CN107374705A - A kind of lung puncture location of operation method under X-ray and preoperative CT guiding - Google Patents
A kind of lung puncture location of operation method under X-ray and preoperative CT guiding Download PDFInfo
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- CN107374705A CN107374705A CN201710468359.5A CN201710468359A CN107374705A CN 107374705 A CN107374705 A CN 107374705A CN 201710468359 A CN201710468359 A CN 201710468359A CN 107374705 A CN107374705 A CN 107374705A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3403—Needle locating or guiding means
Abstract
The present invention relates to a kind of lung puncture location of operation method under X-ray and preoperative CT guiding, including：The first step, establish the three-dimensional shape model and deformation model of lung images；Second step, CT images before corrective surgery is registering with three-dimensional shape model progress, and registration result combination deformation model calculates patient lungs' deformation model；3rd step, generate the x-ray image of simulation；4th step, it is registering with the x-ray image progress simulated to gather x-ray image in operation, the twodimensional displacement field of lung in logistic, calculates puncture needle location coordinate information；5th step, use the displacement field information of the 3-D view in the displacement field and lung's deformation model logistic of two dimension；6th step, the 3-D view after registration is generated using obtained 3-D displacement field and preoperative CT images, calculate the positional information of focus in 3-D view；7th step, adjustment puncture needle position is until complete Needle localization.Compared with prior art, the present invention has the advantages such as quick, accurate, suitable practical application.
Description
Technical field
The present invention relates to Medical Image Processing, more particularly, to the lung puncture hand under a kind of X-ray and preoperative CT guiding
Art localization method, the real-time information of x-ray image in the accurate anatomic information of preoperative CT images and art is combined, direct purpose is not
It is to obtain diagnostic result or health status, and the information processing side as intermediate result is simply obtained from human body living or animal body
Method, provided to doctor and fast and accurately visualize surgical procedure.
Background technology
With the continuous development of the technologies such as medical image, computer science, computer aided medicine is in clinical examination with controlling
Using further extensive in treatment.Under being guided present invention is mainly applied to x-ray image, with reference to the average shape of the preoperative CT images of patient and lung area
Varying model, puncture needle and the accurate location of focus are calculated by quick method for registering images, doctor's visualization is provided in real time
Surgical procedure.Puncturing operation is a kind of minimally invasive intervention operation, is clinically widely used in the inspection and treatment of cancer at present, than
Such as aspiration biopsy and ablation.Either check or treat, it is all a most key step accurately to navigate to lesions position,
So help the technology of doctor's progress lesion localization very crucial under the auxiliary of computer medical image.
With the development of social science, medical technology also in continuous innovation and breaks through.Traditionally, under medical image guiding
Lung puncture operation mainly guided using CT images, doctor according to CT images planning puncture path, according to the puncture of setting
Lung area is inserted in direction with pin depth is entered, and shoots the position of CT image viewings puncture needle and focus, constantly adjustment puncture again afterwards
The position of pin reaches default position until it.Its process needs patient repeatedly to shoot CT images in CT Room, and amount of radiation is larger,
It is slower that operation carries out speed.And x-ray image has that dose of radiation is small, the advantages such as cost is low.But because the dissection of x-ray image is believed
Breath deficiency, especially for the inferior position in soft-tissue imaging, it is impossible to be applied to the guiding of lung puncture operation.Therefore by X-ray figure
The method that the mode that picture and preoperative CT images combine carries out lung puncture combines both respective advantages, takes full advantage of CT imagings
The advantage that x-ray image image taking speed is fast in the anatomic information and art of middle patient, amount of radiation, cost are low, reaches preferably clinical effect
Fruit, there is good application prospect.
Found through the retrieval to existing article, X-ray is widely used the shape in the art of the bone tissues such as femur, basin bone, vertebra
Become and calculate, because bone tissue has prominent pixel characteristic and morphological feature in x-ray image, preferably registration meter can be obtained
Calculate effect.And the method that x-ray image applies to lung's deformation is had into the method based on 3 D auto deformation, use sparse displacement field
So that two dimensional image is projected to after CT image deformations calculates similarity, the change of the sparse displacement field of iterative, whole meter with X-ray
Evaluation time is very long, is not suitable for clinical practice.Lung's statistical model method also based on 4D CT images, it is huge to patient's amount of radiation
Greatly.
The content of the invention
It is an object of the present invention to overcome the above-mentioned drawbacks of the prior art and provide a kind of X-ray and preoperative CT draw
Lung puncture location of operation method under leading.
