Interventional bronchoscopy provides a minimally invasive approach for diagnosis
and treatment of pulmonary diseases such as emphysema and pulmonary carcinoma. Abnormalities identified on chest X-ray computed tomography (CT) scans by using computer-aided diagnosis are often targetted in bronchoscopic intervention.
Recent advances in lung volume reduction (LVR) offer new therapies with much lower complication rates than open surgery for patients with emphysema. Image segmentation of the pulmonary lobes from CT scans to quantify
lobar volumes, and emphysema severity plays a pivotal role in treatment planning and post-operative assessment. The existing automatic lung lobe segmentation strategies are still vulnerable to anatomical variability due
to pathologies. Therefore, to assist lobar density analysis for emphysema patients, an interactive lung lobe segmentation program is developed. A validation study on a cohort of emphysema patients shows the reliability of the program by comparing with commercial software. Furthermore, automatic fi ssure segmentation is explored by adopting a surface growing approach
based on Bayesian network and fully convolutional neural networks.
The pulmonary lobe with the highest emphysema severity identifi ed in the lobar density analysis is usually targeted in the bronchoscopic LVR procedure. Navigation systems have been studied to assist camera localisation either with video-CT registration or electromagnetic tracking. Video-CT
registration is favoured due to easy setup and low cost. Nevertheless, the effect of illumination variations, image artefacts and airway deformation hinders its applicability in real clinical scenarios. Therefore, a video-CT
registration based on depth information is proposed to achieve more robustness
of camera localisation to illumination changes. A structure-preserving depth recovery method based on generative adversarial learning is developed to address partial occlusion due to image artefacts. Moreover, the tissue deformation is tackled by introducing an airway descriptor based on shape context. The proposed navigation approaches have been validated on
phantom data and in vivo data, and results show improved camera localisation accuracy, thus better clinical feasibility for bronchoscopic navigation.