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Marta Diez-Ferrer, Arturo Morales, Rosa Lopez Lisbona, Noelia Cubero, Cristian Tebe, Susana Padrones, et al. (2019). Ultrathin Bronchoscopy with and without Virtual Bronchoscopic Navigation: Influence of Segmentation on Diagnostic Yield . Respiration, 97(3), 252–258.
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.
Keywords: Lung cancer; Peripheral lung lesion; Diagnosis; Bronchoscopy; Ultrathin bronchoscopy; Virtual bronchoscopic navigation
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Marta Diez-Ferrer, Debora Gil, Cristian Tebe, & Carles Sanchez. (2018). "Positive Airway Pressure to Enhance Computed Tomography Imaging for Airway Segmentation for Virtual Bronchoscopic Navigation " . Respiration, 96(6), 525–534.
Abstract: Abstract
RATIONALE:
Virtual bronchoscopic navigation (VBN) guidance to peripheral pulmonary lesions is often limited by insufficient segmentation of the peripheral airways.
OBJECTIVES:
To test the effect of applying positive airway pressure (PAP) during CT acquisition to improve segmentation, particularly at end-expiration.
METHODS:
CT acquisitions in inspiration and expiration with 4 PAP protocols were recorded prospectively and compared to baseline inspiratory acquisitions in 20 patients. The 4 protocols explored differences between devices (flow vs. turbine), exposures (within seconds vs. 15-min) and pressure levels (10 vs. 14 cmH2O). Segmentation quality was evaluated with the number of airways and number of endpoints reached. A generalized mixed-effects model explored the estimated effect of each protocol.
MEASUREMENTS AND MAIN RESULTS:
Patient characteristics and lung function did not significantly differ between protocols. Compared to baseline inspiratory acquisitions, expiratory acquisitions after 15 min of 14 cmH2O PAP segmented 1.63-fold more airways (95% CI 1.07-2.48; p = 0.018) and reached 1.34-fold more endpoints (95% CI 1.08-1.66; p = 0.004). Inspiratory acquisitions performed immediately under 10 cmH2O PAP reached 1.20-fold (95% CI 1.09-1.33; p < 0.001) more endpoints; after 15 min the increase was 1.14-fold (95% CI 1.05-1.24; p < 0.001).
CONCLUSIONS:
CT acquisitions with PAP segment more airways and reach more endpoints than baseline inspiratory acquisitions. The improvement is particularly evident at end-expiration after 15 min of 14 cmH2O PAP. Further studies must confirm that the improvement increases diagnostic yield when using VBN to evaluate peripheral pulmonary lesions.
Keywords: Multidetector computed tomography; Bronchoscopy; Continuous positive airway pressure; Image enhancement; Virtual bronchoscopic navigation
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2017). "Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation " . European Respiratory Journal, .
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, & Samantha Aso. (2017). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation . Journal of Thoracic Oncology, 12(1S), S596–S597.
Abstract: A main weakness of virtual bronchoscopic navigation (VBN) is unsuccessful segmentation of distal branches approaching peripheral pulmonary nodules (PPN). CT scan acquisition protocol is pivotal for segmentation covering the utmost periphery. We hypothesize that application of continuous positive airway pressure (CPAP) during CT acquisition could improve visualization and segmentation of peripheral bronchi. The purpose of the present pilot study is to compare quality of segmentations under 4 CT acquisition modes: inspiration (INSP), expiration (EXP) and both with CPAP (INSP-CPAP and EXP-CPAP).
Keywords: Thorax CT; diagnosis; Peripheral Pulmonary Nodule
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Marta Diez-Ferrer, Debora Gil, Elena Carreño, Susana Padrones, Samantha Aso, Vanesa Vicens, et al. (2016). Positive Airway Pressure-Enhanced CT to Improve Virtual Bronchoscopic Navigation . Chest Journal, 150(4), 1003A.
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David Castells, Vinh Ngo, Juan Borrego-Carazo, Marc Codina, Carles Sanchez, Debora Gil, et al. (2022). "A Survey of FPGA-Based Vision Systems for Autonomous Cars " . IEEE Access, 10, 132525–132563.
Abstract: On the road to making self-driving cars a reality, academic and industrial researchers are working hard to continue to increase safety while meeting technical and regulatory constraints Understanding the surrounding environment is a fundamental task in self-driving cars. It requires combining complex computer vision algorithms. Although state-of-the-art algorithms achieve good accuracy, their implementations often require powerful computing platforms with high power consumption. In some cases, the processing speed does not meet real-time constraints. FPGA platforms are often used to implement a category of latency-critical algorithms that demand maximum performance and energy efficiency. Since self-driving car computer vision functions fall into this category, one could expect to see a wide adoption of FPGAs in autonomous cars. In this paper, we survey the computer vision FPGA-based works from the literature targeting automotive applications over the last decade. Based on the survey, we identify the strengths and weaknesses of FPGAs in this domain and future research opportunities and challenges.
Keywords: Autonomous automobile; Computer vision; field programmable gate arrays; reconfigurable architectures
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Jorge Bernal, F. Javier Sanchez, Gloria Fernandez Esparrach, Debora Gil, Cristina Rodriguez de Miguel, & Fernando Vilariño. (2015). "WM-DOVA Maps for Accurate Polyp Highlighting in Colonoscopy: Validation vs. Saliency Maps from Physicians " . Computerized Medical Imaging and Graphics, 43, 99–111.