The purpose of the present invention can be achieved through the following technical solutions：
A kind of lung puncture location of operation method under X-ray and preoperative CT guiding, comprises the following steps：
The first step, the three-dimensional shape model and deformation model of lung images are established according to clinical physiology feature；
Second step, CT images before corrective surgery is registering with shape progress, and registration result combination deformation model calculates
Patient lungs' deformation model；
3rd step, CT images before corrective surgery are subjected to projection calculating, generate the x-ray image of simulation；
4th step, it is registering with the x-ray image progress simulated to gather x-ray image in operation, the Two-dimensional Position of lung in logistic
Field is moved, calculates puncture needle position；
5th step, use the displacement field of the 3-D view in the displacement field and lung's deformation model logistic of two dimension；
6th step, using the 3-D view after obtained 3-D displacement field and preoperative CT images generation registration, calculate three-dimensional
The position of focus in image；
7th step, in visual 3-D image guided lower adjustment puncture needle position until completing Needle localization.
The three-dimensional shape model and deformation model of described lung images define：
Three-dimensional shape model and deformation model are to be obtained using common CT image patterns as input by statistical procedures
The characteristics of image and deformation characteristics of lung CT；
Minimum breathing phases I is included using M groupsexhaleWith maximum breathing phase IinhaleCT image patterns, wherein every group of image
Minimum and maximum breathing phases are same patient data, wherein M >=10,
Shape：Floating phase by the use of minimum breathing phases as registration, reference of the maximum breathing phase as registration
Phase, affine registration is carried out to the fixed phase between M group CT images first, remove different images size and alternate position spike
Different, using M groups as reference picture, remaining M-1, which is assembled, will definitely arrive conversion coefficient：T={ T1,T2,…,TM-1,TM, TMSupplement as list
Bit map, final form model are：
WhereinTo i-th of imageThe result after affine registration is carried out, takes average sample as shape
The minimum breathing phases feature of lung is described；
Deformation model：Fixed phase using maximum breathing phase as non-rigid body model, minimum breathing phases are as floating
Phase, the 3-D view registration based on free deformation is carried out to M groups image, and the displacement field for obtaining M group phasetophase deformation is expressed as：
DVF={ D1,D2,…,DM, wherein the displacement field of registration meets that deformation converts：Last deformation
Model is：
Wherein,DiRespectively i-th of maximum breathing phase image, minimum breathing phases image, minimum breathing
Phase is to the deformational displacement field of maximum breathing phase, Ti(Di) it is to the displacement field D of i-th of deformationiCarry out the knot after affine registration
Fruit, remove size and location difference.
The method of described calculating patient lungs' deformation model is specially：
Deformation model is refined by the image of the minimum breathing phases of registration, what is obtained first is that the preoperative minimum of patient is exhaled
Inhale the CT images of phaseTo lung shape modelCarry out non-rigid shape deformations registration and obtain displacement fieldSo thatBy shapeCorresponding deformation model DmeanIn this displacement fieldLower deformation obtainsAs patient lungs' deformation model.
The x-ray image method of described generation simulation is specially：
To preoperative obtained CT imagesCarry out projection calculating, using GPU accelerate mode, simulation X-ray transmitting light source and
Ray wears the path for penetrating CT body element, is passed through per a branch of simulation ray as GPU kernal function parallel computation rays
The X-ray attenuation value of all voxels adds up, and improves calculating speed；
Attenuation coefficient α of the voxel Hu values to X-ray in CT imagesiFor：
WhereinFor voxel Hu values, μwater=0.022 is attenuation coefficient of the water to X-ray；
Length in all voxels that simulation ray is passed through adds up with attenuation coefficient obtains simulated projections image (DRR)
Pixel value：DRRi=esrc∑ L* α, wherein esrcFor X-ray emissive porwer, length of the L for simulation ray in passed through voxel, α
For the attenuation coefficient of voxel；
Locus and the coefficient of angularity that projection calculates are obtained by the calibration to X-ray equipment, set the big of projected image
Small and resolution parameter realizes the simulation of patient's x-ray image.
