CN109077804A - A kind of Microwave Coagulation Therapy method of planning based on ct images - Google Patents
A kind of Microwave Coagulation Therapy method of planning based on ct images Download PDFInfo
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- CN109077804A CN109077804A CN201810944806.4A CN201810944806A CN109077804A CN 109077804 A CN109077804 A CN 109077804A CN 201810944806 A CN201810944806 A CN 201810944806A CN 109077804 A CN109077804 A CN 109077804A
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- inserting needle
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/101—Computer-aided simulation of surgical operations
- A61B2034/105—Modelling of the patient, e.g. for ligaments or bones
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/107—Visualisation of planned trajectories or target regions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
- A61B2034/108—Computer aided selection or customisation of medical implants or cutting guides
Abstract
The invention discloses a kind of Microwave Coagulation Therapy method of planning based on ct images, comprising the following steps: reads patient's medical image sequences and shows, carries out three-dimensional reconstruction;According to three-dimensional visualization as a result, selecting best inserting needle number and inserting needle path, which can avoid vital tissue organ and there are safe distances, while the path is the shortest path on skin between entry point and target area;According to the geometry of preset inserting needle path and tumour, using automatic Three Dimensional Thermal injectivity optimizing algorithm, it is Converse solved go out optimal input parameter;The range for showing three-dimensional tissue's damage field and temperature field, to treatment plan outcome evaluation.This method can assist doctor to formulate the preoperative plan that reasonable microwave ablation is performed the operation, simulate the clinical implementation effect of the operation plan of doctor's design in the preoperative by computer simulation method, reliable surgical guidance is provided for doctor, to reduce the difficulty of implementation of operation, so that operation is safer, the damage extra to patient is reduced.
Description
Technical field
The present invention relates to microwave ablation techniques fields, belong to the front subject that computer intersects with medicine intervention field, especially
It is related to a kind of Microwave Coagulation Therapy method of planning based on ct images.
Background technique
Microwave ablation operation is current treatment one of liver cancer or the main means of lung cancer, is that a kind of effective intervention tumour is controlled
Treatment method.Patient after local anaesthesia patient, can pass through needle-like antenna for radiating microwave without operating on over the course for the treatment of for it
It crosses skin penetrating and enters inside tumor, destroy tumor tissues using the local hot spots that microwave generates, and then achieve the purpose that treatment.
Compared with traditional resection operation, microwave ablation operation is with following technical advantage: first, microwave ablation can be anti-
Multiple treatment, it is reproducible, and predictable ablation range size.Second, microwave ablation has very wide and does not depend on tissue
The active heating area of electric conductivity, transmission of the microwave energy in living tissue be not dry by tissue and charing is limited.Therefore, it swells
Enough temperature be can achieve in tumor to guarantee to create a sufficiently large ablation areas, use shorter treatment time is more thorough
Inactivation tumour.Third, less " heat drop " effect by perfusion medium of microwave ablation are influenced, can preferably be inactivated by nearby bleeding
The tumour of pipe.4th, the electron interference phenomenon present in RF ablation will not occur when multiple microwave energies act synergistically,
The ablation range of tumour can easily be expanded by synergistic effect in a short time in this way.5th, micro-wave therapeutic is being performed the operation
In have apparent coagulating effectiveness, the danger bled profusely in patient's art can be effectively reduced.Traditional microwave ablation operation refers to
Under the guidance of medical image, doctor melts tumor region by adjusting microwave power and time, inputs parameter
Selection is heavily dependent on the clinical experience of doctor.Little tumour can be melted using single needle, but work as the diameter of tumour
When larger or in irregular shape, it is excessively high and then lead to carbonized that single needle ablation easily causes local temperature, or even can damage week
Side normal tissue needs to be implanted into more ablation needles just at this time to reach therapeutic purposes.Spininess ablative surgery difficulty is big, while to doctor
More stringent requirements are proposed for raw level.
