Yan Yuling, Luo Shouhua, McWhorter Andrew
Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
Laryngoscope. 2007 Jun;117(6):1026-30. doi: 10.1097/MLG.0b013e31804f812f.
Present a clinical application of virtual laryngoscopy (VL) in the assessment of laryngeal tumor and its extent.
CT data from two subjects are acquired for this preliminary study. One subject is a healthy volunteer and the other is a patient with laryngeal tumor. The laryngeal framework and upper airway are reconstructed using CT data, which allows for computer-aided internal and external anatomical views and interactive fly-through.
These CT data are reconstructed into 0.5 mm slice images, resulting in a total of 200-300 image slices. An advanced commercial visualization software (AMIRA) is used for 3D image segmentation, reconstruction and surface rendering of laryngeal anatomical structures.
The 3D laryngeal framework and upper airway are reconstructed for both the tumor patient and the healthy subject. The conventional views of the reconstructed vocal folds are compared with those obtained from fiber-optic laryngoscope. Additionally, unique views of the vocal folds obtained from retrograde visualization and fly-through are presented, which are not possible to obtain using conventional endoscope imaging. The segmented anatomical model and the tumor from the patient's CT images were displayed individually to show the distribution of the tumor and its extent as well as spatial and contextual relationships to the larynx and airway anatomical structures.
This study demonstrated the potential application of VL as a noninvasive clinical diagnostic tool for the assessment of laryngeal tumor and its extent. Our preliminary results demonstrated that the VL may provide valuable insights for the diagnosis and treatment planning for laryngeal and airway tumors. The noninvasive VL may complement the invasive laryngoscopic examinations for the staging of tumors and follow-ups on surgical interventions.
介绍虚拟喉镜（VL）在评估喉肿瘤及其范围中的临床应用。
获取两名受试者的CT数据用于这项初步研究。一名受试者是健康志愿者，另一名是喉肿瘤患者。利用CT数据重建喉框架和上呼吸道，从而实现计算机辅助的内部和外部解剖视图以及交互式穿行观察。
将这些CT数据重建为0.5毫米的切片图像，总共得到200 - 300张图像切片。使用先进的商业可视化软件（AMIRA）对喉解剖结构进行三维图像分割、重建和表面渲染。
为肿瘤患者和健康受试者都重建了三维喉框架和上呼吸道。将重建声带的传统视图与纤维喉镜获得的视图进行比较。此外，还展示了通过逆行观察和穿行观察获得的声带独特视图，这是使用传统内窥镜成像无法获得的。分别展示了从患者CT图像中分割出的解剖模型和肿瘤，以显示肿瘤的分布及其范围，以及与喉和气道解剖结构的空间和背景关系。
本研究证明了VL作为一种非侵入性临床诊断工具在评估喉肿瘤及其范围方面的潜在应用。我们的初步结果表明，VL可为喉和气道肿瘤的诊断和治疗计划提供有价值的见解。非侵入性的VL可补充侵入性喉镜检查用于肿瘤分期和手术干预后的随访。