The twodimensional displacement field of lung in described logistic, calculating puncture needle position is specially：
The x-ray image of two vertical angles when obtaining minimum breathing phases simultaneously first, figure is gathered from the front and rear side of patient
PictureWith left and right sides imageGeneration simulation x-ray image respectivelyWith
Front and rear side and left and right sides image carry out non-rigid shape deformations registration and obtain twodimensional displacement field D respectivelyAPAnd DLAT, the two
Displacement field of the displacement field in direction as lung in art；
The position of puncture needle can be highlighted in x-ray image, be found out respectively in two dimensional x-ray image by dividing method
In position coordinates, the position P of needle tip in three dimensions is calculated by back projection method and epipolar-line constraintprobe。
The method of the displacement field of 3-D view in described logistic is specially：
The calculating of the dense displacement field of each voxel is realized with GPU accelerated modes, each kernal functions realize an individual
The space three-dimensional degree displacement calculation of element, using patient lungs' displacement model as priori in calculating, with reference to the Hu of voxel
It is worth the 3-D displacement field as coefficient also original image, the displacement of note voxel in space is D3D(i)={ Dx(i),Dy(i),Dz
(i) }, then computational methods are：
Dx(i)=DAP(x)*DT(i)*Map(I(i))
Dy(i)=DLAT(x)*DT(i)*Map(I(i))
Dz(i)=[α * DAP(y)+β*DLAT(y)]*DT(i)*Map(I(i))
Wherein Map (I (i)) is a monotonic decreasing function, when representing that the Hu values of voxel are higher, corresponding tissue
Easy deformation behavior is lower, and because the displacement of AP sides and LAT sides includes the displacement in z directions in three dimensions simultaneously, α and β are bar
The coefficient of part both sides weight, meets alpha+beta=1, DT(i) for patient lungs' deformation model in the displacement of i-th of voxel, DAP(x)、
DAP(y)、DLAT(x)、DLAT(y) for AP sides and LAT sides the corresponding x and y directions of displacement displacement.
3-D view after described generation registration, the position for calculating focus in 3-D view is specially：
After preoperative CT 3-D displacement field is obtained, the 3-D view after the method generation registration of image interpolation is usedThe image coordinate location of focus is obtained by the method for segmentation or hand labeled in CT in the preoperativeIn place
Shifting obtains the position of focus in art in the presence of field
Present invention can be implemented in three-dimensional CT image in art is generated under the guiding of x-ray image in art, pass through lung's averaging model
With the preoperative CT images of patient, the motion priori of three-dimensional CT image is obtained, image is registering with x-ray image quick after CT projections,
Twodimensional displacement field quickly rebuilds 3-D displacement field by priori and morphological constraints, generates in art CT images after three-dimensional deformation.
Ensure that operation is quick, accurately completes while substantially reducing operation amount of radiation, while reduce operation implementation cost.With existing skill
Art is compared, and the present invention has the advantages such as quick, accurate, suitable practical application.
Brief description of the drawings
Fig. 1 is the schematic flow sheet of the present invention.
Embodiment
Below in conjunction with the accompanying drawing in the embodiment of the present invention, the technical scheme in the embodiment of the present invention is carried out clear, complete
Site preparation describes, it is clear that described embodiment is the part of the embodiment of the present invention, rather than whole embodiments.Based on this hair
Embodiment in bright, the every other reality that those of ordinary skill in the art are obtained on the premise of creative work is not made
Example is applied, should all belong to the scope of protection of the invention.
Embodiment
The present embodiment is Core i5-6300HQ 2.3GHz in CPU, and video card is NVIDIA Geforce GTX 960M, interior
Save as and realized in 12.0GB computer, implementation C++.
The implementing procedure of the present embodiment is as shown in Figure 1.
The first step, gathers the abdominal CT data of 10 groups of patients from hospital in advance, and each patient breathes comprising minimum and maximum
The data of phase, the three-dimensional shape model and deformation model of lung images are established, used as follow-up；
Second step, puncturing operation patient CT images, by CT images before corrective surgery and the shape to build
Registration is carried out, registration result combination deformation model calculates lung's deformation model with patient lungs' anatomical information；
3rd step, set according to the camera site of X-ray machine device, CT images before the corrective surgery are subjected to projection calculating, it is raw
Into front and rear side and the simulation x-ray image of left and right sides；
4th step, the location parameter of shooting is set in operation, the x-ray image of side and left and right sides before and after patient is gathered, with mould
The x-ray image of plan carries out registering, the twodimensional displacement field of lung in logistic.Existed using thresholding and Hough transformation segmentation puncture needle
Position in the image of both sides, calculate the three-dimensional coordinate of puncture needle position；
5th step, using the patient's three-dimensional deformation model being computed as priori, by the displacement fields of both sides and
Pixel grey scale mappings constraint, the displacement field of the 3-D view in logistic；
6th step, image interpolation, the graphics after generation is registering are done using obtained 3-D displacement field and preoperative CT images
Picture, pass through the position of focus in three-D displacement field computation 3-D view；
The foregoing is only a specific embodiment of the invention, but protection scope of the present invention is not limited thereto, any
Those familiar with the art the invention discloses technical scope in, various equivalent modifications can be readily occurred in or replaced
Change, these modifications or substitutions should be all included within the scope of the present invention.Therefore, protection scope of the present invention should be with right
It is required that protection domain be defined.
