Abstract: Confident use of medial surfaces in medical decision support systems requires evaluating their quality for detecting pathological deformations and describing anatomical volumes. Validation in the medical imaging field is a challenging task mainly due to the difficulties for getting consensual ground truth. In this paper we propose a validation benchmark for assessing medial surfaces in the context of medical applications. Our benchmark includes a home-made database of synthetic medial surfaces and volumes and specific scores for evaluating surface accuracy, its stability against volume deformations and its capabilities for accurate reconstruction of anatomical volumes.

Abstract: Medial representations are powerful tools for describing and parameterizing the volumetric shape of anatomical structures. Existing methods show excellent results when applied to 2D objects, but their quality drops across dimensions. This paper contributes to the computation of medial manifolds in two aspects. First, we provide a standard scheme for the computation of medial manifolds that avoid degenerated medial axis segments; second, we introduce an energy based method which performs independently of the dimension. We evaluate quantitatively the performance of our method with respect to existing approaches, by applying them to synthetic shapes of known medial geometry. Finally, we show results on shape representation of multiple abdominal organs, exploring the use of medial manifolds for the representation of multi-organ relations.

Abstract: Bronchoscopists use X‐ray fluoroscopy to guide bronchoscopes to the lesion to be biopsied without any kind of incisions. Reducing exposure to X‐ray is important for both patients and doctors but alternatives like electromagnetic navigation require specific equipment and increase the cost of the clinical procedure. We propose a guiding system based on the extraction of airway centers from intra‐operative videos. Such anatomical landmarks could be
matched to the airway centerline extracted from a pre‐planned CT to indicate the best path to the lesion. We present an extraction of lumen centers
from intra‐operative videos based on tracking of maximal stable regions of energy maps.

Abstract: Bronchoscopists use fluoroscopy to guide flexible bronchoscopy to the lesion to be biopsied without any kind of incision. Being fluoroscopy an imaging technique based on X-rays, the risk of developmental problems and cancer is increased in those subjects exposed to its application, so minimizing radiation is crucial. Alternative guiding systems such as electromagnetic navigation require specific equipment, increase the cost of the clinical procedure and still require fluoroscopy. In this paper we propose an image based guiding system based on the extraction of airway centres from intra-operative videos. Such anatomical landmarks are matched to the airway centreline extracted from a pre-planned CT to indicate the best path to the nodule. We present a
feasibility study of our navigation system using simulated bronchoscopic videos and a multi-expert validation of landmarks extraction in 3 intra-operative ultrathin explorations.

Abstract: Bronchoscopy examinations allow biopsy of pulmonary nodules with minimum risk for the patient. Even for experienced bronchoscopists, it is difficult to guide the bronchoscope to most distal lesions and obtain an accurate diagnosis. This paper presents an image-based codification of the bronchial anatomy for bronchoscopy biopsy guiding. The 3D anatomy of each patient is codified as a binary tree with nodes representing bronchial levels and edges labeled using their position on images projecting the 3D anatomy from a set of branching points. The paths from the root to leaves provide a codification of navigation routes with spatially consistent labels according to the anatomy observes in video bronchoscopy explorations. We evaluate our labeling approach as a guiding system in terms of the number of bronchial levels correctly codified, also in the number of labels-based instructions correctly supplied, using generalized mixed models and computer-generated data. Results obtained for three independent observers prove the consistency and reproducibility of our guiding system. We trust that our codification based on viewer’s projection might be used as a foundation for the navigation process in Virtual Bronchoscopy systems.