SBIR-STTR Award

To improve the care of lung-cancer patients, we propose to prototype a computer-based multimedia reporting system. This system, dubbed the 3D Reporter, will enable a physician to construct a multimedia case report of a patient's three-dimensional (3D) X-ray computer-tomography (CT) chest scan. The 3D Reporter draws upon recent innovations in virtual endoscopy, image processing, and computer graphics. This Phase-I project's aims are as follows: (1) prototype the 3D Reporter's main interactive visualization system; (2) devise a 3D path-planning tool that helps build a case report with the interactive system; and (3) conceive the Phase-Il proposal and product development plan. Early efforts assert the basic technology's utility for 3D CT assessment and bronchoscopic procedure planning. The proposed 3D Reporter could enable much easier and more complete 3D CT image assessment. Also, the multimedia report generated by the 3D Reporter could provide useful guidance during bronchoscopic interventions, such as transbronchial needle aspiration, stent design, and laser ablation. in the long run, the proposed system could have further use for complete early detection, staging, diagnosis and treatment of lung cancer. Also, specific protocols and products could be designed for stent design, lymph-node biopsy, solitary cancer-nodule treatment, and mediastinoscopy. PROPOSED COMMERCIAL APPLICATION: Lung Cancer is the leading cause of cancer death. This is true, despite the existence of early assessment devices such as high-resolution 3D computer-tomography (CT) scanners and videobronchoscopes. Since hundreds of thousands of CT scans (cost: $600 each) and bronchoscopies (cost: $1,500) are done yearly, our proposed system has considerable market potential. It could conceivably marke rapid, accurate, in-depth 3D CT scan reading feasible and permit the construction of detailed bronchoscopy treatment plans. This can improve early detection and reduce the cost of lung-cancer management.

This Phase-II SBIR project is in response to PAR-01-102, "Development of Novel Technologies for In Vivo Imaging." Expanding upon our Phase-I feasibility effort, we propose to construct and validate a complete workstation - the Virtual Navigator- for 3D MDCT-based planning and guidance of bronchoscopic biopsy. Lung cancer is the most common cause of cancer death in the western nations, with the current 5-year survival rate under 15%. Despite continued technological improvements, the lung-cancer mortality rate actually increased 11% between 1979 and 1997. The state-of-the-art procedure for diagnosing and staging lung cancer involves three-dimensional (3D) multi-detector computed-tomography (MDCT) scanning followed by bronchoscopic biopsy. Unfortunately, a high percentage of biopsy procedures are unsuccessful because of the: (1) lack of procedure-planning tools, (2) difficulty in seeing biopsy sites during bronchoscopy, and (3) wide range in physician skill level. The project is driven by the following hypothesis: A computer-based system, enabling 3D MDCT-based procedure planning and follow-on image-guided bronchoscopy, can improve current procedures for the staging, diagnosis, and treatment of lung cancer. The specific aims are as follows. Aim 1: Devise automated methods for MDCT-based procedure planning and image-guided bronchoscopy, thereby enabling more effective biopsy planning and subsequent bronchoscopic biopsy. Aim 2: Prototype a workstation for the interactive planning and guidance of bronchoscopy, thereby providing the physician with a user-friendly system for image-guided bronchoscopy. Aim 3: Perform human studies to establish system functionality and to compare the system to standard practice.These studies, which focus on the bronchoscopic biopsy of suspect mediastinal lymph nodes and peripheral nodules, give a preliminary clinical evaluation and motivate later Phase-Ill and FDA 510K tests. Since the current techniques for diagnosing and staging lung cancer are unsatisfactory, it is critical that accurate tools become available for assessing lung cancer. Further, the impact of therapy and treatment remains largely unchanged over the last twenty years. The image-guided methods featured by the proposed system could make possible the accurate delivery of agents directly into the lung tumor nodule or into involved lymph nodes. With the Virtual Navigator, bronchoscopies can be planned better, more difficult sites can be biopsied, and fewer unsuccessful biopsies will be done. These benefits reduce the need for follow-up procedures, reducing cost and gaining time toward successful treatment, or, stated differently, improve the early diagnosis, staging, and treatment of lung cancer.

Thesaurus Terms:
bronchoscopy, computed axial tomography, computer assisted diagnosis, computer system design /evaluation, interactive multimedia, lung imaging /visualization /scanning, lung neoplasm, neoplasm /cancer diagnosis computer human interaction, computer program /software, endoscopy, pneumoradiography bioimaging /biomedical imaging, clinical research, human subject