Pulmonary Analysis and Reporting System

Abstract

A system, method, and executable program for providing lung candidate information to a medical professional. The method includes receiving three-dimensional image data classified as lobe voxels, airway voxels, or pulmonary fissure voxels. A fissure completeness score is generated for the pulmonary fissure voxels. A first oblique perspective view of the classified lobe voxels, the classified airway voxels, and the classified pulmonary fissure voxels is generated based on a first perspective. The first oblique view of the pulmonary fissure voxels includes a visual representation of the fissure completeness based on the generated fissure completeness score for the corresponding voxels. A report is generated including the generated view. The report is output.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of priority to U.S. Provisional Patent Application No. 63 / 259,906, filed June 16, 2021, which is incorporated herein by reference in its entirety. [Background technology]

[0002] Analysis of patients' high-resolution computed tomography (HRCT) information and quantitative computed tomography (QCT) results is critical for successful patient outcomes. To ensure the success of bronchoscopically guided lung volume reduction (BLVR) procedures, reliable key measurements of emphysema severity, fissure integrity, and heterogeneity are necessary to enable physicians to quickly and confidently identify target lobes and potential treatment candidates. [Prior art documents] [Non-patent literature]

[0003] [Non-Patent Document 1] Strange C., Herth, FJ, Kovitz, KL, McLennan, G, Ernst, A, Goldin J, et al., Design of the Endobronchial Valve for Emphysema Palliation Trial(VENT): a nonsurgical method of lung volume reduction, BMC Pulm Med. June 3, 2007, 7:10 [Non-patent document 2] Brown, MS, Ochs, R, Abtin, F, Ordookhani, A, Brown, M, Kim, H, Shaw, G, Chong, D, Goldin, J. Automated Quantitative Assessment of Lung Fissure Integrity on CT. Proceedings of the First International Workshop on Pulmonary Image Analysis, New York, USA, 2008, pp. 93-102. Summary of the Invention [Means for solving the problem]

[0004] The present disclosure provides systems, methods, and executable programs for providing pulmonary candidate information to medical professionals.

[0005] In an exemplary embodiment, the method includes receiving three-dimensional image data of at least a portion of a lung having a pulmonary fissure, the three-dimensional image data including voxels; classifying the voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels; generating a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range; generating a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generating a first oblique view of the classified airway voxels based on the first viewpoint; and generating a first oblique view of the classified pulmonary fissure voxels associated with a first one of the pulmonary fissures based on the first viewpoint, wherein the first oblique view of the pulmonary fissure voxel includes a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated view; and outputting the report.

[0006] In another exemplary embodiment, a system includes a processing device, a memory, and an output device. The memory is configured to store computer-readable instructions configured to cause the processing device to receive three-dimensional image data of at least a portion of a lung having pulmonary fissures, classify voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels, generate a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range, generate a first oblique perspective view of the classified lobe voxels based on a first viewpoint, generate a first oblique view of the classified airway voxels based on the first viewpoint, and generate a first oblique view of the classified pulmonary fissure voxel associated with a first one of the pulmonary fissures based on the first viewpoint, wherein the first oblique view of the pulmonary fissure voxel includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel, and generate a report including the generated views. an output device in signal communication with the processing device, the output device configured to output a report;

[0007] In another exemplary embodiment, a non-transitory computer-readable recording medium having an executable program stored thereon is configured to cause a processor to: receive three-dimensional image data of at least a portion of a lung having pulmonary fissures, the three-dimensional image data including voxels; classify the voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels; generate a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range; generate a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generate a first oblique view of the classified airway voxels based on the first viewpoint; generate a first oblique view of the classified pulmonary fissure voxels associated with a first one of the pulmonary fissures based on the first viewpoint, the first oblique view of the pulmonary fissure voxels including a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel; and generate a first oblique perspective view of the classified lobe voxels based on a second viewpoint. generating a second oblique perspective view; generating a second oblique view of the classified airway voxels based on the second viewpoint; generating a second oblique view of the classified pulmonary fissure voxels associated with a second one of the pulmonary fissures based on the second viewpoint, the second oblique view of the pulmonary fissure voxels associated with a second one of the pulmonary fissures including a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a third oblique perspective view of the classified pulmonary lobe voxels based on a third viewpoint; generating a third oblique view of the classified airway voxels based on the third viewpoint; generating a third oblique view of the classified pulmonary fissure voxels associated with a third one of the pulmonary fissures based on the third viewpoint, the third oblique view of the pulmonary fissure voxels associated with a third one of the pulmonary fissures including a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated views; and outputting the report.

[0008] Further features, advantages and areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are for purposes of illustration only and are not intended to limit the scope of the present disclosure.

