Virtual radial-probe endobronchial ultrasound for image-guided bronchoscopy

To diagnose peripheral lung tumors, bronchoscopy is recommended for tissue sampling. Because most peripheral target regions of interest reside outside the airways, during bronchoscopy radial probe endobronchial ultrasound (RP-EBUS) is often used to provide extraluminal information and assist in locating biopsy sites. RP-EBUSguided transbronchial needle aspiration (TBNA) has demonstrated its potential over conventional TBNA to improve the diagnostic yield of peripheral pulmonary nodule biopsy. Meanwhile, image-guided bronchoscopy systems have been introduced to enable better planning and navigation. Currently, the physician has to deal with two disconnected imaging domains during live bronchoscopy; i.e., an image-guided system and RP-EBUS. The state-of-the-art image-guided bronchoscopy systems provide no guidance for RP-EBUS and biopsy targeting during live bronchoscopy, which is needed for accurate diagnosis of peripheral pulmonary nodules. To fill this gap, we expand the concept of virtual bronchoscopy (VB) in image-guided bronchoscopy systems and build a virtual RP-EBUS model to simulate the RP-EBUS probe in the computed-tomography (CT)-based virtual chest space. Results with human patient data illustrate the synchronized visualization of the virtual RP-EBUS model with the 3D chest model.