Virtual Bronchoscopic Pathfinder (VBP): An Open-Source Web-Based System for Airway Segmentation, Cost-Field Path...

Background/Objectives: Virtual Bronchoscopic Navigation is used to guide bronchoscopes toward peripheral pulmonary lesions, but broad clinical and research adoption remains limited by the cost of proprietary software and by segmentation failures in small distal airways that can interrupt path planning. This study presents Virtual Bronchoscopic Pathfinder, an open-source, web-based system designed to provide automated airway segmentation, robust path generation, and browser-based three-dimensional visualization. Methods: The system integrates five components: a connectivity-aware deep learning model for pulmonary airway segmentation using Connectivity-Aware Surrogate and Local-Sensitive Distance modules; TotalSegmentator for automated tumor localization; a topology-preserving three-dimensional thinning algorithm implemented in C++ for centerline extraction; a bidirectional Dijkstra algorithm operating on a three-tier anatomical cost field with centerline, airway lumen, and parenchymal costs; and a zero-footprint visualization interface built on vtk.js with synchronized axial viewing and interactive volume rendering. VBP was validated on 306 thin-section CT series from 154 subjects in the public Lung-PET-CT-Dx dataset. Results: Among the 306 CT series, 33 series (10.8%) were excluded because of scanner-specific segmentation artifacts. In the remaining 273 anatomically valid series, the system successfully generated complete end-to-end navigation paths for all cases. The overall pipeline success rate was therefore 273 of 306 series (89.2%). The web-based interface was also confirmed to operate without client-side installation across desktop, laptop, and mobile device configurations. Conclusions: Virtual Bronchoscopic Pathfinder demonstrates that a reliable and accessible virtual bronchoscopic navigation workflow can be constructed entirely from open-source components. By combining connectivity-aware segmentation, cost-field path planning, and browser-based visualization, the system provides a practical foundation for imaging informatics research and future development of intra-procedural bronchoscopic guidance.