CN101859341A - Image-guided ablation surgery planning device - Google Patents
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Abstract
The invention discloses an image-guided ablation surgery planning device, which comprises a patient three-dimensional image construction unit, an image display unit, a surgical path input unit, a microwave energy field computing unit, a temperature field computing unit, and a damage field computing unit, wherein the patient three-dimensional image construction unit is used for acquiring a three-dimensional image of the patient according to the CT or MRI medical image of the patient; the image display unit is used for displaying the three-dimensional image of the patient; the surgical path input unit is used for inputting needle inlet point, angle, depth, power and ablation duration of the ablation surgery; the microwave energy field computing unit is used for computing the distribution of microwave energy absorbed by tissues to be ablated in unit time and unit volume; the temperature field computing unit is used for computing the temperature field distribution of the tissues to be ablated by taking the computed microwave energy field as an internal heat source; the damage field computing unit is used for computing temperature damage areas of the tissues to be ablated; and the computed temperature damage areas are displayed on the three-dimensional image of the patient in a fusing way through the image display unit. The device can reflect the true anatomical structures of organisms and tumors in a mode of the three-dimensional image and predict an ablation range accurately so as to provide objective reference for implementing the ablation surgery.
Description
Technical field
The present invention relates to a kind of ablation surgery planning device, relate in particular to a kind of image-guided ablation surgery planning device.
Background technology
Liver cancer is one of common malignancy the most, and there is the million people of surpassing in the whole world every year on average because of liver cancer dead (Esquivel, Keeffe et al.1999).Part excision at present is still the prefered method of treatment liver cancer, but excision only is suitable for the patient (Lai of 9%-27%, Fan et al.1995), most of primary and metastatic hepatic carcinoma patient are because the position of its tumour or have other liver diseases etc. former thereby can not accept resection operation.Therefore, Wicresoft's interventional therapy is necessary for the prognosis that improves liver cancer patient.
For liver cancer, microwave ablation is a kind of very effective heating ablation method, and it has shown many advantages (Liang and Wang 2007) that are better than other operations.It has advantage common in the thermal ablation techniques, for example: elasticity methods of treatment, good tolerability, measurable ablation range size and good reproducibility.Compare with the radio-frequency ablation technique that generally adopts on the our times, microwave ablation has following theoretic advantage.The first, microwave ablation adopts initiatively heating, and RF ablation is passive heating.Microwave ablation has very broad and does not rely on the active heating region of the electric conductivity of tissue.The restriction (Skinner, Lizuka et al.1998) of drying and charing is not organized in the transmission of microwave energy in living tissue.Therefore, thereby temperature can reach enough enough big ablation areas of height assurance creation in the tumour, with short treatment time deactivation tumour more completely.Second, but the heat conduction of the effective heating region of cooling reason appreciable impact of blood flow, but the less influence (Wright, Sampson et al.2005) of being poured into " heat drop " effect of medium of microwave ablation, like this it better deactivation near the tumour in the target zone of blood vessel.The 3rd, the electron interference that exists in RF ablation (Wright, Lee et al.2003) can not occur when several microwave energies are used simultaneously.Can in short treatment time, melt big tumour at an easy rate like this by synergy.
In the microwave ablation operation, up to the present, the surgery planning that most of doctors use gets according to rationalistic reasoning, and is little for the directiveness of practical clinical.So, plan it is very important through the skin operation pathway before the art accurately that the image data at actual patient of a practicality has been done.This planning not only needs to predict ablation range accurately, comprises concrete temperature field and damage fields, also needs accurately to reflect by the mode of 3-dimensional image the real anatomical structure of patient's organ and tumour.
Summary of the invention
The present invention is intended to propose a kind of image-guided ablation surgery planning device, by this device, reflect the real anatomical structure of patient's organ and tumour in the mode of 3-dimensional image, predict ablation range exactly, thereby provide objective reference for implementing ablative surgery.
