Methods, systems, and devices for analyzing lung imaging data to determine collateral ventilation

1 . A method of assessing collateral ventilation in a lung of a patient, the method comprising:

analyzing computerized tomography data of the lung, wherein analyzing the computerized tomography data comprises:

segmenting tomography data representing the lung during one or more breathing cycles into segmented data representing separate lung compartments;

identifying, based on the segmented data, fissure data representing a fissure defect;

identifying, based on the segmented data and the fissure data, lung compartment data representing lung compartments adjacent to the fissure defect;

calculating, based on the lung compartment data for the one or more breathing cycles, volumes of a first lung compartment adjacent to the fissure defect and a second lung compartment adjacent to the fissure defect on an opposing side of the fissure defect during the one or more breathing cycles;

determining, based on the calculated volumes, changes in volumes of the first lung compartment adjacent to the fissure defect and the second lung compartment adjacent to the fissure defect on the opposing side of the fissure defect during the one or more breathing cycles;

determining whether collateral ventilation is present or above a threshold level in the first or second lung compartment based on the changes in volumes of the first and second lung compartments;

responsive to the collateral ventilation being not present or below the threshold level in the first or second lung compartment, generating a treatment plan comprising one or more suggested implantable devices for placement in one or more potential treatment sites based on the lung compartment data and the fissure data for the one or more breathing cycles; and

administering the treatment plan by placing at least one of the one or more suggested implantable devices into the one or more potential treatment sites.

2 . The method of claim 1 , wherein collateral ventilation is determined to be present or above the threshold level if the first and second lung compartments inflate or deflate asynchronously during breathing.

3 . The method of claim 1 , wherein the one or more suggested implantable devices comprises an endobronchial valve, clip, or plug.

4 . The method of claim 1 , wherein the one or more suggested implantable devices comprises a one-way flow control valve configured to allow airflow out of the lung compartment and prevent airflow into the lung compartment to cause lung volume reduction or reduce hyperinflation.

5 . The method of claim 1 , further comprising calculating a fissure defect score based on a size of the fissure defect.

6 . The method of claim 5 , wherein determining whether collateral ventilation is present or above the threshold level is further based on the calculated fissure defect score.

7 . The method of claim 6 , further comprising determining a degree of collateral ventilation based on the changes in volumes of the first and second lung compartments.

8 . The method of claim 1 , further comprising creating a report including the treatment plan, the report indicating lung compartments determined to have collateral ventilation or degrees of collateral ventilation for lung compartments.

9 . The method of claim 8 , wherein the one or more potential treatment sites and one or more suggested implantable devices for a potential treatment site are determined, based on the lung compartment data and the fissure data during the one or more breathing cycles, to cause lung volume reduction or reduce hyperinflation.

10 . The method of claim 9 , wherein the potential treatment site of the one or more potential treatment sites is an airway leading to the first or second lung compartment.

11 . The method of claim 8 , wherein the report comprises one or more suggested therapeutic agents to be delivered to a potential treatment site of the one or more potential treatment sites to cause lung volume reduction or reduce hyperinflation.

12 . The method of claim 11 , wherein the first or second lung compartment is determined to have collateral ventilation or a degree of collateral ventilation above the threshold level and the potential treatment site comprises one or more regions within the first or second lung compartment.

13 . The method of claim 12 , wherein the one or more suggested therapeutic agents comprises a sealant.

14 . The method of claim 8 , wherein the report comprises one or more suggested therapeutic agents to be delivered to a potential treatment site of the one or more potential treatment sites to minimize collateral ventilation between lung compartments.

15 . The method of claim 14 , wherein the first or second lung compartment is determined to have collateral ventilation or a degree of collateral ventilation above the threshold level and the potential treatment site comprises an airway leading to the fissure defect.

16 . The method of claim 15 , wherein the one or more suggested therapeutic agents comprises a sealant.

17 . A method of assessing collateral ventilation in a lung of a patient, the method comprising:

analyzing computerized tomography data of the lung, wherein analyzing the computerized tomography data comprises:

segmenting tomography data representing the lung during one or more breathing cycles into segmented data representing separate lobes;

segmenting the segmented data representing at least one of the separate lobes into sub-segmented data representing a plurality of lung segments;

identifying, based on the sub-segmented data, fissure data representing a fissure defect;

identifying, based on the sub-segmented data and the fissure data, lung segment data representing one or more lung segments of the plurality of lung segments adjacent to the fissure defect;

calculating, based on the lung segment data for the one or more breathing cycles, volumes of a first lung segment adjacent to the fissure defect and a second lung segment adjacent to the fissure defect on an opposing side of the fissure defect during the one or more breathing cycles;

determining, based on the calculated volumes, changes in volumes of the first lung segment adjacent to the fissure defect and the second lung segment adjacent to the fissure defect on the opposing side of the fissure defect during the one or more breathing cycles;

determining whether collateral ventilation is present or above a threshold level in the first or second lung segment based on the changes in volumes of the first and second lung segments;

responsive to the collateral ventilation being not present or below the threshold level in the first or second lung segment, generating a treatment plan comprising one or more suggested implantable devices for placement in one or more potential treatment sites based on the lung segment data and the fissure data for the one or more breathing cycles; and

administering the treatment plan by placing at least one of the one or more suggested implantable devices in the one or more potential treatment sites.

18 . The method of claim 17 , further comprising calculating a fissure defect score based on a size of the fissure defect, wherein determining whether collateral ventilation is present or above the threshold level is further based on the calculated fissure defect score.

19 . The method of claim 17 , wherein the one or more suggested implantable devices comprises an endobronchial valve, clip, or plug.

20 . The method of claim 17 , further comprising determining treatment success based on a comparison of the tomography data representing the lung before treatment to the tomography data representing the lung after treatment.