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Carles Sanchez. (2014)." Tracheal Structure Characterization using Geometric and Appearance Models for Efficient Assessment of Stenosis in Videobronchoscopy" (F. Javier Sanchez, Debora Gil, & Jorge Bernal, Eds.). Ph.D. thesis, Ediciones Graficas Rey, .
Abstract: Recent advances in endoscopic devices have increased their use for minimal invasive diagnostic and intervention procedures. Among all endoscopic modalities, bronchoscopy is one of the most frequent with around 261 millions of procedures per year. Although the use of bronchoscopy is spread among clinical facilities it presents some drawbacks, being the visual inspection for the assessment of anatomical measurements the most prevalent of them. In
particular, inaccuracies in the estimation of the degree of stenosis (the percentage of obstructed airway) decreases its diagnostic yield and might lead to erroneous treatments. An objective computation of tracheal stenosis in bronchoscopy videos would constitute a breakthrough for this non-invasive technique and a reduction in treatment cost.
This thesis settles the first steps towards on-line reliable extraction of anatomical information from videobronchoscopy for computation of objective measures. In particular, we focus on the computation of the degree of stenosis, which is obtained by comparing the area delimited by a healthy tracheal ring and the stenosed lumen. Reliable extraction of airway structures in interventional videobronchoscopy is a challenging task. This is mainly due to the large variety of acquisition conditions (positions and illumination), devices (different digitalizations) and in videos acquired at the operating room the unpredicted presence of surgical devices (such as probe ends). This thesis contributes to on-line stenosis assessment in several ways. We
propose a parametric strategy for the extraction of lumen and tracheal rings regions based on the characterization of their geometry and appearance that guide a deformable model. The geometric and appearance characterization is based on a physical model describing the way bronchoscopy images are obtained and includes local and global descriptions. In order to ensure a systematic applicability we present a statistical framework to select the optimal
parameters of our method. Experiments perform on the first public annotated database, show that the performance of our method is comparable to the one provided by clinicians and its computation time allows for a on-line implementation in the operating room.
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Aura Hernandez-Sabate, & Debora Gil. (2012). "The Benefits of IVUS Dynamics for Retrieving Stable Models of Arteries " In Yasuhiro Honda (Ed.), Intravascular Ultrasound (pp. 185–206). Intech.
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Aura Hernandez-Sabate. (2009). "Exploring Arterial Dynamics and Structures in IntraVascular Ultrasound Sequences " (Debora Gil, Ed.). Ph.D. thesis, Ediciones Graficas Rey, .
Abstract: Cardiovascular diseases are a leading cause of death in developed countries. Most of them are caused by arterial (specially coronary) diseases, mainly caused by plaque accumulation. Such pathology narrows blood flow (stenosis) and affects artery bio- mechanical elastic properties (atherosclerosis). In the last decades, IntraVascular UltraSound (IVUS) has become a usual imaging technique for the diagnosis and follow up of arterial diseases. IVUS is a catheter-based imaging technique which shows a sequence of cross sections of the artery under study. Inspection of a single image gives information about the percentage of stenosis. Meanwhile, inspection of longitudinal views provides information about artery bio-mechanical properties, which can prevent a fatal outcome of the cardiovascular disease. On one hand, dynamics of arteries (due to heart pumping among others) is a major artifact for exploring tissue bio-mechanical properties. On the other one, manual stenosis measurements require a manual tracing of vessel borders, which is a time-consuming task and might suffer from inter-observer variations. This PhD thesis proposes several image processing tools for exploring vessel dy- namics and structures. We present a physics-based model to extract, analyze and correct vessel in-plane rigid dynamics and to retrieve cardiac phase. Furthermore, we introduce a deterministic-statistical method for automatic vessel borders detection. In particular, we address adventitia layer segmentation. An accurate validation pro- tocol to ensure reliable clinical applicability of the methods is a crucial step in any proposal of an algorithm. In this thesis we take special care in designing a valida- tion protocol for each approach proposed and we contribute to the in vivo dynamics validation with a quantitative and objective score to measure the amount of motion suppressed.
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Antonio Esteban Lansaque. (2019)." An Endoscopic Navigation System for Lung Cancer Biopsy" (Debora Gil, & Carles Sanchez, Eds.). Ph.D. thesis, Ediciones Graficas Rey, .
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.
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