3D endobronchial ultrasound reconstruction and analysis for multimodal image-guided bronchoscopy

State-of-the-art image-guided intervention (IGI) systems for lung-cancer management draw upon high-resolution three-dimensional multi-detector computed-tomography (MDCT) images and bronchoscopic video. An MDCT scan provides a high-resolution three-dimensional (3D) image of the chest that is used for preoperative procedure planning, while bronchoscopy gives live intraoperative video of the endobronchial airway tree structure. However, because neither source provides live extraluminal information on suspect nodules or lymph nodes, endobronchial ultrasound (EBUS) is often introduced during a procedure. Unfortunately, existing IGI systems provide no direct synergistic linkage between the MDCT/video data and EBUS data. Hence, EBUS proves difficult to use and can lead to inaccurate interpretations. To address this drawback, we present a prototype of a multimodal IGI system that brings together the various image sources. The system enables 3D reconstruction and visualization of structures depicted in the 2D EBUS video stream. It also provides a set of graphical tools that link the EBUS data directly to the 3D MDCT and bronchoscopic video. Results using phantom and human data indicate that the new system could potentially enable smooth natural incorporation of EBUS into the system-level work flow of bronchoscopy.