[0009] The drawings described herein are for illustrative purposes only and are not intended to limit the scope of the present disclosure in any way. The components in the drawings are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention. [Brief explanation of the drawings]

[0010] [Figure 1] 1 is a block diagram of an exemplary system formed in accordance with one embodiment of the present invention; [Figure 2] FIG. 2 is a flow diagram of an exemplary process performed by at least the system of FIG. 1. [Figure 3] 3 is an image of a report generated by the system of FIG. 1 according to the process shown in FIG. 2. [Figure 4] 2 is an image of a report generated by the system of FIG. 1. [Figure 5] Figure 4 is an image of part of the report. [Figure 6] FIG. 2 is a flow diagram of an exemplary process performed by at least the system of FIG. 1. DETAILED DESCRIPTION OF THE INVENTION

[0011] The following description is merely exemplary in nature and is not intended to limit the present disclosure, its application, or uses. The following description describes, by way of example only, and not by way of limitation, various embodiments of devices and methods for analyzing and providing comprehensive reports for use in determining candidacy of lung lobes for pending bronchoscopic-guided lung volume reduction (BLVR) procedures.

[0012] One embodiment describes a process for automating, displaying, interacting with, and characterizing aspects of the lung. When a human lung is imaged in vivo by an image acquisition device, the image can be reconstructed and evaluated to depict normal and pathological conditions. Due to different subclasses of disease and different depictions (phenotypes) of disease entities, evaluation of the lung lobule regions and the fissures separating them is important for accurately characterizing the disease and predicting response to BLVR treatment.

[0013] The present disclosure includes systems and methods that provide visualization of values ​​related to lung lobes, fissure completeness, and emphysema extent in an automated manner that enables clinical decision making.

[0014] The left and right lungs are each divided into multiple lobes by deep fissures, or interlobar fissures, referred to herein simply as fissures. The exterior of the lungs is covered by a pleura, including an inner layer, the visceral pleura, which penetrates into the fissures to surround the lobes. Thus, the fissures are the junctions between the lobes of the lung, defined by the outermost surface of the lobe and the visceral pleura where the lobes abut. Thus, the fissures themselves are actually the interfaces between abutting lobes, but are rather a very thin layer of lobe interface that can be detected on volumetric images and interpreted as fissures. The right lung contains three lobes (upper, middle, and lower) divided by two fissures known as the oblique and horizontal fissures. The left lung contains two lobes (upper and lower) with one fissure, the oblique fissure, between them.

[0015] The edges of the lobes and the pleura surrounding the lobes define fissures, separating the lobes so that the ventilation of each lobe is separate from the ventilation of adjacent lobes. Additionally, the pleura normally forms a smooth surface, allowing abutting lobes to slide over one another during inspiration and expiration. However, in certain pathologies, the pleura may thicken or adhere. Additionally, abutting lobes may adhere to one another, resulting in loss of the pleural and lung edges that normally define the fissures. Fissures are described by a level of completeness, below which air may flow between the lobes. Various embodiments described herein use volumetric radiographic images to identify the completeness of fissures and visually present them in 2D images.

[0016] FIG. 1 illustrates an exemplary lung visualization system 10, which may include a processing device 40, such as a processor in a computer, and an output device 42, such as a visual display (monitor or screen) or a printing device. The system 10 may also include instructions contained in software (a computer-readable medium) stored in memory 44 of the system 10 and operable on / by the processing device 40. The software may include instructions for the processing device 40 to perform the various steps and methods described herein, including instructions for receiving patient data, including volumetric image data, from data sources 20, which may be connected to the processing device 40 via a public and / or private data network 30, analyzing the data to characterize the lungs, and generating resultant images from the analysis of the image data. The generated images may be transmitted via the data network 30 to a customer's computing device or output in physical form and delivered to the customer.

[0017] Example embodiments may be implemented using a combination of hardware, firmware, and / or software. For example, in many cases, some or all of the functionality provided by the examples may be implemented in executable software instructions that can be executed on a programmable computer processor. Similarly, some examples of the present invention include a computer-readable storage device on which such executable software instructions are stored. In certain examples, the system processor itself may include instructions for performing one or more tasks. System processing power is not limited to any particular configuration, and those skilled in the art will understand that the teachings provided herein may be implemented in several different ways.

