SYNERGISTIC CT BRONCHOSCOPY FOR LUNG CANCER ASSESSMENT

肺癌是导致成人癌症死亡的最常见原因。 然而，在对嫌疑人的评估方面并没有取得真正的进展 自纤维支气管镜技术发展以来的肺癌患者 上世纪70年代初的S和80年代初的CT扫描的S。以改善 对于肺癌患者的护理，这个项目旨在设计和 验证基于计算机的系统，3D导航器，将 结合三维(3D)高分辨率计算 体层摄影术(HRCT)和支气管镜检查。该项目是 由以下假设驱动： 3D HRCT成像、支气管镜检查和 图像处理改进了现有的基于HRCT的肺部检查程序 癌症评估。此外，在支气管镜检查期间，这种结合 工具允许更准确的评估和更高的活检产量。 3D导航器由一个基于计算机的系统组成， 与支气管镜对接。它用于初始HRCT评估 同时在支气管镜检查期间。该系统在 虚拟内窥镜的新概念：医生与 系统的可视化和量化工具，用于探索和评估 有罪不罚--患者3D HRCT所体现的“虚拟解剖” 扫描。在支气管镜检查中使用时，3D导航器-提供 医生的视力增强，潜在地增加了 手术成功。 妇女干预营养研究(WINS)是一项前瞻性的研究， 随机、多中心临床试验验证了这一假设 减少膳食脂肪摄入量作为标准乳腺癌的佐剂 治疗成功，手术成功。该项目的四个具体目标是 具体如下。目标1：构建3D导航器系统，包括 MALN软件与支气管镜接口。目标2：设计自动 用于三维HRCT胸部分析的图像处理方法 方法，帮助医生进行CT评估和 支气管镜检查计划，重点是病变/淋巴结检测， 航道分析、量化和“路线图”的计算 可疑的损伤部位。目标3：对于仅限CT的评估，验证3D 导航员与标准人类评估。目标4：验证 3D导航仪与支气管镜检查同时使用时。为了AIMS 3和4，进行了幻影、身体和人体研究；影响 还考虑了CT扫描方案的选择。从长远来看，我们 相信我们的工具组合，体现在3D中 导航器，将为早期提供更有效的手段 肺癌的检测、分期、诊断和治疗 传统方法采用CT和支气管镜检查。它也可以证明 适用于一般肺部疾病的评估和治疗 送货。最后，我们提出的视觉和定量方法 可以直接适用于其他内窥镜手术，如 作为纵隔镜检查、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).