Image-guided ablation surgery planning device of the present invention comprises: patient's 3-dimensional image construction unit is used for the 3-dimensional image that CT or MRI medical image according to the patient obtain the patient; Image display cell is used to show patient's 3-dimensional image; The operation pathway input block is used to import entry point, angle, the degree of depth, the power of ablative surgery and melts the duration; The microwave energy field computing unit is used for the microwave energy absorbed of organizing that unit of account chronomere volume will melt and distributes; The temperature field computing unit, as internal heat resource, the temperature field of the tissue that calculating will be melted distributes with the microwave energy field that calculates gained; Damage field computing unit, the fire damage zone that is used to calculate the tissue that will melt; The fire damage zone of calculating gained is integrated and shown on patient's the 3-dimensional image by image display cell.
By image-guided ablation surgery planning device of the present invention, the doctor can rebuild the 3-dimensional image of patient's bone and important organ by CT data before the art, and according to the damage range of bio-heat transfer principle accurate Calculation operation with generation, result to operation carries out anticipation, adjust in advance entry point, angle, the degree of depth, power and the time of ablation needle repeatedly according to the result of anticipation, obtain best entry point, angle, the degree of depth, power and time, improve the success ratio of operation, reduce patient's operation misery.
Description of drawings
From the following description to preferred embodiments and drawings that purport of the present invention and use thereof are described, above and other purpose of the present invention, characteristics and advantage will be conspicuous, in the accompanying drawings:
Fig. 1 is the system construction drawing of image-guided ablation surgery planning device of the present invention;
Fig. 2 is the view when should image-guided ablation surgery planning device of the present invention undergoing surgery planning.
Embodiment
Be illustrated in figure 1 as the system construction drawing of image-guided ablation surgery planning device of the present invention.This image-guided ablation surgery planning device comprises patient's 3-dimensional image construction unit, is used for the 3-dimensional image that CT or MRI medical image according to the patient obtain the patient; Image display cell is used to show patient's 3-dimensional image; The operation pathway input block is used to import entry point, angle, the degree of depth, the power of ablative surgery and melts the duration; The microwave energy field computing unit is used for the microwave energy absorbed of organizing that unit of account chronomere volume will melt and distributes; The temperature field computing unit, as internal heat resource, the temperature field of the tissue that calculating will be melted distributes with the microwave energy field that calculates gained; Damage field computing unit, the fire damage zone that is used to calculate the tissue that will melt; The fire damage zone of calculating gained is integrated and shown on patient's the 3-dimensional image by image display cell.The patient's that patient's 3-dimensional image construction unit will obtain according to CT or the MRI medical image of patient before the art 3-dimensional image is shown to image display cell, the doctor is based on shown patient's 3-dimensional image, imports entry point, angle, the degree of depth, the power of ablative surgery and melts the duration by the operation pathway input block; According to the operation pathway of being imported, the microwave energy field computing unit calculates the microwave energy absorbed of organizing that the unit interval unit volume will melt and distributes; As internal heat resource, the temperature field computing unit calculates the temperature field and distributes with microwave energy field; Distribute based on the temperature field of calculating gained, damage field computing unit calculates the fire damage zone of the tissue that melts; The fire damage zone of calculating gained is integrated and shown in by image display cell on patient's the 3-dimensional image, judges the effect that melts under this operation pathway for the doctor.
Here, image display cell is a display.The operation pathway input block is mouse, keyboard or touch pad, handwriting pad etc.
Patient's 3-dimensional image construction unit shows the anatomical structure of patient's focus region exactly by the three-dimensional visualization of medical image in the surgery planning process.This patient's 3-dimensional image construction unit is programmable graphics processor GPU (Graphic Processing Unit), and GPU makes up patient's 3-dimensional image by the method for volume drawing.
Volume drawing is the most frequently used a kind of method for visualizing, its main thought is, each pixel from the imaging plane, send a ray along direction of visual lines (just pointing to the direction of pixel on the screen) by observation point, this ray passes 3 d data field, select several equidistant sampled points along this ray, the color of sampled point and opacity can be by obtaining by doing Tri linear interpolation from the color value of the contiguous voxel of this sampled point and opacity value.Behind the opacity value and color value of asking all sampled points on this ray, adopt from back to front or method is from front to back mixed the color and the opacity of each sampled point, thereby calculate the color value at this pixel place on the screen.Traditional object plotting method often uses based on the serial algorithm of CPU and finishes calculating, and counting yield is subjected to bigger limitation, is difficult to reach the real-time rendering in the dynamic man-machine interaction, plans in clinical operation thereby be difficult to practice.