[0018] 2 shows a flowchart of a lung characterization and visualization method 60 that may be implemented, for example, using software as part of system 10. In block 64, volumetric radiographic or image data of a patient is transmitted from data source 20 to processing device 40. The volumetric radiographic or image data may be a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, and / or a positron emission tomography (PET) scan, from which a series of two-dimensional planar images (referred to herein as two-dimensional volumetric images or two-dimensional images) can be generated in multiple planes. In block 66, the lungs, airways, and / or blood vessels are segmented using the received image data. Methods for performing lung, airway, and vessel segmentation from volumetric or image data may be methods described in various research papers (e.g., Strange C., Herth FJ, Kovitz KL, McLennan G, Ernst A, Goldin J et al., Design of the Endobronchial Valve for Emphysema Palliation Trial (VENT): a nonsurgical method of lung volume reduction, BMC Pulm Med. June 3, 2007, 7:10). Lung, airway, and vessel segmentation results in the identification of lung tissue, airways, and vessels as distinct from surrounding tissue and the separation of the lungs, airways, and vessels into smaller, distinct portions that can be individually identified according to standard lung anatomy. Lung lobes are then delineated from the separated data. In block 68, an emphysema score is generated for each lobe based on the Hounsfield Unit (i.e., radiodensity (HU)) value of each voxel in the lobe data for the lobe of interest. In one embodiment, the emphysema score is determined as the percentage of emphysema in a lobe, calculated by determining what percentage of lobe voxels have Hounsfield unit values ​​below a threshold amount (e.g., −920 HU) or within a range of Hounsfield unit values.In block 70, a fissure completeness value is generated for each of the three fissures based on the analysis of the image data. An exemplary method for calculating the fissure completeness value is described in Brown, MS, Ochs, R, Abtin, F, Ordookhani, A, Brown, M, Kim, H, Shaw, G, Chong, D, Goldin, J. Automated Quantitative Assessment of Lung Fissure Integrity on CT. Proceedings of the First International Workshop on Pulmonary Image Analysis, New York, USA, 2008, pp. 93-102. In block 72, a heterogeneity score is generated for each lobe based on the difference between the emphysema score of the target lobe and the emphysema score of the lobe adjacent to the target lobe. In block 74, a report is generated including an image including BLVR candidate icons for at least two lobes, fissure completeness indicators, and emphysema level visual identifiers. Based on the review of the generated report, the healthcare provider performs the BLVR procedure, i.e., places one or more interbronchial valves (IBVs) in the lung lobes, at block 76. An exemplary IBV is the IBV valve system manufactured by Olympus®.

[0019] 3 illustrates an exemplary report 80 generated by processing device 40 (block 74 of FIG. 2). Report 80 may be generated in any of several different formats and delivered in any number of different ways to the entity that originally made the request for the report (e.g., a medical professional responsible for treating the patient associated with the analyzed image data). Report 80 includes a lung display area 82 that includes an image of lung lobes 84. The previously calculated emphysema score is graphically represented on the image of lobe 84 by either a particular pattern or color based on where the emphysema score falls within a predefined scale (see the emphysema score scale to the left of lung display area 82).

[0020] Fissure lines 86 are shown between their respective lobes in the lung display area 82. The fissure lines 86 are represented by a particular line pattern and / or color based on the previously calculated fissure completeness score and fissure completeness scale (see fissure completeness scale shown under the emphysema score scale).

[0021] BLVR candidate icons 90 are shown adjacent to or overlaying the relevant lung lobes in the lung display area 82. In this example, icons 90 are shown only for the left upper lobe, right lower lobe, left upper lobe, and left lower lobe. However, calculated scores are shown for all lobes in a table at the bottom of the report 80. The BLVR candidate icons 90 include calculated scores for emphysema, fissure completeness, and heterogeneity. The background color or pattern of each score in the icon 90 represents whether or not the predefined inclusion criteria (i.e., thresholds) for each score are met. The icons 90 provide a visual tool to enable medical professionals to determine which lobes are good candidates for BLVR treatment. In the example of FIG. 3, the left upper lobe is the only lobe for which all three scores meet the relevant predefined criteria (i.e., thresholds). The criteria were determined based on experience gained from multiple clinical trials.

[0022] 4, a pulmonary report 98 is generated by processing device 40. Pulmonary report 98 may be generated in any of several different formats and delivered in any number of different ways to the entity that originally requested the report (e.g., a medical professional responsible for treating a patient associated with the analyzed image data). Pulmonary report 98 includes pulmonary report 80 (FIG. 3) and a pulmonary fissure display area 100.

[0023] 5, lung fissure display area 100 includes three two-dimensional renderings 102, 104, and 106 of lung, airway, and fissure information generated by processing device 40. First two-dimensional rendering 102 includes a perspective left lung feature 114, a perspective right lung feature 116, a lung airway feature 118, and a right oblique fissure feature 120. Second two-dimensional rendering 104 includes a perspective left lung image feature 132, a perspective right lung feature 130, a lung airway feature 134, and a right horizontal fissure feature 140. Third two-dimensional rendering 106 includes a perspective left lung feature 144, a perspective right lung feature 142, a lung airway feature 146, and a left oblique fissure feature 148.

[0024] The processing device 40 classifies voxels from the volumetric radiographic images as lobe-type, airway-type, or fissure-type. A unique viewpoint is selected for each of the two-dimensional renderings 102, 104, and 106. The processing device 40 generates the two-dimensional renderings 102, 104, and 106 of the classified voxels based on the unique viewpoint. It will be understood by those skilled in the art that the two-dimensional renderings of voxels classified as lobe-type and airway-type need only be determined once and can be reused for each of the two-dimensional renderings 102, 104, and 106 as long as the viewpoints are comparable.

