Abstract: Background: Bronchoscopy is a safe technique for diagnosing peripheral pulmonary lesions (PPLs), and virtual bronchoscopic navigation (VBN) helps guide the bronchoscope to PPLs. Objectives: We aimed to compare the diagnostic yield of VBN-guided and unguided ultrathin bronchoscopy (UTB) and explore clinical and technical factors associated with better results. We developed a diagnostic algorithm for deciding whether to use VBN to reach PPLs or choose an alternative diagnostic approach. Methods: We compared diagnostic yield between VBN-UTB (prospective cases) and unguided UTB (historical controls) and analyzed the VBN-UTB subgroup to identify clinical and technical variables that could predict the success of VBN-UTB. Results: Fifty-five cases and 110 controls were included. The overall diagnostic yield did not differ between the VBN-guided and unguided arms (47 and 40%, respectively; p = 0.354). Although the yield was slightly higher for PPLs ≤20 mm in the VBN-UTB arm, the difference was not significant (p = 0.069). No other clinical characteristics were associated with a higher yield in a subgroup analysis, but an 85% diagnostic yield was observed when segmentation was optimal and the PPL was endobronchial (vs. 30% when segmentation was suboptimal and 20% when segmentation was optimal but the PPL was extrabronchial). Conclusions: VBN-guided UTB is not superior to unguided UTB. A greater impact of VBN-guided over unguided UTB is highly dependent on both segmentation quality and an endobronchial location of the PPL. Segmentation quality should be considered before starting a procedure, when an alternative technique that may improve yield can be chosen, saving time and resources.

Abstract: This study shows the generation process and the subsequent study of the representation space obtained by extracting GLCM texture features from computer-aided tomography (CT) scans of pulmonary nodules (PN). For this, data from 92 patients from the Germans Trias i Pujol University Hospital were used. The workflow focuses on feature extraction using Pyradiomics and the VGG16 Convolutional Neural Network (CNN). The aim of the study is to assess whether the data obtained have a positive impact on the diagnosis of lung cancer (LC). To design a machine learning (ML) model training method that allows generalization, we train SVM and neural network (NN) models, evaluating diagnosis performance using metrics defined at slice and nodule level.

Abstract: The usage of medical images is part of the clinical daily in several healthcare centers around the world. Particularly, Computer Tomography (CT) images are an important key in the early detection of suspicious lung lesions. The CT image exploration allows the detection of lung lesions before any invasive procedure (e.g. bronchoscopy, biopsy). The effective localization of lesions is performed using different image processing and computer vision techniques. Lately, the usage of deep learning models into medical imaging from detection to prediction shown that is a powerful tool for Computer-aided software. In this paper, we present an approach to localize pulmonary lung lesion using fuzzy deep learning. Our approach uses a simple convolutional neural network based using the LIDC-IDRI dataset. Each image is divided into patches associated a probability vector (fuzzy) according their belonging to anatomical structures on a CT. We showcase our approach as part of a full CAD system to exploration, planning, guiding and detection of pulmonary lesions.

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.

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.