Abstract: Endoscopic estimation of the degree of stenosis in central airway obstruction is subjective and highly variable. Objective: To determine the benefits of using SENSA (System for Endoscopic Stenosis Assessment), an image-based computational software, for obtaining objective stenosis index (SI) measurements among a group of expert bronchoscopists and general pulmonologists. Methods: A total of 7 expert bronchoscopists and 7 general pulmonologists were enrolled to validate SENSA usage. The SI obtained by the physicians and by SENSA were compared with a reference SI to set their precision in SI computation. We used SENSA to efficiently obtain this reference SI in 11 selected cases of benign stenosis. A Web platform with three user-friendly microtasks was designed to gather the data. The users had to visually estimate the SI from videos with and without contours of the normal and the obstructed area provided by SENSA. The users were able to modify the SENSA contours to define the reference SI using morphometric bronchoscopy. Results: Visual SI estimation accuracy was associated with neither bronchoscopic experience (p = 0.71) nor the contours of the normal and the obstructed area provided by the system (p = 0.13). The precision of the SI by SENSA was 97.7% (95% CI: 92.4-103.7), which is significantly better than the precision of the SI by visual estimation (p < 0.001), with an improvement by at least 15%. Conclusion: SENSA provides objective SI measurements with a precision of up to 99.5%, which can be calculated from any bronchoscope using an affordable scalable interface. Providing normal and obstructed contours on bronchoscopic videos does not improve physicians' visual estimation of the SI.

Abstract: Bronchoscopy biopsy can be used to diagnose lung cancer without risking complications of other interventions like transthoracic needle aspiration. During bronchoscopy, the clinician has to navigate through the bronchial tree to the target lesion. A main drawback is the difficulty to check whether the exploration is following the correct path. The usual guidance using fluoroscopy implies repeated radiation of the clinician, while alternative systems (like electromagnetic navigation) require specific equipment that increases intervention costs. We propose to compute the navigated path using anatomical landmarks extracted from the sole analysis of videobronchoscopy images. Such landmarks allow matching the current exploration to the path previously planned on a CT to indicate clinician whether the planning is being correctly followed or not. We present a feasibility study of our landmark based CT-video matching using bronchoscopic videos simulated on a virtual bronchoscopy interactive interface.

Abstract: Longitudinal motion during in vivo pullbacks acquisition of intravascular ultrasound (IVUS) sequences is a major artifact for 3-D exploring of coronary arteries. Most current techniques are based on the electrocardiogram (ECG) signal to obtain a gated pullback without longitudinal motion by using specific hardware or the ECG signal itself. We present an image-based approach for cardiac phase retrieval from coronary IVUS sequences without an ECG signal. A signal reflecting cardiac motion is computed by exploring the image intensity local mean evolution. The signal is filtered by a band-pass filter centered at the main cardiac frequency. Phase is retrieved by computing signal extrema. The average frame processing time using our setup is 36 ms. Comparison to manually sampled sequences encourages a deeper study comparing them to ECG signals.