Abstract: Lung cancer is one of the most diagnosed cancers among men and women. Actually,
lung cancer accounts for 13% of the total cases with a 5-year global survival
rate in patients. Although Early detection increases survival rate from 38% to 67%, accurate diagnosis remains a challenge. Pathological confirmation requires extracting a sample of the lesion tissue for its biopsy. The preferred procedure for tissue biopsy is called bronchoscopy. A bronchoscopy is an endoscopic technique for the internal exploration of airways which facilitates the performance of minimal invasive interventions with low risk for the patient. Recent advances in bronchoscopic devices have increased their use for minimal invasive diagnostic and intervention procedures, like lung cancer biopsy sampling. Despite the improvement in bronchoscopic device quality, there is a lack of intelligent computational systems for supporting in-vivo clinical decision during examinations. Existing technologies fail to accurately reach the lesion due to several aspects at intervention off-line planning and poor intra-operative guidance at exploration time. Existing guiding systems radiate patients and clinical staff,might be expensive and achieve a suboptimlal 70% of yield boost. Diagnostic yield could be improved reducing radiation and costs by developing intra-operative support systems able to guide the bronchoscopist to the lesion during the intervention. The goal of this PhD thesis is to develop an image-based navigation systemfor intra-operative guidance of bronchoscopists to a target lesion across a path previously planned on a CT-scan. We propose a 3D navigation system which uses the anatomy of video bronchoscopy frames to locate the bronchoscope within the airways. Once the bronchoscope is located, our navigation system is able to indicate the bifurcation which needs to be followed to reach the lesion. In order to facilitate an off-line validation
as realistic as possible, we also present a method for augmenting simulated virtual bronchoscopies with the appearance of intra-operative videos. Experiments performed on augmented and intra-operative videos, prove that our algorithm can be speeded up for an on-line implementation in the operating room.

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 dierent 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.

Abstract: A usual tool in cardiac disease diagnosis is vessel plaque assessment by analysis of IVUS sequences. Manual detection of lumen-intima, intima-media and media-adventitia vessel borders is the main activity of physicians in the process of plaque quantification. Large variety in vessel border descriptors, as well as, shades, artifacts and blurred response due to ultrasound physical properties troubles automated media-adventitia segmentation. This experimental work presents a solution to such a complex problem. The process blends advanced anisotropic filtering operators and statistic classification techniques, achieving an efficient vessel border modelling strategy. First of all, we introduce the theoretic base of the method. After that, we show the steps of the algorithm, validating the method with statistics that show that the media-adventitia border detection achieves an accuracy in the range of inter-observer variability regardless of plaque nature, vessel geometry and incomplete vessel borders. Finally, we present a little Matlab application to the automatic media-adventitia border.