Automatic procedure planning for radial-probe endobronchial ultrasound

The examination of suspicious peripheral pulmonary lesions (PPLs) is an important part of lung cancer diagnosis. The physician performs bronchoscopy and then employs radial-probe endobronchial ultrasound (RP-EBUS) to examine and biopsy suspect lesions. Physician skill, however, plays a significant part in the success of these procedures. This has driven the introduction of image-guided bronchoscopy systems. Yet, while such systems enable route planning through the airways to reach a desired region of interest (ROI), the route does not come with the appropriate device maneuvers crucial for instructing the physician on how to use the bronchoscope and the R-EBUS probe during the procedure. Our recently proposed image-guided bronchoscopy system, the Multimodal Virtual Navigation System (MVNS), does offer such instructions for the devices involved. Unfortunately, the system relies on a time-consuming, error-prone, manual approach to generate these device maneuvers. We propose an automatic approach for creating a complete set of device maneuvers for both the bronchoscope and the R-EBUS probe, fully integrating it into the MVNS in the process. Results show that planning the device maneuvers, which previously took on the order of 5 minutes or more per ROI, is reduced to under one second.