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: 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: PURPOSE:
Lack of objective measurement of tracheal obstruction degree has a negative impact on the chosen treatment prone to lead to unnecessary repeated explorations and other scanners. Accurate computation of tracheal stenosis in videobronchoscopy would constitute a breakthrough for this noninvasive technique and a reduction in operation cost for the public health service.
METHODS:
Stenosis calculation is based on the comparison of the region delimited by the lumen in an obstructed frame and the region delimited by the first visible ring in a healthy frame. We propose a parametric strategy for the extraction of lumen and tracheal ring regions based on models of their geometry and appearance that guide a deformable model. To ensure a systematic applicability, we present a statistical framework to choose optimal parametric values and a strategy to choose the frames that minimize the impact of scope optical distortion.
RESULTS:
Our method has been tested in 40 cases covering different stenosed tracheas. Experiments report a non- clinically relevant [Formula: see text] of discrepancy in the calculated stenotic area and a computational time allowing online implementation in the operating room.
CONCLUSIONS:
Our methodology allows reliable measurements of airway narrowing in the operating room. To fully assess its clinical impact, a prospective clinical trial should be done.

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.