Along with the continuous development of 3D graphic hardware, programmable graphics processor GPU (GraphicProcessing Unit) has developed into a kind of multithreading, many-core processor of highly-parallelization.Relative CPU, it has outstanding computing power.Why the floating-point ability exists such difference between CPU and the GPU, and reason designs with regard to being GPU to aim at the calculating of computation-intensive, highly-parallelization, and the design of GPU is used for data processing with more transistor, but not metadata cache and current control.In particular, GPU is exclusively used in solution can be expressed as the problem that data parallel calculates, and the program of executed in parallel on many data elements has high bulk density, thereby can greatly improve the counting yield of corresponding program.The render process that the present invention effectively utilizes the GPU computation capability to come acceleration bodies to draw, the speed and the precision of three-dimensional visualization have significantly been improved, for the real-time rendering in the high-resolution three-dimension scene and man-machine interactive operation provide may, thereby can reduce the required time of surgery planning significantly, greatly improve the efficient of surgery planning.
Before carrying out the GPU drafting, at first need to create two groups of data texturings that are used to play up.First group is the three-D grain in the video memory, be mainly used in the three-dimensional data that preservation obtains the original CT data normalization, the CT value of tissue mainly is distributed between-1024 to 1024, can be with the floating point values of original CT value linear mapping to the 0-1 interval, and be kept in the three-D grain in the video memory, be used for the resampling of drawing process.Second group is the one dimension texture in the video memory, be mainly used in preservation from the CT value to color value with the mapping relations the opacity value, it is preserved with the form of look-up table, this look-up table can be used as index with the data in the 0-1 interval, and obtains color value and opacity value with the preservation of rgba four component forms.Owing to the CT value is evenly distributed between the 0-1 by mapping, therefore can adopts the value that sampling obtains from CT three-dimensional data texture directly to carry out double sampling, and obtain the color and the opacity value of this point as the parameter of searching of color lookup table.
The volume drawing process is based on mainly that above two class data texturings carry out.At each pixel, what at first need to determine is the essential information of pixel along the direction of visual lines ray, comprises that ray passes the inlet point of volume data field, and the length of ray process in the volume data field.Subsequently, can begin in CT data texture, to carry out equally spaced sampling by inlet point according to directions of rays, and utilize the CT value of sampled point in look-up table, to inquire about corresponding color and opacity value, the result who obtains progressively mixes the sampled point color value according to formula (1) by the vertical order of direction of visual lines, till ray penetrates the volume data field.In order further to improve operation efficiency, here adopted light premature termination technology, that is to say, when color value in mixed process, opacity also can be accumulated, when opacity value is higher than a certain value, such as 0.99, think that then part that ray passes has stopped the further propagation of light fully, when promptly can't see the voxel of back, further the sampling along ray just there is no need.At this moment stop the sampling on this ray, and present color value as the final color value of this pixel.This method can reduce calculated amount, raises the efficiency.The algorithm flow of blend of colors is as follows:
(1) obtains first sampling point position; (2) sampling obtains color value and the opacity value that gray-scale value and double sampling obtain this sampled point; (3) calculate mixing back opacity value and color value according to formula (1).If opacity, turns to (5) greater than 0.99;
(4) the current sampling point position is added a sampling interval,, repeat (2)-(4) if the position that obtains and first sampling point position difference are passed length less than ray; (5) opacity and the color value of output mixing;
Because at drawing process, all pixel rendering results' calculating all is totally independent of other pixels, so from putting in order, the implementation of whole algorithm is parallel fully, can make full use of the advantage that the GPU multi-core parallel concurrent calculates; In addition, in the process of playing up, used sampling operation in a large number, owing to these method of samplings are all finished by specific hardware cell, so can further improve the rendering efficiency of volume rendering algorithm for GPU to the video memory texture.
