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Image-guided system for radial-probe endobronchial ultrasound bronchoscopy

During the diagnosis of peripheral pulmonary lesions (PPLs), radial-probe endobronchial ultrasound (RP-EBUS) is often used in combination with bronchoscopy to visualize extraluminal structures and confirm lesion sites. However, due to the steep learning curve, a physician’s ability to use RP-EBUS varies greatly in practice. On another front, image-guided bronchoscopy systems are now commonly used to assist with bronchoscopy planning and guidance.1 A procedure plan is first generated from the patient’s CT scan consisting of airway routes leading to each target lesion. Next, during live bronchoscopy, the system helps navigate the bronchoscope along the preplanned airway route close to the target lesion. However, there is no direct modality linkage and guidance between RP-EBUS and the guidance system during image-guided bronchoscopy. We now propose a multimodal image-guided methodology for guiding RP-EBUS consisting of two parts: 1) a CT-based procedure planning method that enables optimal RP-EBUS invocation, localization, preview, and RP-EBUS video simulation. 2) an intra-operative guidance system tailored to RP-EBUS localization of PPLs. We present results demonstrating the proposed system.