Claims (7)
1. a kind of lung puncture location of operation method under X-ray and preoperative CT guiding, it is characterised in that comprise the following steps：
The first step, the three-dimensional shape model and deformation model of lung images are established according to clinical physiology feature；
Second step, CT images before corrective surgery is registering with three-dimensional shape model progress, and registration result combination deformation model calculates
Patient lungs' deformation model；
3rd step, CT images before corrective surgery are subjected to projection calculating, generate the x-ray image of simulation；
4th step, it is registering with the x-ray image progress simulated to gather x-ray image in operation, the twodimensional displacement field of lung in logistic,
Calculate puncture needle location coordinate information；
5th step, use the displacement field information of the 3-D view in the displacement field and lung's deformation model logistic of two dimension；
6th step, using the 3-D view after obtained 3-D displacement field and preoperative CT images generation registration, calculate 3-D view
The positional information of middle focus；
7th step, in visual 3-D image guided lower adjustment puncture needle position until completing Needle localization.
2. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In three-dimensional shape model and the deformation model definition of described lung images are specially：
Three-dimensional shape model and deformation model are to obtain lung by statistical procedures as input using common CT image patterns
CT characteristics of image and deformation characteristics；
Minimum breathing phases I is included using M groupsexhaleWith maximum breathing phase IinhaleCT image patterns, wherein every group of image is most
Small and maximum breathing phase is same patient data, wherein M >=10,
Shape：Floating phase by the use of minimum breathing phases as registration, fixed phase of the maximum breathing phase as registration,
Affine registration is carried out to the fixed phase between M group CT images first, removes different images size and position difference, with
M groups are reference picture, and remaining M-1, which is assembled, will definitely arrive conversion coefficient：T={ T1,T2,…,TM-1,TM, TMSupplement and become for unit
Change, final form model is：
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WhereinTo i-th of imageThe result after affine registration is carried out, takes average sample as shape to describe lung
The minimum breathing phases feature in portion；
Deformation model：Fixed phase using maximum breathing phase as non-rigid body model, minimum breathing phases as floating phase,
The 3-D view registration based on free deformation is carried out to M groups image, the displacement field for obtaining M group phasetophase deformation is expressed as：DVF=
{D1,D2,…,DM, wherein the displacement field of registration meets that deformation converts：Last deformation model
For：
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Wherein,DiRespectively i-th of maximum breathing phase image, minimum breathing phases image, minimum breathing phases arrive
The deformational displacement field of maximum breathing phase, Ti(Di) it is to the displacement field D of i-th of deformationiThe result after affine registration is carried out, is gone
Except size and location difference.
3. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In the method for described calculating patient lungs' deformation model is specially：
Deformation model is refined by the image of the minimum breathing phases of registration, what is obtained first is the preoperative minimum breathing phase of patient
The CT images of positionTo lung shape modelCarry out non-rigid shape deformations registration and obtain displacement fieldSo thatBy shapeCorresponding deformation model DmeanIn this displacement fieldLower deformation obtainsAs patient lungs' deformation model.
4. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In the x-ray image method of described generation simulation is specially：
To preoperative obtained CT imagesProjection calculating is carried out, the mode accelerated using GPU, simulation X-ray launches light source and ray
The path for penetrating CT body element is worn, passes through per a branch of simulation ray as GPU kernal function parallel computation rays and owns
The X-ray attenuation value of voxel adds up, and improves calculating speed；
Attenuation coefficient α of the voxel Hu values to X-ray in CT imagesiFor：
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WhereinFor voxel Hu values, μwater=0.022 is attenuation coefficient of the water to X-ray；
Length in all voxels that simulation ray is passed through adds up with attenuation coefficient obtains simulated projections image (DRR) pixel
Value：DRRi=esrc∑ L* α, wherein esrcFor X-ray emissive porwer, length of the L for simulation ray in passed through voxel, α is body
The attenuation coefficient of element；
By to X-ray equipment calibration obtain projection calculate locus and coefficient of angularity, set projected image size and
Resolution parameter realizes the simulation of patient's x-ray image.
5. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In the twodimensional displacement field of lung in described logistic, calculating puncture needle position is specially：
The x-ray image of two vertical angles when obtaining minimum breathing phases simultaneously first, image is gathered from the front and rear side of patient
With left and right sides imageGeneration simulation x-ray image respectivelyWith
Front and rear side and left and right sides image carry out non-rigid shape deformations registration and obtain twodimensional displacement field D respectivelyAPAnd DLAT, the two directions
Displacement field of the displacement field as lung in art；
The position of puncture needle can be highlighted in x-ray image, be found out respectively in two dimensional x-ray image by dividing method
Position coordinates, the position P of needle tip in three dimensions is calculated by back projection method and epipolar-line constraintprobe。
6. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In the method for the displacement field of the 3-D view in described logistic is specially：
Realize the calculating of the dense displacement field of each voxel with GPU accelerated modes, each kernal functions realize voxel
Space three-dimensional degree displacement calculation, using patient lungs' displacement model as priori in calculating, make with reference to the Hu values of voxel
For the 3-D displacement field of coefficient also original image, the displacement of note voxel in space is D3D(i)={ Dx(i),Dy(i),Dz(i) },
Then computational methods are：
Dx(i)=DAP(x)*DT(i)*Map(I(i))
Dy(i)=DLAT(x)*DT(i)*Map(I(i))
Dz(i)=[α * DAP(y)+β*DLAT(y)]*DT(i)*Map(I(i))
Wherein Map (I (i)) is a monotonic decreasing function, when representing that the Hu values of voxel are higher, the easy shape of corresponding tissue
Denaturation is lower, and because the displacement of AP sides and LAT sides includes the displacement in z directions in three dimensions simultaneously, α and β are condition two
The coefficient of side weight, meets alpha+beta=1, DT(i) for patient lungs' deformation model in the displacement of i-th of voxel, DAP(x)、DAP
(y)、DLAT(x)、DLAT(y) for AP sides and LAT sides the corresponding x and y directions of displacement displacement.
7. the lung puncture location of operation method under a kind of X-ray according to claim 1 and preoperative CT guiding, its feature exist
In the 3-D view after described generation registration, the position for calculating focus in 3-D view is specially：
After preoperative CT 3-D displacement field is obtained, the 3-D view after the method generation registration of image interpolation is usedThe image coordinate location of focus is obtained by the method for segmentation or hand labeled in CT in the preoperativeIn place
Shifting obtains the position of focus in art in the presence of field
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| CN110033454A (en) * | 2019-04-19 | 2019-07-19 | 河北大学 | The dividing method for the lung neoplasm that large area adhesion lung boundary is organized in CT image |
| CN110584752A (en) * | 2018-06-13 | 2019-12-20 | 彭水苗族土家族自治县人民医院 | Percutaneous lung puncture positioning method under CT guidance |
| CN111728627A (en) * | 2020-06-02 | 2020-10-02 | 北京昆仑医云科技有限公司 | Diagnosis support method and diagnosis support device |
| CN114831732A (en) * | 2022-07-04 | 2022-08-02 | 真健康（北京）医疗科技有限公司 | Puncture position verification method and device based on X-ray image |
| CN114842004A (en) * | 2022-07-04 | 2022-08-02 | 真健康（北京）医疗科技有限公司 | Puncture position verification method and device based on neural network model |
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| WO2022206416A1 (en) * | 2021-04-01 | 2022-10-06 | 上海复拓知达医疗科技有限公司 | Puncture process-based dynamic information display system and method |
| KR102513565B1 (en) * | 2021-10-08 | 2023-03-24 | 주식회사 피맥스 | Method and apparatus for matching lung areas autimatically |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110584752A (en) * | 2018-06-13 | 2019-12-20 | 彭水苗族土家族自治县人民医院 | Percutaneous lung puncture positioning method under CT guidance |
| CN110033454A (en) * | 2019-04-19 | 2019-07-19 | 河北大学 | The dividing method for the lung neoplasm that large area adhesion lung boundary is organized in CT image |
| CN111728627A (en) * | 2020-06-02 | 2020-10-02 | 北京昆仑医云科技有限公司 | Diagnosis support method and diagnosis support device |
| WO2022206416A1 (en) * | 2021-04-01 | 2022-10-06 | 上海复拓知达医疗科技有限公司 | Puncture process-based dynamic information display system and method |
| KR102513565B1 (en) * | 2021-10-08 | 2023-03-24 | 주식회사 피맥스 | Method and apparatus for matching lung areas autimatically |
| CN114831732A (en) * | 2022-07-04 | 2022-08-02 | 真健康（北京）医疗科技有限公司 | Puncture position verification method and device based on X-ray image |
| CN114842004A (en) * | 2022-07-04 | 2022-08-02 | 真健康（北京）医疗科技有限公司 | Puncture position verification method and device based on neural network model |
| CN115005802A (en) * | 2022-07-21 | 2022-09-06 | 首都医科大学宣武医院 | Method, system and device for positioning onset part of brain network disease |
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