SYNERGISTIC CT BRONCHOSCOPY FOR LUNG CANCER ASSESSMENT

肺癌是成人癌症死亡的最常见原因。 然而，在评估疑似癌症方面没有取得真实的进展。 自柔性支气管镜发展以来， 70年代早期的CT扫描和80年代早期的CT扫描。提高 肺癌患者的护理，该项目旨在设计和 验证一个基于计算机的系统，3D导航器， 三维（3D）高分辨率计算 高分辨率CT（HRCT）成像和支气管镜检查。该项目 由以下假设驱动： 3D HRCT成像、支气管镜检查和 图像处理改进了基于HRCT的肺的当前程序， 癌症评估此外，在支气管镜检查期间， 工具允许更准确的评估和更高的活检产量。 3D导航仪由一个基于计算机的系统组成， 连接到支气管镜。它用于初始HRCT评估 同时进行支气管镜检查。该系统扩展了 虚拟内窥镜的新概念：医生与 系统的可视化和定量工具来探索和评估， 有罪不罚，通过患者的3D HRCT体现的“虚拟解剖” 扫描.当在支气管镜检查期间使用时，3D导航器-提供 医生增强视力，可能会增加 成功的程序。 妇女干预营养研究（WMD）是一项前瞻性研究， 随机、多中心临床试验检验假设， 减少膳食脂肪摄入作为标准乳腺癌的辅助治疗 治疗成功的程序。 该项目的四个具体目标是 如下目标1：构建3D Navigator系统，包括 MALN软件和支气管镜接口。目标2：设计自动化 3D HRCT胸部分析的图像处理方法; 方法，协助医生进行CT评估， 支气管镜检查计划，重点关注病变/淋巴结检测， 气道分析、量化和“路线图”计算， 可疑病变部位。目标3：对于仅CT评估，确认3D 导航员与标准人类评估。目标4：消除 与支气管镜检查同时使用时的3D Navigator。为了目标 3和4，完成了体模、尸体和人体研究; 的CT扫描协议也被考虑。从长远看我们 相信我们在3D中体现的工具组合 导航仪，将提供一个更有效的手段， 肺癌的检测、分期、诊断和治疗 传统方法使用CT和支气管镜检查。这也可以证明 用于一般肺部疾病的评估和治疗 交付.最后，我们提出的可视化和定量方法， 可以直接应用于其它内窥镜手术 如纵隔镜检查、结肠镜检查（结直肠癌）和膀胱镜检查 （膀胱癌）。

Lung cancer is the most common cause of cancer death in adults. Yet, no real advances have been made in the evaluation of suspected lung-cancer patients since the development of flexible bronchoscopy in the early 1970's and CT scanning in the early 1980's. To improve the care of lung-cancer patients, this project seeks to devise and validate a computer-based system, the 3D Navigator, that ties together three-dimensional (3D)high-resolution computed tomographic (HRCT) imaging and bronchoscopy. The project is driven by the following hypothesis: A synergistic combination of 3D HRCT imaging, bronchoscopy, and image processing improves current procedures for HRCT-based lung- cancer assessment. Also, during bronchoscopy, this combination of tooLs permits more accurate assessment and higher biopsy yields. The 3D Navigator consists of a computer-based system that interfaces to a bronchoscope. It is used for initial HRCT assessment and concurrently during bronchoscopy. The system expands upon the new concept of virtual endoscopy: the physician interacts with the system's visual and quantitative tools to explore and evaluate, with impunity, the "virtual anatomy" embodied by a patient's 3D HRCT scan. When used during bronchoscopy, the 3D Navigator-gives the physician augmented vision, potentially increasing the likelihood of successful procedures. The women's Intervention Nutrition Study (WINS) is a prospective, randomized, multi-center clinical trIal testing the hypothesis that dietary fat intake reduction as an adjuvant to standard breast cancer therapy successful procedures. The project'S four specific aims are as follows. Aim 1: Construct the 3D Navigator system, including the maln software and bronchoscope interface. Aim 2: Devise automatic imageprocessing methods for 3D HRCT thoracic analysis; the methods, which assist the physician in CT assessment and bronchoscopy planning, focus on lesion/lymph-node detection, airway analysis, quantitation, and computation of "road maps" to suspect lesion sites. Aim 3: For CT-only assessment, validate the 3D Navigator versus standard human assessment. Aim 4: Validate the 3D Navigator when used concurrently with bronchoscopy. For aims 3 and 4, phantom, cadaver, and human studies are done; the impact of CT scanning protocol is also considered. In the long run, we believe that our combination of tools, as embodied in the 3D Navigator, will provide a more effective means for the early detection, staging, diagnosis, and treatment of lung cancer than the traditional approach using CT and bronchoscopy. It also could prove useful for general pulmonary disease assessment and treatment delivery. Finally, our proposed visual and quantitative methodology could have direct applicability to other endoscopic procedures such as mediastinoscopy, colonoscopy (colorectal cancer), and cystoscopy (bladder cancer).