshot
LiveLiveEndoscoEndosco
picpicvideovideo
LiveLiveEndoscoEndosco
picpicvideovideo
MatcheMatched video d video frame frame with with ROIROI
MatcheMatched video d video frame frame with with ROIROI
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Snapshots are misaligned to compensate for Snapshots are misaligned to compensate for differing placement during CT scanning.differing placement during CT scanning.
Note:Note:
Actual siteActual site after guided after guided dye marker placement.dye marker placement.Actual siteActual site after guided after guided dye marker placement.dye marker placement.
Planned sitePlanned site from CT analysis. from CT analysis.Planned sitePlanned site from CT analysis. from CT analysis.
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Bronchoscope Bronchoscope video video
matched to matched to rendered CT rendered CT during live during live procedure.procedure.
Bronchoscope Bronchoscope video video
matched to matched to rendered CT rendered CT during live during live procedure.procedure.
National Center National Center for for Research Research Resources Resources of theof the NIH NIH
(grant RR11800)(grant RR11800)
National Center National Center for for Research Research Resources Resources of theof the NIH NIH
(grant RR11800)(grant RR11800)
Whitaker FoundationWhitaker FoundationWhitaker FoundationWhitaker Foundation
National Cancer Institute National Cancer Institute of theof the NIH NIH (grant CA74325)(grant CA74325)National Cancer Institute National Cancer Institute of theof the NIH NIH (grant CA74325)(grant CA74325)