[0025] Voxels for each of the cleft features (right oblique cleft feature 120, right horizontal cleft feature 140, and left oblique cleft feature 148) are identified as complete or incomplete. The completeness or incompleteness of the cleft is based on the previously calculated cleft completeness score and / or cleft completeness scale. Numbers 122, 150, and 156 refer to the portions of the cleft features 120, 140, and 148, respectively, that are identified as complete. Numbers 124, 152, and 154 refer to the portions of the cleft features 120, 140, and 148, respectively, that are identified as incomplete.

[0026] Beneath the two-dimensional renderings 102, 104, and 106 of the pulmonary fissure display region 100 are fissure labels 160, 162, and 164. The fissure labels 160, 162, and 164 identify the fissures contained within the rendering located above the label. The fissure labels 160, 162, and 164 are determined by the processing device 40. Beneath the fissure labels 160, 162, and 164 are completeness scores 166, 168, and 170 for each fissure. The completeness scores 166, 168, and 170 are also performed by the processing device 40 as described above.

[0027] Referring now to FIG. 6 , an exemplary process 180 for generating a two-dimensional image of a lung with fissure completeness information may be performed. In block 182, three-dimensional image data of at least a portion of a lung having a pulmonary fissure is received by a processing device. In block 184, the processing device classifies voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels. In block 186, the processing device generates a fissure completeness score for each pulmonary fissure voxel based on a predefined radiodensity value threshold or radiodensity value threshold range. In block 188, the processing device generates a first oblique perspective view of the classified lobe voxels based on a first viewpoint. In block 190, the processing device generates a first oblique view of the classified airway voxels based on the first viewpoint. In block 192, the processing device generates a first oblique view of the classified pulmonary fissure voxel associated with the first pulmonary fissure based on the first viewpoint. In block 194, the processing device outputs a report that includes the generated diagram.

[0028] Blocks 188-194 are repeated for other clefts contained within the three-dimensional image data, and the processing device generates a cleft label and a cleft completeness score for each cleft represented in the report.

[0029] The description of the invention is merely exemplary in nature, and variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations should not be considered a departure from the spirit and scope of the invention.

[0030] Embodiment A. A method comprising: receiving three-dimensional image data of at least a portion of a lung having pulmonary fissures, the three-dimensional image data including voxels; classifying the voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels; generating a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range; generating a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generating a first oblique view of the classified airway voxels based on the first viewpoint; generating a first oblique view of the classified pulmonary fissure voxels associated with a first one of the pulmonary fissures based on the first viewpoint, wherein the first oblique view of the pulmonary fissure voxel includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated view; and outputting the report.

[0031] B. The method of A, further comprising the steps of determining a fissure completeness score for a first one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, and adding the determined fissure completeness score to the generated report.

[0032] C. The method of A, further comprising the steps of: generating a second oblique perspective view of the classified lung lobe voxels based on a second viewpoint; generating a second oblique view of the classified airway voxels based on the second viewpoint; and generating a second oblique view of the classified lung fissure voxels associated with a second one of the pulmonary fissures based on the second viewpoint, wherein the second oblique view of the lung fissure voxel includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel.

[0033] D. The method of C, further comprising the steps of determining a second fissure completeness score for a second one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to a second one of the pulmonary fissures, and adding the determined fissure completeness score to the generated report.

[0034] E. The method of C, further comprising the steps of generating a third oblique perspective view of the classified pulmonary lobe voxels based on a third viewpoint; generating a third oblique view of the classified airway voxels based on the third viewpoint; and generating a third oblique view of the classified pulmonary fissure voxels associated with a third of the pulmonary fissures based on the third viewpoint, wherein the third oblique view of the pulmonary fissure voxel includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel.

[0035] F. The method of E, further comprising the steps of determining a third fissure completeness score for a third of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the third of the pulmonary fissures, and adding the determined fissure completeness score to the generated report.

[0036] G. The method of E further comprising the steps of generating a fissure label for each of the three pulmonary fissures and adding the fissure labels to the report.

[0037] H. The method of E, wherein the step of generating the report includes the steps of placing a first figure on the report, placing a second figure on the report, and placing a third figure on the report.

[0038] I. A method for detecting a lung fissure comprising: receiving, at a processing device, three-dimensional image data of at least a portion of a lung having a pulmonary fissure, the three-dimensional image data including voxels; classifying the voxels as at least one of a lobe voxel, an airway voxel, or a pulmonary fissure voxel; generating a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range; generating a first oblique perspective view of the classified lobe voxels based on a first viewpoint; and generating a first oblique perspective view of the classified airway voxels based on the first viewpoint. and generating a report including the generated views; and an output device in signal communication with the processing device, the output device configured to output the report.

[0039] J. The system of I, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to determine a fissure completeness score for a first one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, and add the determined fissure completeness score to the generated report.

[0040] K. The system of I, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to: generate a second oblique perspective view of the classified pulmonary lobe voxels based on a second viewpoint; generate a second oblique view of the classified airway voxels based on the second viewpoint; and generate a second oblique view of the classified pulmonary fissure voxels associated with a second one of the pulmonary fissures based on the second viewpoint, wherein the second oblique view of the pulmonary fissure voxel includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel.