Abstract: We introduce in this paper a novel polyp localization method for colonoscopy videos. Our method is based on a model of appearance for polyps which defines polyp boundaries in terms of valley information. We propose the integration of valley information in a robust way fostering complete, concave and continuous boundaries typically associated to polyps. This integration is done by using a window of radial sectors which accumulate valley information to create WMDOVA1 energy maps related with the likelihood of polyp presence. We perform a double validation of our maps, which include the introduction of two new databases, including the first, up to our knowledge, fully annotated database with clinical metadata associated. First we assess that the highest value corresponds with the location of the polyp in the image. Second, we show that WM-DOVA energy maps can be comparable with saliency maps obtained from physicians' fixations obtained via an eye-tracker. Finally, we prove that our method outperforms state-of-the-art computational saliency results. Our method shows good performance, particularly for small polyps which are reported to be the main sources of polyp miss-rate, which indicates the potential applicability of our method in clinical practice.
Keywords: Polyp localization; Energy Maps; Colonoscopy; Saliency; Valley detection
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Juan Borrego-Carazo, Carles Sanchez, David Castells, Jordi Carrabina, & Debora Gil. (2023). "BronchoPose: an analysis of data and model configuration for vision-based bronchoscopy pose estimation " . Computer Methods and Programs in Biomedicine, 228, 107241.
Abstract: Vision-based bronchoscopy (VB) models require the registration of the virtual lung model with the frames from the video bronchoscopy to provide effective guidance during the biopsy. The registration can be achieved by either tracking the position and orientation of the bronchoscopy camera or by calibrating its deviation from the pose (position and orientation) simulated in the virtual lung model. Recent advances in neural networks and temporal image processing have provided new opportunities for guided bronchoscopy. However, such progress has been hindered by the lack of comparative experimental conditions.
In the present paper, we share a novel synthetic dataset allowing for a fair comparison of methods. Moreover, this paper investigates several neural network architectures for the learning of temporal information at different levels of subject personalization. In order to improve orientation measurement, we also present a standardized comparison framework and a novel metric for camera orientation learning. Results on the dataset show that the proposed metric and architectures, as well as the standardized conditions, provide notable improvements to current state-of-the-art camera pose estimation in video bronchoscopy.
Keywords: Videobronchoscopy guiding; Deep learning; Architecture optimization; Datasets; Standardized evaluation framework; Pose estimation
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Juan Borrego-Carazo, Carles Sanchez, David Castells, Jordi Carrabina, & Debora Gil. (2022)." A benchmark for the evaluation of computational methods for bronchoscopic navigation" . International Journal of Computer Assisted Radiology and Surgery, 17(1).
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Sonia Baeza, Debora Gil, I.Garcia Olive, M.Salcedo, J.Deportos, Carles Sanchez, et al. (2022). "A novel intelligent radiomic analysis of perfusion SPECT/CT images to optimize pulmonary embolism diagnosis in COVID-19 patients " . EJNMMI Physics, 9(1, Article 84), 1–17.
Abstract: Background: COVID-19 infection, especially in cases with pneumonia, is associated with a high rate of pulmonary embolism (PE). In patients with contraindications for CT pulmonary angiography (CTPA) or non-diagnostic CTPA, perfusion single-photon emission computed tomography/computed tomography (Q-SPECT/CT) is a diagnostic alternative. The goal of this study is to develop a radiomic diagnostic system to detect PE based only on the analysis of Q-SPECT/CT scans.
Methods: This radiomic diagnostic system is based on a local analysis of Q-SPECT/CT volumes that includes both CT and Q-SPECT values for each volume point. We present a combined approach that uses radiomic features extracted from each scan as input into a fully connected classifcation neural network that optimizes a weighted crossentropy loss trained to discriminate between three diferent types of image patterns (pixel sample level): healthy lungs (control group), PE and pneumonia. Four types of models using diferent confguration of parameters were tested.
Results: The proposed radiomic diagnostic system was trained on 20 patients (4,927 sets of samples of three types of image patterns) and validated in a group of 39 patients (4,410 sets of samples of three types of image patterns). In the training group, COVID-19 infection corresponded to 45% of the cases and 51.28% in the test group. In the test group, the best model for determining diferent types of image patterns with PE presented a sensitivity, specifcity, positive predictive value and negative predictive value of 75.1%, 98.2%, 88.9% and 95.4%, respectively. The best model for detecting
pneumonia presented a sensitivity, specifcity, positive predictive value and negative predictive value of 94.1%, 93.6%, 85.2% and 97.6%, respectively. The area under the curve (AUC) was 0.92 for PE and 0.91 for pneumonia. When the results obtained at the pixel sample level are aggregated into regions of interest, the sensitivity of the PE increases to 85%, and all metrics improve for pneumonia.
Conclusion: This radiomic diagnostic system was able to identify the diferent lung imaging patterns and is a frst step toward a comprehensive intelligent radiomic system to optimize the diagnosis of PE by Q-SPECT/CT.
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