Bronchoscopy

What it does

Bronchoscopy reads a recorded diagnostic airway examination, as video or as the stills saved during it. A white-light bronchoscopy passes through the trachea, main carina and the lobar and segmental bronchi; endobronchial tumours and subtle mucosal changes along that path are what the inspection is meant to find.

The run follows the recording, records which airway segments the scope visited, and detects endobronchial tumours and mucosal abnormalities. Each finding is tracked across the frames where it is visible, reported once with its airway location, and linked to a key frame and the timestamps of its first and last appearance.

Intended use

Decision support after the procedure: a second look at the airway survey, a check that the expected segments were entered, and a key-frame record of every abnormal area for the report and for biopsy planning at a repeat procedure.

Who it is for

Pulmonologists, interventional pulmonologists, thoracic surgeons, and respiratory trainees building their airway inspection routine. Developers use the run to add structured findings and key frames to a bronchoscopy reporting system.

Accepted input

• Video: flexible bronchoscopy recordings as MP4, MOV or MKV (H.264/H.265), or DICOM Video Endoscopic Image.
• Stills: JPEG/PNG images or DICOM VL Endoscopic Image captured during the examination.
• A complete airway survey gives the fullest map of visited segments; short clips are read for the lesions they show.

Requirements

Requirement	Why
Recording of the full inspection, from the trachea onwards	Only recorded segments can be listed as visited
Clear airway with secretions suctioned	Mucus and blood mimic or hide mucosal change
Frame rate in the video file	Timestamps and lesion tracks depend on it
Close views of abnormal areas	Mucosal abnormalities are judged on near, stable frames

Optional context

The indication (suspected lung cancer, haemoptysis, persistent cough, airway stenosis, follow-up after treatment) and relevant CT findings can be passed in clinical_context; the guidance and draft report take them into account.

The result

Section	Content
Airway lesions	Endobronchial tumours and mucosal abnormalities with airway location, key frames and timestamps, plus the airway segments visited
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

The findings, key frames and the procedure timeline come back in one JSON result, so each lesion can be replayed on the frames it was detected on. The list of visited segments shows which parts of the bronchial tree the recording covers.

Standards

• DICOM: key frames as VL Endoscopic Image, annotated clips as Video Endoscopic Image, a Key Object Selection document listing the key frames, findings in SR TID 1500 and the report as Encapsulated PDF.
• Interoperability: FHIR R4 Procedure, DiagnosticReport and Observation, with SNOMED CT codes for procedure, finding and anatomic site.