[0041] L. The system of K, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to determine a second fissure completeness score for a second one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the second one of the pulmonary fissures, and add the determined fissure completeness score to the generated report.

[0042] M. The system of K, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to: generate a third oblique perspective view of the classified pulmonary lobe voxels based on a third viewpoint; generate a third oblique view of the classified airway voxels based on the third viewpoint; and generate a third oblique view of the classified pulmonary fissure voxels associated with a third of the pulmonary fissures based on the third viewpoint, wherein the third oblique view of the pulmonary fissure voxels includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel.

[0043] N. The system of M, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to determine a third fissure completeness score for a third of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the third of the pulmonary fissures, and add the determined fissure completeness score to the generated report.

[0044] O. The system of M, wherein the memory is further configured to store computer-executable instructions configured to cause the processing device to generate a fissure label for each of three pulmonary fissures and add the fissure labels to a report.

[0045] P. The system of M, wherein the memory is further configured to store computer-executable instructions configured to cause a processing device to arrange a first figure on the report, arrange a second figure on the report, and arrange a third figure on the report.

[0046] Q. A non-transitory computer-readable recording medium having an executable program stored thereon, the program causing a processor to: receive three-dimensional image data of at least a portion of a lung having pulmonary fissures, the three-dimensional image data including voxels; classify the voxels as at least one of lobe voxels, airway voxels, or pulmonary fissure voxels; generate a fissure completeness score for each of the pulmonary fissure voxels based on at least one of a predefined radiodensity value threshold or a radiodensity value threshold range; generate a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generate a first oblique view of the classified airway voxels based on the first viewpoint; generate a first oblique view of the classified pulmonary fissure voxels associated with a first one of the pulmonary fissures based on the first viewpoint, the first oblique view of the pulmonary fissure voxels including a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxel; and generate a second oblique perspective view of the classified lobe voxels based on a second viewpoint. generating a second perspective view of the classified lung lobe voxels based on the second perspective view; generating a second perspective view of the classified airway voxels based on the second perspective view; generating a second perspective view of the classified lung fissure voxels associated with a second one of the pulmonary fissures based on the second perspective view, wherein the second perspective view of the pulmonary fissure voxels includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxels; generating a third perspective view of the classified lung lobe voxels based on a third perspective view; generating a third perspective view of the classified airway voxels based on the third perspective view; and generating a third perspective view of the classified lung fissure voxels associated with a third one of the pulmonary fissures based on the third perspective view, wherein the third perspective view of the pulmonary fissure voxels includes a visual representation of fissure completeness based on the fissure completeness score generated for the corresponding voxels; generating a report including the generated views; and outputting the report.

[0047] R. A non-transitory computer-readable storage medium of Q, wherein the program is further configured to cause the processor to determine a fissure completeness score for a first one of the pulmonary fissures based on the fissure completeness score generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, determine a second fissure completeness score for a second one of the pulmonary fissures based on the fissure completeness score generated for each of the pulmonary fissure voxels corresponding to the second one of the pulmonary fissures, determine a third fissure completeness score for a third one of the pulmonary fissures based on the fissure completeness score generated for each of the pulmonary fissure voxels corresponding to the third one of the pulmonary fissures, and add the determined fissure completeness scores to the generated report.

[0048] S. A non-transitory computer-readable storage medium of Q, the program further configured to cause the processor to generate a fissure label for each of three pulmonary fissures and add the fissure labels to a report.

[0049] T. A non-transitory computer-readable storage medium of Q, wherein the program is further configured to cause a processor to place a first figure on the report, place a second figure on the report, and place a third figure on the report.

[0050] The term controller / processing device, as used in the foregoing / following disclosure, may refer to a collection of one or more components arranged in a particular way, or a collection of one or more general-purpose components that may be configured to operate in a particular way at one or more particular times and / or may also be configured to operate in one or more additional ways at one or more additional times. For example, the same hardware, or the same portion of hardware, may be configured / reconfigured in sequential / parallel times as a first type of controller (e.g., at a first time), as a second type of controller (e.g., at a second time that may be concurrent with, overlap with, or subsequent to the first time, in some cases), and / or as a third type of controller (e.g., at a third time that may be concurrent with, overlap with, or subsequent to the first and / or second time, in some cases), etc. A reconfigurable and / or controllable component (e.g., a general-purpose processor, a digital signal processor, a field programmable gate array, etc.) can be configured as a first controller with a first purpose, then as a second controller with a second purpose, then as a third controller with a third purpose, etc. The transition of the reconfigurable and / or controllable component may occur in just a few nanoseconds, or may occur over a period of minutes, hours, or days.

[0051] In some such examples, once a processing device is configured to perform a second purpose, the controller may no longer be able to perform its first purpose until it is reconfigured. A processing device may switch between configurations as different components / modules in just a few nanoseconds. A processing device may reconfigure on the fly; for example, reconfiguration of a processing device from a first processing device to a second processing device may occur as soon as the first processing device is needed. A processing device may reconfigure incrementally; for example, portions of a first processing device that are no longer needed may be reconfigured to a second processing device even before the first processing device has ceased its operation. Such reconfiguration may occur automatically or through prompting by an external source, whether that source is another component, an instruction, a signal, a condition, an external stimulus, etc.

