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Antonio Esteban Lansaque, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2016). "Stable Anatomical Structure Tracking for video-bronchoscopy Navigation " In 19th International Conference on Medical Image Computing and Computer Assisted Intervention Workshops.
Abstract: Bronchoscopy allows to examine the patient airways for detection of lesions and sampling of tissues without surgery. A main drawback in lung cancer diagnosis is the diculty to check whether the exploration is following the correct path to the nodule that has to be biopsied. The most extended guidance uses uoroscopy which implies repeated radiation of clinical sta and patients. Alternatives such as virtual bronchoscopy or electromagnetic navigation are very expensive and not completely robust to blood, mocus or deformations as to be extensively used. We propose a method that extracts and tracks stable lumen regions at di erent levels of the bronchial tree. The tracked regions are stored in a tree that encodes the anatomical structure of the scene which can be useful to retrieve the path to the lesion that the clinician should follow to do the biopsy. We present a multi-expert validation of our anatomical landmark extraction in 3 intra-operative ultrathin explorations.
Keywords: Lung cancer diagnosis; video-bronchoscopy; airway lumen detection; region tracking
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Carles Sanchez, Antonio Esteban Lansaque, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2017). "Towards a Videobronchoscopy Localization System from Airway Centre Tracking " In 12th International Conference on Computer Vision Theory and Applications (pp. 352–359).
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.
Keywords: Video-bronchoscopy; Lung cancer diagnosis; Airway lumen detection; Region tracking; Guided bronchoscopy navigation
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2017). "Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation " . European Respiratory Journal, .
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2016). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation . Chest Journal, 150(4), 1003A.
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Esmitt Ramirez, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2018). "BronchoX: bronchoscopy exploration software for biopsy intervention planning " . Healthcare Technology Letters, 5(5), 177–182.
Abstract: Virtual bronchoscopy (VB) is a non-invasive exploration tool for intervention planning and navigation of possible pulmonary lesions (PLs). A VB software involves the location of a PL and the calculation of a route, starting from the trachea, to reach it. The selection of a VB software might be a complex process, and there is no consensus in the community of medical software developers in which is the best-suited system to use or framework to choose. The authors present Bronchoscopy Exploration (BronchoX), a VB software to plan biopsy interventions that generate physician-readable instructions to reach the PLs. The authors’ solution is open source, multiplatform, and extensible for future functionalities, designed by their multidisciplinary research and development group. BronchoX is a compound of different algorithms for segmentation, visualisation, and navigation of the respiratory tract. Performed results are a focus on the test the effectiveness of their proposal as an exploration software, also to measure its accuracy as a guiding system to reach PLs. Then, 40 different virtual planning paths were created to guide physicians until distal bronchioles. These results provide a functional software for BronchoX and demonstrate how following simple instructions is possible to reach distal lesions from the trachea.
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Debora Gil, Ruth Aris, Agnes Borras, Esmitt Ramirez, Rafael Sebastian, & Mariano Vazquez. (2019). "Influence of fiber connectivity in simulations of cardiac biomechanics " . International Journal of Computer Assisted Radiology and Surgery, 14(1), 63–72.
Abstract: PURPOSE:
Personalized computational simulations of the heart could open up new improved approaches to diagnosis and surgery assistance systems. While it is fully recognized that myocardial fiber orientation is central for the construction of realistic computational models of cardiac electromechanics, the role of its overall architecture and connectivity remains unclear. Morphological studies show that the distribution of cardiac muscular fibers at the basal ring connects epicardium and endocardium. However, computational models simplify their distribution and disregard the basal loop. This work explores the influence in computational simulations of fiber distribution at different short-axis cuts.
METHODS:
We have used a highly parallelized computational solver to test different fiber models of ventricular muscular connectivity. We have considered two rule-based mathematical models and an own-designed method preserving basal connectivity as observed in experimental data. Simulated cardiac functional scores (rotation, torsion and longitudinal shortening) were compared to experimental healthy ranges using generalized models (rotation) and Mahalanobis distances (shortening, torsion).
RESULTS:
The probability of rotation was significantly lower for ruled-based models [95% CI (0.13, 0.20)] in comparison with experimental data [95% CI (0.23, 0.31)]. The Mahalanobis distance for experimental data was in the edge of the region enclosing 99% of the healthy population.
CONCLUSIONS:
Cardiac electromechanical simulations of the heart with fibers extracted from experimental data produce functional scores closer to healthy ranges than rule-based models disregarding architecture connectivity.
Keywords: Cardiac electromechanical simulations; Diffusion tensor imaging; Fiber connectivity
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Esmitt Ramirez, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, Antoni Rosell, & Debora Gil. (2018). "Image-Based Bronchial Anatomy Codification for Biopsy Guiding in Video Bronchoscopy " In OR 2.0 Context-Aware Operating Theaters, Computer Assisted Robotic Endoscopy, Clinical Image-Based Procedures, and Skin Image Analysis (Vol. 11041).
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.
Keywords: Biopsy guiding; Bronchoscopy; Lung biopsy; Intervention guiding; Airway codification
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Debora Gil, Antonio Esteban Lansaque, Agnes Borras, & Carles Sanchez. (2019). "Enhancing virtual bronchoscopy with intra-operative data using a multi-objective GAN " . International Journal of Computer Assisted Radiology and Surgery, 7(1).
Abstract: This manuscript has been withdrawn by bioRxiv due to upload of an incorrect version of the manuscript by the authors. Therefore, this manuscript should not be cited as reference for this project.
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Debora Gil, Carles Sanchez, Agnes Borras, Marta Diez-Ferrer, & Antoni Rosell. (2019). "Segmentation of Distal Airways using Structural Analysis " . PloS one, 14(12).
Abstract: Segmentation of airways in Computed Tomography (CT) scans is a must for accurate support of diagnosis and intervention of many pulmonary disorders. In particular, lung cancer diagnosis would benefit from segmentations reaching most distal airways. We present a method that combines descriptors of bronchi local appearance and graph global structural analysis to fine-tune thresholds on the descriptors adapted for each bronchial level. We have compared our method to the top performers of the EXACT09 challenge and to a commercial software for biopsy planning evaluated in an own-collected data-base of high resolution CT scans acquired under different breathing conditions. Results on EXACT09 data show that our method provides a high leakage reduction with minimum loss in airway detection. Results on our data-base show the reliability across varying breathing conditions and a competitive performance for biopsy planning compared to a commercial solution.
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Carles Sanchez, Miguel Viñas, Coen Antens, Agnes Borras, & Debora Gil. (2018). "Back to Front Architecture for Diagnosis as a Service " In 20th International Symposium on Symbolic and Numeric Algorithms for Scientific Computing (pp. 343–346).
Abstract: Software as a Service (SaaS) is a cloud computing model in which a provider hosts applications in a server that customers use via internet. Since SaaS does not require to install applications on customers' own computers, it allows the use by multiple users of highly specialized software without extra expenses for hardware acquisition or licensing. A SaaS tailored for clinical needs not only would alleviate licensing costs, but also would facilitate easy access to new methods for diagnosis assistance. This paper presents a SaaS client-server architecture for Diagnosis as a Service (DaaS). The server is based on docker technology in order to allow execution of softwares implemented in different languages with the highest portability and scalability. The client is a content management system allowing the design of websites with multimedia content and interactive visualization of results allowing user editing. We explain a usage case that uses our DaaS as crowdsourcing platform in a multicentric pilot study carried out to evaluate the clinical benefits of a software for assessment of central airway obstruction.
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