Automated vision-based assistance tools in bronchoscopy: stenosis severity estimation

TL;DR

This paper introduces an automated, vision-based method for assessing subglottic stenosis severity during bronchoscopy, providing consistent, repeatable measurements without the need for CT scans, thus improving diagnosis efficiency and safety.

Contribution

It presents the first automated pipeline for stenosis severity estimation from bronchoscopy images, utilizing lumen segmentation and 3D modeling from a single frame.

Findings

Automated severity measurement aligns with CT and expert assessments.

Method demonstrates high repeatability across multiple estimations.

First public dataset and benchmark for subglottic stenosis assessment.

Abstract

Purpose: Subglottic stenosis refers to the narrowing of the subglottis, the airway between the vocal cords and the trachea. Its severity is typically evaluated by estimating the percentage of obstructed airway. This estimation can be obtained from CT data or through visual inspection by experts exploring the region. However, visual inspections are inherently subjective, leading to less consistent and robust diagnoses. No public methods or datasets are currently available for automated evaluation of this condition from bronchoscopy video. Methods: We propose a pipeline for automated subglottic stenosis severity estimation during the bronchoscopy exploration, without requiring the physician to traverse the stenosed region. Our approach exploits the physical effect of illumination decline in endoscopy to segment and track the lumen and obtain a 3D model of the airway. This 3D model is obtained from a single frame and is used to measure the airway narrowing. Results: Our pipeline is the first to enable automated and robust subglottic stenosis severity measurement using bronchoscopy images. The results show consistency with ground-truth estimations from CT scans and expert estimations, and reliable repeatability across multiple estimations on the same patient. Our evaluation is performed on our new Subglottic Stenosis Dataset of real bronchoscopy procedures data. Conclusion: We demonstrate how to automate evaluation of subglottic stenosis severity using only bronchoscopy. Our approach can assist with and shorten diagnosis and monitoring procedures, with automated and repeatable estimations and less exploration time, and save radiation exposure to patients as no CT is required. Additionally, we release the first public benchmark for subglottic stenosis severity assessment.