Image Guided Endoscopy Application

1
Image Guided Endoscopy Application

• Members Monica Vajani
• Robbie Sutkay
• Brian Stowe

Mentors Dr. Parag Parikh Dr. Marty Mayse
2
Background

• Lung cancer is a leading cause of cancer death in
  the US
• More than 150,000 solitary pulmonary nodules
  (SPNs) are reported annually in the US
• Less than 3-4 cm in diameter (no larger than 6
  cm)
• 60 of all SPNs are benign (not cancerous).

3
CT scans and Fluoroscopy

• A chest CT scan is often performed to evaluate a
  solitary pulmonary nodule in detail.
• Uses a computer and a rotating x-ray device to
  create detailed, cross-sectional images, or
  slices, of organs and body parts.
• About 1,000 profiles are taken in one rotation
• Each profile is analyzed by computer
• Full set of profiles from each rotation is
  compiled to form a two-dimensional image.

• Fluoroscopy is often used to locate pulmonary
  nodules
• Continuous x-ray beam is passed through the body
  part being examined
• A dye or contrast substance may be injected into
  the IV line in order to better visualize the
  structure being studied.
• Less accurate than a CT scan
• Used to detect internal movement

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Problem

• Biopsy is needed

• Bronchoschopy

• Needle Biopsy

• Inserted through the mouth or nose, then slowly
  passed down into the trachea and bronchi
• Too large to penetrate past trachea

• Memorize location using CT data

http//www.nlm.nih.gov/medlineplus/ency/images/enc
y/fullsize/9761.jpg
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Problem

• Fluoroscopy
• Shows a 2-D real-time X-Ray
• Nodules are three-dimensional
• Does not recognize masses smaller than 2cm
• Success rate of reaching lesions in the periphery
  35
• False negatives (50)

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Existing Solutions superDimension

• A flexible catheter with 360 degree steering
  capability (US 7,233,820)
• Catheter tip has a sensor
• Accurate up to 1 mm
• Samples over 150 times/sec
• High signal-to-noise ratio
• Localization board generates an electromagnetic
  field (Journal of Bronchology Vol 12, Number 3,
  July 2005)
• Sensor is activated once it enters EM field
• Wirelessly tracked by board as it moves through
  the patient
• Displayed on 3D CT Roadmap
• Bronchoscopic - compatible

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superDimension Benefits

• Non - invasive
• Many patients are elderly and fragile
• Low cost (70,000/unit, 700-900 for
  disposables)
• Higher accuracy earlier detection

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Preliminary Analysis of Improvements

• Localization board
• Minimum accuracy .27 mm X, .36 mm Y, .48 mm
  Z
• 4D CT Scan
• Scans at 1.5 mm intervals
• 21 gauge needle
• Diameter .8128 mm
• Apparatus and method for equalizing histogram of
  an image (No. 10087831, 3/5/2002)
• Account for biomechanical forces friction

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Bronchoscopy Specifications

• Reach 85 of the lungs
• Have a success rate of 75 (Success defined as
  obtaining a portion of the correct tissue mass)
• 1 mm accuracy obtaining a biopsy
• Observation Range 0.1 5 cm
• Field of View 120
• Flexible Portion Diameter 0.49cm
• Location sensor on tip 1 mm large
• System cost 70,000
• Catheter length of 90 cm (60 cm working length)
• Dimensions 35cm x 7.5cm x 42cm
• Weight 8 kg
• Power 120V 60Hz 0.36A

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Design Schedule
24 Sep First Oral Report (Monica) 28 Sep Watch
Bronchoscopy 1 Oct Written Report (Whole
team) 10 Oct Webpage submission 18 Oct Design
Solidified 22 Oct 2nd Oral Report (Robbie) 29
Oct 1st Written Report Due 31 Oct Risk
Assessment / DesignSafe 5 Dec Final Oral
Report (Brian) 5 Dec 2nd Written Report Due 12
Dec Poster Symposium
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Organization of Our Team
12
References

• Dvorin, Nancy. superDimension Guided
  Bronchoscopy to the Lungs Periphery.Windhover
  Information 10 (2005)
• Gildea, Thomas. "Electromagnetic Navigation
  Diagnostic Bronchoscopy A Prospective Study."
  American Journal of Critical Care and Respiration
  2(2006)
• Becker, Heinrich D.,Bronchoscopic Biopsy of
  Peripheral Lung Lesion Under Electromagnetic
  Guidance A Pilot Study. The Journal of
  Bronchology 12 (2003)
• Computed Tomography (CT) Body 23 Sep 2007
  lthttp//www.radiologyinfo.org/en/info.cfm?pgbodyc
  tbhcp1.gt
• Computed Tomography (CT) Scan of the Body 21
  Sep 2007 lthttp//www.webmd.com/a-to-z-guides/Compu
  ted-Tomography-CT-Scan-of-the-Body.gt