In the surgery planning process, need carry out the analog computation of microwave thermal field.The scope in the tumour deactivation zone that accurately calculates surgical procedure and produced according to predefined surgery planning path just, and this need of work is realized in conjunction with the ultimate principle of bio-heat transfer and the experimental result of clinical testing.Specifically, calculate main three steps of dividing: the distribution of microwave energy field, the temperature field of tissue distribute and calculate the fire damage field.Be that example describes below with the liver.
The microwave energy field computing unit is used to finish the calculating of microwave energy field, can be calculated according to equation (2) here
Wherein, W is a microwave power, C
tBe proportionality constant, this hypothesis is to be based upon Q
rWith on the basis that microwave energy is directly proportional, N is the index constant, gets 2.2 at this; R is a radial distance; Z is an axial distance; z
0Be empirical constant.This formula is a semiempirical formula, keeps the framework of this formula constant, two involved parameters C
tAnd Z
0Have corresponding difference according to different types of organizations and different thermotherapy conditions, need revise to reach the analog result of degree of precision by from the measurement result of clinical operation, obtaining further statistics.
The temperature field computing unit is used to calculate the temperature field distribution of hepatic tissue, just hepatic tissue is in different time and diverse location temperature change in net, here can utilize the regularity of distribution and the Pennes biological heat diffusivity equation of microwave energy field to calculate, the Pennes equation as the formula (3):
Wherein, T is the thermodynamic temperature of biological tissue; ρ is the density of biological tissue; C is the specific heat of biological tissue; λ is the thermal conductivity of biological tissue; ρ
bDensity for arterial blood; c
bSpecific heat for arterial blood; T
bThermodynamic temperature for arterial blood; ω
bBe blood perfusion rate; Q
rBe unit interval unit volume biological tissue microwave energy absorbed; Q
mBe metabolic heat production, Q
cBe the heat conduction between microwave and biological tissue,, in calculating, generally it ignored because Qm and Qc are very little to the influence of result of calculation.
At the initial stage of ablation procedure, with the rising of temperature, blood vessel expands, blood flow quickens, thereby causes the blood perfusion rate of biological tissue to become big, causes blood perfusion rate to reduce owing to blood constantly solidifies again subsequently.Here, blood perfusion rate ω
bDepend on the temperature of tissue and the degree of fire damage, concrete relation as the formula (5): ω
b(T, Ω)=ω
B0f
tf
u(5) ω wherein
B0Initial filling rate for tissue for hepatic tissue, is about 0.0182m
3s
-1m
-3f
tBe the temperature variant scale-up factor of filling rate.
Damage field computing unit is used for computation organization fire damage zone, and it is the most important standard of assessment tumour microwave ablation surgical effect, and a large amount of necrosis and apoptosis can appear in inner tumour cell in the fire damage zone.At present, utilize the temperature of biological tissue to judge to organize whether be subjected to fire damage usually.What this method compared is simple and convenient, and former most studies personnel and the doctor of Clinical Surgery adopt this method.Yet this method is coarse as a rule.The fire damage of increasing test card open-birth fabric texture is not only relevant with the temperature of tissue, and to be in time of this temperature relevant with tissue.This problem can utilize the Arrhenius equation to calculate, this equation as the formula (6):
Wherein, A is a pre-exponential factor; Δ E is an energy of activation; R is a universal gas constant; T is drawn by temperature field Pennes Equation for Calculating for the temperature of tissue; Ω is the fire damage function, and it is subjected to the influence of tissue temperature and these two parameters of the duration under this temperature.Be the meaning that the another one mathematic(al) representation of function can more directly show Ω with Ω, promptly (Ω), the cell number that fire damage takes place in its expression tissue accounts for the share of the total cell number in the tissue to 1-exp.According to relevant theoretical and experiment, further think when cell fire damage about 63% is arranged in organizing, can think to organize irreversible fire damage takes place.Therefore, through type Arrhenius Equation for Calculating if draw Ω 〉=1, thinks so and organizes fire damage that this tissue is arranged in the fire damage field.
