Evaluation of the human airway with multi-detector x-ray-computed tomography and optical imaging

Defining the healthy human airway is important in enhancing our understanding of pulmonary disease states such as inflammation and cancer. The structure of the human airway, both static and dynamic, can be assessed using multi-detector CT (MDCT) scanning. This modality also allows for the evaluation of structures outside of the airway. The airway wall can be directly visualized using CCD chip high-resolution color optical imaging through endoscopy allowing bronchial wall evaluation by traditional biopsy methods, as well as by newer optically based strategies. We suggest that these two imaging modalities, MDCT and optical imaging, provide complementary information about the normal airway, and the airway in various diseases. Methods for evaluating the human airway using MDCT images are presented facilitating automatic airway segmentation, branchpoint finding and airway dimension analysis. The airway wall color is objectively evaluated as an important surrogate for airway wall inflammation and cancer formation, and the integration of the color endoscopic information into the MDCT scan data set is currently ongoing. The amalgamation of these two digital imaging modalities appears increasingly useful for enabling biopsy techniques, and for relating structure and function of the airway. In addition, these developments may be progressively more useful in understanding the normal airway structure and function, for defining airway diseases patterns and for guiding biopsy and therapeutic procedures.