[0052] For example, a central processing unit or the like of a processing device may, by configuring its logic gates according to its instructions, at various times operate as a component / module for displaying graphics on a screen, a component / module for writing data to a storage medium, a component / module for receiving user input, and a component / module for multiplying two large prime numbers. Such reconfiguration may be invisible to the naked eye and, in some embodiments, may involve activating, deactivating, and / or rerouting various portions of the component, e.g., switches, logic gates, inputs, and / or outputs. Thus, in examples found above / in the disclosure below, when an example includes or lists multiple components / modules, the example includes the possibility that the same hardware may implement two or more of the listed components / modules, either simultaneously or at discrete times or timings. Implementation of multiple components / modules, whether using more components / modules, fewer components / modules, or the same number of components / modules as the number of components / modules, is merely an implementation choice and generally does not affect the operation of the components / modules themselves. Thus, any description of multiple individual components / modules in this disclosure should be understood to include implementations of those components / modules as any number of underlying components / modules, including, but not limited to, a single component / module that reconfigures itself over time to perform the functions of the multiple components / modules, and / or multiple components / modules that similarly reconfigure, and / or special-purpose reconfigurable components / modules.

[0053] In some cases, one or more components may be referred to herein as being "configured to," "configured by," "configurable to," "operable to," "adapted," "capable of," "adaptable to," etc. Those skilled in the art will recognize that such terms (e.g., "configured to") generally encompass active and / or inactive and / or standby components unless the context requires otherwise.

[0054] While particular aspects of the present subject matter described herein have been shown and described, it will be apparent to those skilled in the art that, based on the teachings herein, changes and modifications can be made without departing from the subject matter described herein and its broader aspects; therefore, the appended claims are intended to encompass within their scope all such changes and modifications that are within the true spirit and scope of the subject matter described herein. In general, it will be understood by those skilled in the art that the terms used in this specification, and particularly in the appended claims (e.g., the body of the appended claims), are generally intended as "open" terms (e.g., the term "including" should be interpreted as "including, but not limited to," the term "having" should be interpreted as "having at least," the term "including" should be interpreted as "including, but not limited to," etc.). Where a specific number of the recitations of the introduced claims are intended, such intention will be explicitly recited in the claims; it will be further understood by those skilled in the art that, in the absence of such recitation, no such intention exists. For example, as an aid to understanding, the following appended claims may include the use of the introductory phrases "at least one" or "one or more" to introduce claim recitations. However, the use of such phrases should not be construed to mean that introducing a claim recitation with the indefinite article "a" or "an" limits any particular claim that includes such an introduced claim recitation to claims that include only one such recitation, even if the same claim includes the introductory phrase "one or more" or "at least one" and an indefinite article such as "a" or "an" (e.g., "a" and / or "an" should typically be construed to mean "at least one" or "one or more"); the same is true for the use of definite articles used to introduce claim recitations.Additionally, even when a specific number of recitations in an introduced claim is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., a minimum recitation of "two recitations" without other modifiers typically means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention similar to "such as at least one of A, B, and C" is used, such configuration is generally intended in the sense that those skilled in the art would understand the convention (e.g., "a system having at least one of A, B, and C" includes, but is not limited to, systems having A only, B only, C only, A and B together, A and C together, B and C together, and / or A, B, and C together, etc.). It will further be understood by those skilled in the art that disjunctive words and / or disjunctive phrases presenting two or more alternative terms, whether in the specification, claims, or drawings, should typically be understood to contemplate the possibility of including one of the terms, either of the terms, or both terms, unless the context dictates otherwise. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B."

[0055] The foregoing detailed description has set forth various embodiments of devices and / or processes via block diagrams, flowcharts, and / or examples. To the extent that such block diagrams, flowcharts, and / or examples include one or more functions and / or operations, it will be understood by those skilled in the art that each function and / or operation within such block diagrams, flowcharts, or examples may be individually and / or collectively implemented by a wide range of hardware, software (e.g., high-level computer programs acting as hardware specifications), firmware, or virtually any other subject matter patentable under 35 U.S.C. 101. In one embodiment, portions of the subject matter described herein may be implemented via an application-specific integrated circuit (ASIC), a field-programmable gate array (FPGA), a digital signal processor (DSP), or other integrated format. However, those skilled in the art will recognize that certain aspects of the embodiments disclosed herein may be equivalently implemented, in whole or in part, as one or more computer programs running on one or more computers (e.g., as one or more programs running on one or more computer systems), as one or more programs running on one or more processors (e.g., as one or more programs running on one or more microprocessors), as firmware, or substantially any combination thereof, in integrated circuits, and that it is within the skill of one of ordinary skill in the art in light of this disclosure to design circuitry and / or write code for software (high-level computer programs that act as hardware specifications) and / or firmware. Additionally, those skilled in the art will understand that the mechanisms of the subject matter described herein may be distributed as a program product in a variety of forms, and that exemplary embodiments of the subject matter described herein apply regardless of the particular type of signal-bearing medium used to actually effect the distribution.Examples of signal-bearing media include, but are not limited to, the following: recordable-type media such as floppy disks, hard disk drives, compact disks (CDs), digital video disks (DVDs), digital tape, computer memory, and transmission-type media such as digital and / or analog communications media (e.g., fiber optic cables, wave guides, wired communications links, wireless communications links (e.g., transmitters, receivers, transmitting logic, receiving logic, etc.)).

