title: A bronchoscopic navigation system using bronchoscope center calibration for accurate registration of electromagnetic tracker and CT volume without markers.
abstract: OBJECTIVE
  Various bronchoscopic navigation systems are developed for diagnosis, staging, and treatment of lung and bronchus cancers. To construct electromagnetically navigated bronchoscopy systems, registration of preoperative images and an electromagnetic tracker must be performed. This paper proposes a new marker-free registration method, which uses the centerlines of the bronchial tree and the center of a bronchoscope tip where an electromagnetic sensor is attached, to align preoperative images and electromagnetic tracker systems.
  
  
  METHODS
  The chest computed tomography (CT) volume (preoperative images) was segmented to extract the bronchial centerlines. An electromagnetic sensor was fixed at the bronchoscope tip surface. A model was designed and printed using a 3D printer to calibrate the relationship between the fixed sensor and the bronchoscope tip center. For each sensor measurement that includes sensor position and orientation information, its corresponding bronchoscope tip center position was calculated. By minimizing the distance between each bronchoscope tip center position and the bronchial centerlines, the spatial alignment of the electromagnetic tracker system and the CT volume was determined. After obtaining the spatial alignment, an electromagnetic navigation bronchoscopy system was established to real-timely track or locate a bronchoscope inside the bronchial tree during bronchoscopic examinations.
  
  
  RESULTS
  The electromagnetic navigation bronchoscopy system was validated on a dynamic bronchial phantom that can simulate respiratory motion with a breath rate range of 0-10 min(-1). The fiducial and target registration errors of this navigation system were evaluated. The average fiducial registration error was reduced from 8.7 to 6.6 mm. The average target registration error, which indicates all tracked or navigated bronchoscope position accuracy, was much reduced from 6.8 to 4.5 mm compared to previous registration methods.
  
  
  CONCLUSIONS
  An electromagnetically navigated bronchoscopy system was constructed with accurate registration of an electromagnetic tracker and the CT volume on the basis of an improved marker-free registration approach that uses the bronchial centerlines and bronchoscope tip center information. The fiducial and target registration errors of our electromagnetic navigation system were about 6.6 and 4.5 mm in dynamic bronchial phantom validation.
authors.affiliation: Robarts Research Institute, Western University, London, Ontario N6A 5K8, Canada.
authors.forename: Xiongbiao
authors.initials: X
authors.lastname: Luo
mesh_terms: D001980:Bronchi / Q000601:surgery; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods*; D002138:Calibration; D055590:Electromagnetic Phenomena; D004867:Equipment Design; D006801:Humans; D008954:Models, Biological; D009038:Motion; D019047:Phantoms, Imaging; D012119:Respiration; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*