BronchoLumen: Analysis of recent YOLO-based architectures for real-time bronchial orifice detection in video bronchoscopy
Authors: Yongchao Li, Marian Himstedt
Organizations: Faculty of Electrical Engineering and Computer Science, Technical University of Applied Sciences Lübeck, Mönkhofer Weg 239, Lübeck, 23562, Germany.
Bronchoscopy is routinely conducted in pulmonary clinics and intensive care units, but navigating the complex branching of the respiratory tract remains challenging. This paper introduces BronchoLumen, a real-time YOLO-based system for detecting bronchial orifices in video bronchoscopy, aiming to assist navigation and CAD systems. The paper investigates if bronchial orifices can be robustly detected across image domains using state-of-the-art object detection and a limited set of public image data. The study includes the description and comparison of YOLOv8, a widely adopted architecture, and YOLOv12, a more recent architecture integrating attention-based modules to improve spatial reasoning. Both models are trained and tested solely on publicly available datasets comprising different image domains. A comparison of both models is conducted based on the common metrics mAP@0.5 and mAP@0.5:0.9 with the latter emphasizing localization accuracy. For YOLOv8 we obtained a mAP@0.5 of 0.91 on an in-domain and 0.68 on a cross-domain test set. YOLOv12 achieved 0.84 and 0.68 respectively with slightly better localization accuracy with mAP@0.5:0.9 of 0.48 and 0.26 compared to YOLOv8 with 0.45 and 0.25. Challenges like motion blur and low contrast occasionally entailed uncertainties but the system demonstrated overall robustness in most scenarios. BronchoLumen is an open-weight, YOLO-based solution for bronchial orifice detection offering high accuracy and efficiency across multiple image domains. While the more recent YOLOv12 achieves better localization accuracy, we observed a slightly worse precision. The models have been made publicly available to foster further research in bronchoscopy navigation.
Accurate localization of the bronchoscope within the bronchial tree is essential for clinicians to be able to reach target lesions, perform biopsies and avoid misidentification of airway segments during diagnostic and therapeutic procedures. However, existing navigation systems typically rely on patient-specific CT scans or additional external sensors, increasing cost, setup time and patient radiation exposure. This work presents BronchoTop, a real-time, RGB-only framework for topological bronchoscopy localization that eliminates the need for patient-specific data. BronchoTop estimates scope location relative to a generic airway model through four modules: lumen detection and tracking, lumen-branch label association, probabilistic scope location estimation, and switch verification. By using only standard bronchoscopy video input, BronchoTop provides practical, real-time navigational assistance to physicians. Evaluation on phantom, simulated and real data demonstrates state-of-the-art accuracy, improving existing approaches performance by over 20% on real bronchoscopy sequences. BronchoTop is the first published framework including both the localization algorithms as well as all the real data used, together with code to generate additional simulations, encouraging and facilitating further developments and benchmarking. The results highlight BronchoTop's potential to enhance procedural safety, efficiency and accessibility in clinical and robotic bronchoscopy.
Clara Tomasini, Ana Cristina Murillo, Luis Riazuelo
Camera localization in bronchoscopy remains a challenging problem due to stringent accuracy requirements, real-time constraints, and limited training data. Compared to natural scenes, the confined anatomical structures demand millimeter-level precision, while intraoperative guidance necessitates low-latency inference. However, existing methods often fail to effectively exploit preoperative geometric priors, limiting their robustness and accuracy. To address these limitations, we propose a unified geometry-aware bronchoscope localization framework (GABL) that effectively fuses preoperative structural priors with paired intraoperative video to estimate 6-DoF camera poses. Specifically, to address visual ambiguity in complex airways, we propose a graph-guided coarse-to-fine localization scheme that effectively leverages structural priors for precise pose estimation. Furthermore, to mitigate pose jitter and bridge the visual-structural gap, we integrate a Transformer-based tracking model with a novel RGB-depth matching objective, jointly enforcing spatio-temporal and geometric consistency. Extensive experiments demonstrate that our method yields remarkable reductions of 8.37% and 31.76% in translation and rotation errors over the prior state-of-the-art, alongside 4 times inference speedup (33.6 FPS) for robust real-time bronchoscope localization. Project website: https://paulili08.github.io/GABL/.
Navigational bronchoscopy is critical for pulmonary interventions, yet current platforms depend heavily on pre-operative CT or external sensors, limiting their use in critical care and resource-constrained settings. Vision-only navigation offers a scalable alternative, but conventional visual odometry (VO) struggles with texture-poor airway images, specularities, and the vanishing-point singularities of tubular anatomy, leading to frequent tracking failures and drift. We present a geometry-aware VO framework that explicitly leverages vanishing-point cues from airway lumens. Detected lumens are back-projected to 3D rays, whose weighted fusion yields a stable forward heading even when parallax cues are absent. This heading, together with looming-based velocity estimates, is fused with noisy VO outputs using a bespoke high-gain observer that enforces airway-following priors and rejects drift. We validate the method on ex-vivo mechanically ventilated human lungs with electromagnetic tracking ground truth. Compared to state-of-the-art pipelines (ORB-SLAM2, LoFTR-VO, DPVO), our approach reduces absolute trajectory error by more than 50% and achieves the lowest relative pose error across all test sequences.
Mohammadreza Kasaei, Francis Xiatian Zhang, Feng Li +3