[0056] With respect to the appended claims, those skilled in the art will understand that the operations described therein may generally be performed in any order. Also, while various operational flows are presented sequentially, it should be understood that various operations may be performed in orders other than those depicted, or may be performed simultaneously. Examples of such alternative orders may include overlapping, interleaved, interrupted, reordered, incremental, preliminary, supplemental, simultaneous, reverse, or other variant orders, unless the context dictates otherwise. Furthermore, terms such as "responsive to," "related to," or other past-tense adjectives generally are not intended to exclude such variants, unless the context dictates otherwise.

[0057] While the disclosed subject matter has been described with reference to exemplary embodiments, those skilled in the art will recognize that various modifications can be made thereto without departing from the scope of the claimed subject matter as set forth in the claims. [Explanation of symbols]

[0058] 10 Lung Visualization System 20 Data Sources 30 Public and / or private data networks, data networks 40 Processing Device 42 Output Devices 44 memory 80 Report, Lung Report 82 Lung display area 84 Lung lobe, lobe 86 Crack Line 90 BLVR candidate icons, icons 98 Lung Report 100 Lung fissure display area 102 2D rendering, first 2D rendering 104 2D Rendering, 2nd 2D Rendering 106 2D Rendering, 3D Rendering 114 Fluoroscopic left lung characteristics 116 Fluoroscopic right lung features 118 Pulmonary Airway Characteristics 120 Right oblique fissure characteristics 122 number 124 number 130 Fluoroscopic right lung features 132 Fluoroscopic left lung image characteristics 134 Pulmonary Airway Characteristics 140 Right horizontal fissure 142 Fluoroscopic right lung features 144 Fluoroscopic left lung characteristics 146 Pulmonary Airway Characteristics 148 Left oblique fissure features 150 Number 152 Number 154 Number 156 Number 160 Crack Label 162 Crack Label 164 Crack Label 166 Completeness Score 168 Completeness Score 170 Completeness Score

Claims

1. a processing device; the processing device, receiving three-dimensional image data of at least a portion of a lung having a pulmonary fissure, the three-dimensional image data including voxels; classifying the voxel as at least one of a lobe voxel, an airway voxel, or a fissure voxel; generating a fissure completeness score for each of the pulmonary fissure voxels based on a predefined radiodensity value threshold, the fissure completeness score being specified as a percentage of fissure completeness; generating a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generating a first perspective view of the classified airway voxels based on the first viewpoint; generating a first perspective view of the classified pulmonary fissure voxel associated with a first one of the pulmonary fissures based on the first viewpoint, the first perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated diagram; a memory configured to store computer readable instructions configured to cause the an output device in signal communication with the processing device, the output device configured to output the report; A system comprising:

2. The memory is configured to include: determining a fissure completeness score for the first one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, wherein the fissure completeness score is specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; and 10. The system of claim 1, further configured to store computer-executable instructions configured to cause:

3. The memory is configured to include: generating a second oblique perspective view of the classified lobe voxels based on a second viewpoint; generating a second perspective view of the classified airway voxels based on the second viewpoint; generating a second perspective view of the classified pulmonary fissure voxel associated with a second one of the pulmonary fissures based on the second perspective, the second perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; 10. The system of claim 1, further configured to store computer-executable instructions configured to cause:

4. The memory is configured to include: determining a second fissure completeness score for the second one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the second one of the pulmonary fissures, the second fissure completeness score being specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; and 4. The system of claim 3, further configured to store computer-executable instructions configured to cause:

5. The memory is configured to include: generating a third oblique perspective view of the classified lobe voxels based on a third viewpoint; generating a third perspective view of the classified airway voxels based on the third viewpoint; generating a third perspective view of the classified pulmonary fissure voxel associated with a third one of the pulmonary fissures based on the third perspective, the third perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; 4. The system of claim 3, further configured to store computer-executable instructions configured to cause:

6. The memory is configured to include: determining a third fissure completeness score for the third one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the third one of the pulmonary fissures, wherein the third fissure completeness score is specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; and 6. The system of claim 5, further configured to store computer-executable instructions configured to cause:

7. The memory is configured to include: generating a fissure label for each of the three pulmonary fissures; adding said cleft label to said report; 6. The system of claim 5, further configured to store computer-executable instructions configured to cause:

