The Penn State Research Foundation

William E Higgins

Scott A Merritt

Lav Rai

Jason David Gibbs

Kun-Chang Yu

Kongkuo Lu

Rahul Khare

Michael W Graham

Yuxuan He

Trevor Kuhlengel

Qi Chang

Vahid Daneshpajooh

Wennan Zhao

Jason D Gibbs

A methodology is for deriving a guidance route to any selected site including an unplanned ROI site observed in a radiologic imaging view or endoscopic video view on an assisted-endoscopy system during a live surgical endoscopic procedure based on a preloaded initial procedure plan. The initial procedure plan can be updated by identifying a new site s at the unplanned ROI on one of graphical visualization tools of an image-guided endoscope system as a new examination destination and automatically computing the new navigation airway route that leads to the new examination destination.

Extemporaneous route planning during live endoscopic surgical procedures

A method for planning and guiding an endoscopic procedure, taking place in a hollow structure inside of a multi-organ cavity, that compensates for image-to-body divergence, first derives a procedure plan based on two scans of the multi-organ cavity at different volumes, which includes computing anatomical models for each scan, defining a region of interest (ROI) in the in the first scan, determining a route leading through the hollow structure to the ROI, deriving guidance cues that instruct how to maneuver the endoscope along the route toward the ROI, computing a 3D transformation that maps points in the first scan to corresponding points in the second scan, using the transformation to convert the route for the first scan into a corresponding route in the space of the second scan, and deriving guidance cues for the second scan that instruct how to maneuver the endoscope along the route toward the ROI.

Methods for planning and guiding endoscopic procedures that incorporate image-to-body divergence reduction

A two-stage method for guiding an endoscope and second device toward a target destination near the ROI includes navigation and localization. The endoscope is navigated near the vicinity of the ROI according to a pre-procedure plan. When the ROI location is reached, the second device's tip is pushed far enough through the endoscope so that its tip is outside the endoscope and in the endoscope's video view. Then a two-phase registration mechanism is used: i. Phase 1: Align the endoscope by registering the endoscope's video to a virtual bronchoscope's simulated video stream; ii. Phase 2: Align the second device by registering the second device's shape in the endoscope's video to a virtual second device model.

Two-phase instrument guidance for accurate endoscopic surgical procedures

A method for planning a tour visiting a set of target diagnostic sites via endoscopy passing through a hollow organ system includes computing a 3D virtual space of the hollow organ system based on the 3D imaging scan depicting the diagnostic sites and hollow organ system, computing a series of preliminary endoscopic routes leading to each diagnostic site including a set of contiguous device poses through the hollow organ system that connect each target diagnostic site to all of the other target diagnostic sites, and computing an optimal tour having a minimum cost corresponding to the smallest set of contiguous poses that visit all of the target diagnostic sites once and only once, where the cost between each pair of diagnostic sites is defined as the distance accumulated by the smallest set of contiguous poses connecting the pair of diagnostic sites together within the hollow organ system.

Multi-destination procedure planning and guidance for endoscopic surgery

A global registration system and method identifies bronchoscope position without the need for significant bronchoscope maneuvers, technician intervention, or electromagnetic sensors. Virtual bronchoscopy (VB) renderings of a 3D airway tree are obtained including VB views of branch positions within the airway tree. At least one real bronchoscopic (RB) video frame is received from a bronchoscope inserted into the airway tree. An algorithm according to the invention is executed on a computer to identify the several most likely branch positions having a VB view closest to the received RB view, and the 3D position of the bronchoscope within the airway tree is determined in accordance with the branch position identified in the VB view. The preferred embodiment involves a fast local registration search over all the branches in a global airway-bifurcation search space, with the weighted normalized sum of squares distance metric used for finding the best match.

Image-based global registration system and method applicable to bronchoscopy guidance

This invention relates generally to medical imaging and, in particular, to a method and system for automatic lymph node station mapping, automatic path or route report generation. A computer-based system for automatically locating the central chest lymph-node stations in a 3D MDCT image is described. Automated analysis methods extract the airway tree, airway-tree centerlines, aorta, pulmonary artery, lungs, key skeletal structures, and major-airway labels. Geometrical and anatomical cues arising from the extracted structures are used to localize the major nodal stations. The system calculates and displays the nodal stations in 3D. Visualization tools within the system enable the user to interact with the stations to locate visible lymph nodes.

Medical image reporting system and method

Two system-level bronchoscopy guidance solutions are presented. The first incorporates a global-registration algorithm to provide the physician with updated navigational and guidance information during bronchoscopy. The system can handle general navigation to a region of interest (ROI), as well as adverse events, and it requires minimal commands so that it can be directly controlled by the physician. The second solution visualizes the global picture of all the bifurcations and their relative orientations in advance and suggests the maneuvers needed by the bronchoscope to approach the ROI. Guided bronchoscopy results using human airway-tree phantoms demonstrate the potential of the two solutions.