It should be noted that in the microwave ablation process thermal properties and blood perfusion rate constantly change with the loss of the raising of temperature and heat, this just is accompanied by energy field and the temperature field is influenced by this.Therefore, in order to satisfy physical condition better, the method for using iterative is the characteristic iterative of temperature field, damage fields and these dynamic changes, thereby draws accurate more result.
In actual operation, need at first scanning patient abdominal cavity CT before the art, and it is imported in the image-guided ablation surgery planning device, the mode by real-time volume drawing is presented at patient's 3 D anatomy structure on the display.Subsequently, the surgeon can add and adjust the position and the power time parameter of operation pathway, and at particular path, system reconstructing goes out damage field and merge to be shown on patient's the anatomical structure figure.The doctor can compare this damage fields zone and tumor region, thereby judges that surgical planning whether can effectively deactivation tumour, till the needs that satisfy actual operation, as shown in Figure 2.In order to realize tumour original position complete inactivation, damage field should enlarge 5～10mm outside tumour, and cover whole tumour fully for the ablation areas that makes operation, usually need a plurality of surgery plannings whiles or successively act on tumor region, the thermal field analogy method of mentioning herein is equally applicable to the situation of many operation pathway.Assisting down of image-guided ablation surgery planning device, the doctor can guarantee that operation pathway can not pass through bone and trunk.
The image-guided ablation surgery planning device of this paper has all been obtained good effect in zoopery and clinical operation.By to the zoopery result and to the tolerance of clinical operation postoperative CT data, the thermal field calculating parameter in this image guided ablation surgery planning device and the accuracy of surgical simulation are constantly revised.The microwave ablation equipment that uses in this experiment is that the frequency of operation of Beijing Science and Technology Ltd. of Hua Kangtong nation development is the image-guided microwave ablation instrument of the IGMA-I type of 2450MHz, the computer system that is used for thermal field simulation and surgery planning adopts Intel i7 920 4 nuclear CPU, 4G internal memory and Nvidia GeForce 285 video cards.In this image guided ablation surgery planning device, the calculating in fire damage zone and three-dimensionalreconstruction required time were lower than for 1 second, and play up the speed of playing up that can reach 40 frames/per second based on the volume drawing that GPU quickens, faster more than 100 times than the method that pure CPU plays up, the user interface of complete real-time interactive is provided for the doctor.
For the simulation of microwave energy field in the calculating of microwave thermal field, the parameters C in the equation (1)
tAnd Z
0Need determine that they are directly related with the distributional pattern of energy field by a large amount of experiment statistics data, thus final decision the size and the form of fire damage field.This experiment obtains statistics as shown in table 1, and brings these data in the equation anti-C of solving by repeatedly testing and measure on the pork liver that exsomatizes
tAnd Z
0Two parameters.The animal experiment that adopt to exsomatize, reason is that the theoretical parameter of thermal field is subjected to the minimum that influences of blood flow under this condition, thereby can obtain the experimental data that matches with the theoretical prediction value, for the initial value of parameter estimation provides a relatively more consistent experiment condition.But it is to be noted, in the live body surgical procedure, because blood flow especially trunk is taken away the influence of factors such as heat, the form of damage fields can be different, the postoperative CT data that these need be by clinical operation and surgery planning in addition further correction recently.
Table 1
| Power (W) | Time (s) | Trans D (cm) | Vertical diameter (cm) | ??C t | ??Z 0 |
| ??50 | ??600 | ??2.32±0.0 | ??3.23±0.1 | ??0.0218 | ??3.6180 |
| ??60 | ??600 | ??2.35±0.1 | ??4.15±0.1 | ??0.0236 | ??3.5547 |
| ??70 | ??600 | ??2.37±0.1 | ??4.42±0.1 | ??0.0229 | ??3.3492 |
| ??80 | ??600 | ??2.37±0.1 | ??4.92±0.1 | ??0.0248 | ??3.2236 |
For the patient who undergos surgery, within 5 days to two weeks after surgery, rescan abdominal CT, on the CT data, measure the actual damage zone size and and the data calculated of surgery planning compare, with the precision of measurement surgical simulation.Clinical statistics result to many cases typical case liver cancer patient operative treatment is as shown in table 2, and the result shows the method emulation damage fields exactly of this paper and is suitable for clinical testing.