8. The memory is configured to include: placing the first perspective view and the first oblique view on the report; placing the second perspective view and the second perspective view on the report; placing the third perspective view and the third oblique view on the report; 6. The system of claim 5, further configured to store computer-executable instructions configured to cause:

9. A non-transitory computer-readable recording medium having an executable program stored thereon, the program causing a processor to: receiving three-dimensional image data of at least a portion of a lung having a pulmonary fissure, the three-dimensional image data including voxels; classifying the voxel as at least one of a lobe voxel, an airway voxel, or a fissure voxel; generating a fissure completeness score for each of the pulmonary fissure voxels based on a predefined radiodensity value threshold, the fissure completeness score being specified as a percentage of fissure completeness; generating a first oblique perspective view of the classified lobe voxels based on a first viewpoint; generating a first perspective view of the classified airway voxels based on the first viewpoint; generating a first perspective view of the classified pulmonary fissure voxel associated with a first one of the pulmonary fissures based on the first viewpoint, the first perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a second oblique perspective view of the classified lobe voxels based on a second viewpoint; generating a second perspective view of the classified airway voxels based on the second viewpoint; generating a second perspective view of the classified pulmonary fissure voxel associated with a second one of the pulmonary fissures based on the second viewpoint, the second perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a third oblique perspective view of the classified lobe voxels based on a third viewpoint; generating a third perspective view of the classified airway voxels based on the third viewpoint; generating a third perspective view of the classified pulmonary fissure voxel associated with a third one of the pulmonary fissures based on the third viewpoint, the third perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated diagram; outputting said report; A non-transitory computer-readable storage medium configured to cause

10. The program causes the processor to: determining a fissure completeness score for the first one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, wherein the fissure completeness score is specified as a percentage of fissure completeness; determining a second fissure completeness score for the second one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the second one of the pulmonary fissures; and determining a third fissure completeness score for the third one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the third one of the pulmonary fissures; and adding the determined crack completeness score to the generated report; and 10. The non-transitory computer-readable storage medium of claim 9, further configured to:

11. The program causes the processor to: generating a fissure label for each of the three pulmonary fissures; adding said cleft label to said report; 10. The non-transitory computer-readable storage medium of claim 9, further configured to:

12. The program causes the processor to: placing the first perspective view and the first oblique view on the report; placing the second perspective view and the second perspective view on the report; placing the third perspective view and the third oblique view on the report; 10. The non-transitory computer-readable storage medium of claim 9, further configured to:

13. receiving three-dimensional image data of at least a portion of a lung having a pulmonary fissure, the three-dimensional image data comprising voxels; classifying the voxel as at least one of a lobe voxel, an airway voxel, or a fissure voxel; generating a fissure completeness score for each of the pulmonary fissure voxels based on a predefined radiodensity value threshold, the fissure completeness score being specified as a percentage of fissure completeness; generating a first oblique perspective view of the classified lung lobe voxels based on a first viewpoint; generating a first perspective view of the classified airway voxels based on the first viewpoint; generating a first perspective fissure view of the classified pulmonary fissure voxel associated with a first one of the pulmonary fissures based on the first perspective, the first perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; generating a report including the generated diagram; outputting the report; A method executed by a processor, comprising:

14. determining a fissure completeness score for the first one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the first one of the pulmonary fissures, the fissure completeness score being specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; 14. The method of claim 13, further comprising:

15. generating a second oblique perspective view of the classified lobe voxels based on a second viewpoint; generating a second perspective view of the classified airway voxels based on the second viewpoint; generating a second perspective view of the classified pulmonary fissure voxel associated with a second one of the pulmonary fissures based on the second perspective, the second perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; 14. The method of claim 13, further comprising:

16. determining a second fissure completeness score for the second one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the second one of the pulmonary fissures, the second fissure completeness score being specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; 16. The method of claim 15, further comprising:

17. generating a third oblique perspective view of the classified lobe voxels based on a third viewpoint; generating a third perspective view of the classified airway voxels based on the third viewpoint; generating a third perspective view of the classified pulmonary fissure voxel associated with a third one of the pulmonary fissures based on the third perspective, the third perspective view of the pulmonary fissure voxel including a visual representation of the fissure completeness based on the fissure completeness score generated for the corresponding voxel; 16. The method of claim 15, further comprising:

18. determining a third fissure completeness score for the third one of the pulmonary fissures based on the fissure completeness scores generated for each of the pulmonary fissure voxels corresponding to the third one of the pulmonary fissures, the third fissure completeness score being specified as a percentage of fissure completeness; adding the determined crack completeness score to the generated report; 18. The method of claim 17, further comprising:

19. generating a fissure label for each of the three pulmonary fissures; adding said cleft labels to said report; 18. The method of claim 17, further comprising:

20. generating the report, placing the first perspective view and the first perspective view on the report; placing the second perspective view and the second perspective view on the report; placing the third perspective view and the third perspective view on the report; 18. The method of claim 17, comprising:

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