Global and semi-global registration for image-based bronchoscopy guidance

Methods and apparatus assist in planning routes through hollow, branching organs in patients to optimize subsequent endoscopic procedures. Information is provided about the organ and a follow-on endoscopic procedure associated with the organ. The most appropriate navigable route or routes to a target region of interest (ROI) within the organ are then identified given anatomical, endoscopic-device, or procedure-specific constraints derived from the information provided. The method may include the step of modifying the viewing direction at each site along a route to give physically meaningful navigation directions or to reflect the requirements of a follow-on live endoscopic procedure. An existing route may further be extended, if necessary, to an ROI beyond the organ. The information provided may include anatomical constraints that define locations or organs to avoid; anatomical constraints that confine the route within specific geometric locations; or a metric for selecting the most appropriate route. For example, the metric may define the closest route to the ROI such that the route satisfies all applicable anatomical, device, and procedural constraints.

Methods and apparatus for 3D route planning through hollow organs

This invention relates generally to medical imaging and, in particular, to a method and system for reconstructing a model path through a branched tubular organ. Novel methodologies and systems segment and define accurate endoluminal surfaces in airway trees, including small peripheral bronchi. An automatic algorithm is described that searches the entire lung volume for airway branches and poses airway-tree segmentation as a global graph-theoretic optimization problem. A suite of interactive segmentation tools for cleaning and extending critical areas of the automatically segmented result is disclosed. A model path is reconstructed through the airway tree.

Fast and continuous registration between two imaging modalities makes it possible to completely determine the rigid transformation between multiple sources at real-time or near real-time frame-rates in order to localize video cameras and register the two sources. A set of reference images are computed or captured within a known environment, with corresponding depth maps and image gradients defining a reference source. Given one frame from a real-time or near-real time video feed, and starting from an initial guess of viewpoint, a real-time video frame is warped to the nearest viewing site of the reference source. An image difference is computed between the warped video frame and the reference image. Steps are repeated for each frame until the viewpoint converges or the next video frame becomes available. The final viewpoint gives an estimate of the relative rotation and translation between the camera at that particular video frame and the reference source.

Fast 3D-2D image registration method with application to continuously guided endoscopy

Methods and apparatus provide continuous guidance of endoscopy during a live procedure. A data-set based on 3D image data is pre-computed including reference information representative of a predefined route through a body organ to a final destination. A plurality of live real endoscopic (RE) images are displayed as an operator maneuvers an endoscope within the body organ. A registration and tracking algorithm registers the data-set to one or more of the RE images and continuously maintains the registration as the endoscope is locally maneuvered. Additional information related to the final destination is then presented enabling the endoscope operator to decide on a final maneuver for the procedure. The reference information may include 3D organ surfaces, 3D routes through an organ system, or 3D regions of interest (ROIs), as well as a virtual endoscopic (VE) image generated from the precomputed data-set. The preferred method includes the step of superimposing one or both of the 3D routes and ROIs on one or both of the RE and VE images. The 3D organ surfaces and routes may correspond to the surfaces and paths of a tracheobronchial airway tree extracted, for example, from 3D MDCT images of the chest.

Method and apparatus for continuous guidance of endoscopy

A novel framework for fast and continuous registration between two imaging modalities is disclosed. The approach makes it possible to completely determine the rigid transformation between multiple sources at real-time or near real-time frame-rates in order to localize the cameras and register the two sources. A disclosed example includes computing or capturing a set of reference images within a known environment, complete with corresponding depth maps and image gradients. The collection of these images and depth maps constitutes the reference source. The second source is a real-time or near-real time source which may include a live video feed. Given one frame from this video feed, and starting from an initial guess of viewpoint, the real-time video frame is warped to the nearest viewing site of the reference source. An image difference is computed between the warped video frame and the reference image. The viewpoint is updated via a Gauss-Newton parameter update and certain of the steps are repeated for each frame until the viewpoint converges or the next video frame becomes available. The final viewpoint gives an estimate of the relative rotation and translation between the camera at that particular video frame and the reference source. The invention has far-reaching applications, particularly in the field of assisted endoscopy, including bronchoscopy and colonoscopy. Other applications include aerial and ground-based navigation.

Fast 3D-2D image registration system with application to continuously guided endoscopy

A method provides guidance to the physician during a live bronchoscopy or other endoscopic procedures. The 3D motion of the bronchoscope is estimated using a fast coarse tracking step followed by a fine registration step. The tracking is based on finding a set of corresponding feature points across a plurality of consecutive bronchoscopic video frames, then estimating for the new pose of the bronchoscope. In the preferred embodiment the pose estimation is based on linearization of the rotation matrix. By giving a set of corresponding points across the current bronchoscopic video image, and the CT-based virtual image as an input, the same method can also be used for manual registration. The fine registration step is preferably a gradient-based Gauss-Newton method that maximizes the correlation between the bronchoscopic video image and the CT-based virtual image. The continuous guidance is provided by estimating the 3D motion of the bronchoscope in a loop. Since depth-map information is available, tracking can be done by solving a 3D-2D pose estimation problem. A 3D-2D pose estimation problem is more constrained than a 2D-2D pose estimation problem and does not suffer from the limitations associated with computing an essential matrix. The use of correlation-based cost, instead of mutual information as a registration cost, makes it simpler to use gradient-based methods for registration.

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State College, PA, United States of America

William E Higgins