Table 2
| Power (W) | Time (s) | Cross measure diameter (cm) | Vertically measure diameter (cm) | Horizontal emulation diameter (cm) | Vertical emulation diameter (cm) |
| ??50 | ??180 | ??1.88 | ??2.67 | ??1.97 | ??2.55 |
| ??50 | ??300 | ??2.03 | ??2.87 | ??2.13 | ??2.63 |
| ??50 | ??600 | ??2.73 | ??3.93 | ??2.85 | ??3.62 |
| ??50 | ??900 | ??2.98 | ??4.15 | ??2.99 | ??3.89 |
By image-guided ablation surgery planning device of the present invention, the doctor can rebuild the 3-dimensional image of patient's bone and important organ by CT data before the art, and will produce damage range according to bio-heat transfer principle accurate Calculation operation, result to operation carries out anticipation, adjust in advance entry point, angle, the degree of depth, power and the time of ablation needle repeatedly according to the result of anticipation, obtain best entry point, angle, the degree of depth, power and time, improve the success ratio of operation, reduce patient's operation misery.
Although illustrated and described the preferred embodiments of the present invention, it is contemplated that those skilled in the art can design various modifications of the present invention in the spirit and scope of claims.The present invention also is not limited to previous embodiment, also can be applicable to other tumours.
Claims (7)
1. image-guided ablation surgery planning device comprises:
Patient's 3-dimensional image construction unit is used for the 3-dimensional image that CT or MRI medical image according to the patient obtain the patient;
Image display cell is used to show patient's 3-dimensional image;
The operation pathway input block is used to import entry point, angle, the degree of depth, the power of ablative surgery and melts the duration;
The microwave energy field computing unit is used for the microwave energy absorbed of organizing that unit of account chronomere volume will melt and distributes;
The temperature field computing unit, as internal heat resource, the temperature field of the tissue that calculating will be melted distributes with the microwave energy field that calculates gained;
Damage field computing unit, the fire damage zone that is used to calculate the tissue that will melt; The fire damage zone of calculating gained is integrated and shown on patient's the 3-dimensional image by image display cell.
2. image-guided ablation surgery planning device as claimed in claim 1 is characterized in that: described patient's 3-dimensional image construction unit is realized by GPU.
3. image-guided ablation surgery planning device as claimed in claim 1 is characterized in that: patient's 3-dimensional image obtains by the method for volume drawing.
4. image-guided ablation surgery planning device as claimed in claim 1 is characterized in that: the calculating of microwave energy field is based on following equation:
Wherein, W is a microwave power, C
tBe proportionality constant, N is the index constant, gets 2.2 at this; R is a radial distance; Z is an axial distance; z
0Be empirical constant; The result who calculates is transformed into the suffered microwave energy field of human body particular location in conjunction with entry point, angle and the degree of depth of operation pathway.
5. image-guided ablation surgery planning device as claimed in claim 1 is characterized in that: the calculating in temperature field is based on following equation:
Wherein, T is the thermodynamic temperature of biological tissue; ρ is the density of biological tissue; C is the specific heat of biological tissue; λ is the thermal conductivity of biological tissue; ρ
bDensity for arterial blood; c
bSpecific heat for arterial blood; T
bThermodynamic temperature for arterial blood; ω
bBe blood perfusion rate; Q
rBe unit interval unit volume biological tissue microwave energy absorbed; Q
mBe metabolic heat production, Q
cBe the heat conduction between microwave and biological tissue.
6. image-guided ablation surgery planning device as claimed in claim 5 is characterized in that: blood perfusion rate ω
b(T, Ω)=ω
B0f
tf
u, ω wherein
B0Be the initial filling rate of tissue, f
tBe the temperature variant scale-up factor of filling rate.
7. image-guided ablation surgery planning device as claimed in claim 1 is characterized in that: the calculating of damage fields is based on following equation:
Wherein, A is a pre-exponential factor; Δ E is an energy of activation; R is a universal gas constant; Ω is the fire damage function; T is a tissue temperature, is calculated by the temperature field.
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