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 a lung, wherein analyzing the computerized tomography data comprises:

segmenting the lung into separate lobes;

segmenting at least one of the separate lobes into a plurality of lung segments;

calculating emphysema scores for one or more regions of each of the plurality of lung segments based on a density mask;

identifying a fissure defect;

identifying one or more lung segments of the plurality of lung segments adjacent to the fissure defect;

calculating a fissure defect score based on a size of the fissure defect;

determining a proximity of the fissure defect to the one or more regions of the one or more identified lung segments;

selecting a lung segment of the one or more identified lung segments; and

determining whether collateral ventilation is present or above a threshold level in the selected lung segment based on the calculated emphysema scores for the one or more regions of the selected lung segment, fissure defect score, and the proximity of the fissure defect to the one or more regions of the selected lung segment.

2. The method of claim 1 , wherein collateral ventilation is determined to be present or above a threshold level if the one or more regions of the selected lung segment has an emphysema score above a threshold emphysema score value, that the fissure defect has a fissure defect score above a threshold fissure defect score value, and that the proximity of the fissure defect to the one or more regions of the selected lung segment is within a threshold proximity.

3. The method of claim 1 , wherein determining whether collateral ventilation is present or above a threshold level in the selected lung segment is further based on which fissure comprises the fissure defect, where on the fissure the fissure defect is located, or which of the plurality of lung segments the fissure defect separates.

4. The method of claim 1 , further comprising:

identifying airways, wherein determining whether collateral ventilation is present or above a threshold level in the selected lung segment is based on whether an airway is identified within a threshold proximity to the one or more regions of the selected lung segment.

5. The method of claim 1 , further comprising:

identifying airways, wherein determining whether collateral ventilation is present or above a threshold level in the selected lung segment is based on whether an airway is identified within a threshold proximity to the fissure defect.

6. The method of claim 1 , further comprising:

calculating a collateral ventilation score for the selected lung segment based on the calculated emphysema scores for the one or more regions of the selected lung segment, fissure defect score, and proximity of the fissure defect to the one or more regions of the selected lung segment, wherein determining whether collateral ventilation is present or above a threshold level in the selected lung segment is based on the calculated collateral ventilation score.

7. The method of claim 6 , further comprising:

determining a degree of collateral ventilation based on the calculated collateral ventilation score.

8. The method of claim 1 , further comprising:

creating a report indicating one or more lung segments of the plurality of lung segments determined to have collateral ventilation or degrees of collateral ventilation for the one or more lung segments.

9. The method of claim 8 , wherein the report comprises one or more potential treatment sites and one or more suggested implantable devices for the one or more potential treatment sites to cause lung volume reduction or reduce hyperinflation, wherein the selected lung segment is determined not to have collateral ventilation or a degree of collateral ventilation below a threshold level and at least one potential treatment site of the one or more potential treatment sites is an airway leading to the selected lung segment.

10. The method of claim 8 , wherein the report comprises one or more potential treatment sites and one or more suggested therapeutic agents or implantable devices to be delivered to the one or more potential treatment sites to cause lung volume reduction or reduce hyperinflation, wherein the selected lung segment is determined to have collateral ventilation or a degree of collateral ventilation above a threshold level and at least one potential treatment site of the one or more potential treatment sites comprises the one or more regions within the selected lung segment.

11. The method of claim 8 , wherein the report comprises one or more potential treatment sites and one or more suggested therapeutic agents or implantable devices to be delivered to the one or more potential treatment sites to minimize collateral ventilation between the one or more lung segments of the plurality of lung segments, wherein the selected lung segment is determined to have collateral ventilation or a degree of collateral ventilation above a threshold level and at least one potential treatment site of the one or more potential treatment sites comprises an airway leading to the fissure defect.

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

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

segmenting the lung into separate lobes;

segmenting at least one of the separate lobes into a plurality of lung segments;

identifying a fissure defect;

identifying one or more lung segments of the plurality of lung segments adjacent to the fissure defect;

calculating emphysema scores for one or more regions of a first lung segment of the one or more lung segments adjacent to the fissure defect and for one or more regions of a second lung segment of the one or more lung segments adjacent to the fissure defect on an opposing side of the fissure defect based on a density mask;

calculating a fissure defect score based on a size of the fissure defect;

determining proximity of the fissure defect to the one or more regions of the first lung segment and the one or more regions of the second lung segment; and

determining whether collateral ventilation is present or above a threshold level in the first or second lung segment based on the calculated emphysema scores, fissure defect score, and the proximity the fissure defect to the one or more regions of the first and second lung segments.

13. The method of claim 12 , wherein collateral ventilation is determined to be present or above a threshold level if the one or more regions of the first lung segment has a first emphysema score above a threshold emphysema score value, the one or more regions of the second lung segment has a second emphysema score above the threshold emphysema score value, the fissure defect has a fissure defect score above a threshold fissure defect score value, the proximity of the fissure defect to the one or more regions of the first lung segment is within a threshold proximity, and the proximity of the fissure defect to the one or more regions of the second lung segment is within the threshold proximity.

14. The method of claim 12 , further comprising:

Calculating a collateral ventilation score for the first or second lung segments based on the calculated emphysema scores of the one or more regions of the first and second lung segments, fissure defect score, and proximity the fissure defect to the one or more regions of the first and second lung segments, wherein determining whether collateral ventilation is present or above a threshold level in the first or second lung segments is based on the calculated collateral ventilation score.

15. The method of claim 14 , further comprising:

determining a degree of collateral ventilation based on the calculated collateral ventilation score.

16. The method of claim 12 , further comprising:

creating a report indicating one or more lung segments of the plurality of lung segments determined to have collateral ventilation or degrees of collateral ventilation for the one or more lung segments.

17. The method of claim 16 , wherein the report comprises one or more potential treatment sites and one or more suggested implantable devices for the one or more potential treatment sites to cause lung volume reduction or reduce hyperinflation, wherein the first or second lung segment is determined not to have collateral ventilation or a degree of collateral ventilation below a threshold level and at least one potential treatment site of the one or more potential treatment sites is an airway leading to the first or second lung segment.

18. The method of claim 16 , wherein the report comprises one or more potential treatment sites and one or more suggested therapeutic agents or implantable devices to be delivered to the one or more potential treatment sites to cause lung volume reduction or reduce hyperinflation, wherein the first or second lung segment is determined to have collateral ventilation or a degree of collateral ventilation above a threshold level and at least one potential treatment site of the one or more potential treatment sites comprises the one or more regions within the first or second lung segment.

19. The method of claim 16 , wherein the report comprises one or more potential treatment sites and one or more suggested therapeutic agents or implantable devices to be delivered to the one or more potential treatment sites to minimize collateral ventilation between the one or more lung segments, wherein the first or second lung segment is determined to have collateral ventilation or a degree of collateral ventilation above a threshold level and at least one potential treatment site of the one or more potential treatment sites comprises an airway leading to the fissure defect.