SESSION TITLE: Bronchoscopy and Interventional Procedures Posters I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Current bronchoscopes use either CCD(Charge Couple Device) image-sensors or fiber-optics(FO) for image-guidance. There’s incremental improvement in image-resolution of CCDs, but “chip” size limits miniaturization. Smaller fiber-optic or “hybrid” bronchoscopes (CCD sensor in hand-control and FO in shaft) allow navigation to peripheral segments but sacrifice image quality and channel size. CMOS (Complementary Metal Oxide Semiconductor) image-sensors also capture digital image but through different processing technology. CMOS adoption is widespread in various devices(cell-phones) but hasn't been incorporated into flexible endoscopes. We evaluated a flexible steerable-catheter mounted micro-CMOS camera and guide-sheath combination designed as maneuverable high-resolution alternative to target peripheral lung lesions.
METHODS: Prototype 3 mm CMOS camera-GS system compared ex-vivo with “standard” bronchoscopes for image-resolution with standard USAF Resolution Power Test Target charts and during porcine airway inspection. Resolution graded, extent of airway-segments reached and maneuverability recorded.
RESULTS: Image-Resolutions: Compared to two Pentax(P)CCD, eight Olympus(O)CCD and Olympus “hybrid” bronchoscopes. Resolution presented as ability to distinguish lines in the Group-Element USAF-Target charts, higher number-combinations mean better resolution. Best resolution:O-BFQ180 & P-EB1970K(therapeutic) scopes with 3-3; next:O-1T180(therapeutic), O-180(standard) & P-EB1570K scopes with 3-1; third:O-XT160(large thetapeutic) & O-MP160F(hybrid) scopes 2-2, lowest:O-P160(“pediatric 4.9mm) & O-XP160F(hybrid “ultrathin”2.8mm) scopes with 1-5. The 3mmCMOS system scored 3-1, comparable with “standard” 5.1-5.3mm shaft/5.9-6mm distal tip bronchoscopes. Manueverability: The steerable CMOS-system has upward/downward bending-angle of 145 degrees and bending-radius of 12mm, this compares with upward bending-angles of 180-210/downward bending-angles of 130 degrees of the present bronchoscopes; their bend-radius vary from 7mm(O-XP160F) to average 15-22mm. In porcine experiments, the CMOS system is maneuvered to all lobes and between 4-10 generations airways depending on segment and distances. Because the GS is outside the CMOS, the “working-channel” with CMOS removed is 3mm.
CONCLUSIONS: CMOS-based flexible-endoscope systems has high-resolution and extended range.
CLINICAL IMPLICATIONS: CMOS-systems have potential as high-resolution bronchoscopes to reach lung periphery and provide large-diameter biopsy-channel sampling.
DISCLOSURE: Rex Yung: Grant monies (from industry related sources): Institutional Research Grant & Master Agreement with Philips Imaging, N.A., Consultant fee, speaker bureau, advisory committee, etc.: Sanovas Incorporated, maker of CMOS camera system, Consultant fee, speaker bureau, advisory committee, etc.: Terumo Incorporated, manufacturer of catheters, not used for these experiments Mingying Zeng: Grant monies (from industry related sources): Research support from Philips Imaging NA Devin Scheifele: Employee: Engineer involved in development of catheters and cameras Erhan Gunday: Shareholder: Founder of Sanovas, Employee: Designer of CMOS camera system Michael Humason: Employee: Sanovas Inc, developer of instrumentation The following authors have nothing to disclose: Xin Zhang
This is preliminary pre-clinical data of new devices that are being developed for human clinical use as potential alternatives to current standard bronchoscopes. Declaration of financial relationship will be stated.