The quality of ablative surgery effect depends primarily on whether zone of ablation is completely covered target area, and whether vitals are by heat
Damage, whether normal surrounding tissue is by biggish damage.Preoperative planning is significant for ablative surgery, it can have
A possibility that effect reduces the damage to patient body and reduces postoperative recurrence.
Summary of the invention
Purpose of the invention is to overcome the shortcomings in the prior art, provides a kind of microwave ablation based on ct images and controls
Method of planning is treated, this method can assist doctor to formulate the preoperative plan of reasonable microwave ablation operation, pass through computer simulation
Method simulates the clinical implementation effect of the operation plan of doctor's design in the preoperative, provides reliable surgical guidance for doctor, thus
The difficulty of implementation of operation is reduced, so that operation is safer, reduces the damage extra to patient.
The purpose of the present invention is what is be achieved through the following technical solutions:
A kind of Microwave Coagulation Therapy method of planning based on ct images, for assist doctor formulate surgical planning, including into
Needle path diameter, depth of needle and microwave input parameter, comprising the following steps:
(1) patient's medical image sequences are read and are shown, three-dimensional reconstruction is carried out;
(2) according to three-dimensional visualization as a result, selecting best inserting needle number and inserting needle path, which can avoid important set
It knits organ and there are safe distance, while the path is the shortest path on skin between entry point and target area;
(3) according to the geometry of preset inserting needle path and tumour, using automatic Three Dimensional Thermal injectivity optimizing algorithm,
It is Converse solved go out optimal input parameter;
(4) range of display three-dimensional tissue damage field and temperature field, to treatment plan outcome evaluation.
3. in step (3), to obtain optimal treatment parameter setting objective function, making target area thermal dose highest, remaining group
Knit smaller, the objective function that is heated are as follows:
Wherein, NkThe thermal field of the organ covered for k-th by thermal dose calculates the number of point, ωn.kFor k-th by thermit powder
Measure the weight factor of n-th of target spot in the organ of covering, ωn.kSize according to the significance level of the organ covered by thermal dose
Setting, the smaller distribution for indicating thermal dose of the value of F are more reasonable;
Automatic Three Dimensional Thermal injectivity optimizing algorithm flow is as follows:
A. after providing inserting needle number and inserting needle path, original state i, initial input power P are set0When with heating
Between t0, annealing temperature Ti, calculate objective function FiValue;
B. current state is added and is disturbed, changed microwave power, treatment time or needle position of cusp, a new shape will be obtained
State j;
C. the objective function F of state j is calculatedj, and the size of new and old two objective functions: Δ T=Fj-Fi;If Δ
Input parameter and needle position of cusp are then adjusted to j state by T < 0;If Δ T > 0, parameter or needle position of cusp are inputted at this time
It can be with exp (- Δ T/Ti) be adjusted;
D. annealing temperature T is calculatedi+1=α Ti, α is the coefficient for controlling annealing temperature decrease speed, if annealing temperature Ti+1Not
Reach minimum temperature, then continue step b, if annealing temperature Ti+1Reach minimum temperature, judges whether there is the target not inactivated
Point;If so, carrying out step b starts new round iteration;If it is not, input power P and heating time after output optimization
t。
Compared with prior art, the beneficial effects brought by the technical solution of the present invention are as follows:
(1) the method for the present invention can reduce the blindness of microwave ablation operation, reduce the damage to patient body, improve hand
The accuracy of art.
(2) the method for the present invention can be by the three-dimensional visualizations such as targeted site, bone, big blood vessel and vitals, Yi Shengke
Intuitively to determine specific location of the tumour in 3 D anatomy structure, and reasonable ablation needle number is selected, it can be constantly
Adjust inserting needle path.
(3) this method can be according to preset path and tumour geometry, and target area can be completely covered by calculating
And the smallest microwave power and treatment time are damaged to normal surrounding tissue.Existing preoperative planning system is to pass through doctor mostly
Input parameter is manually set, according to the relativeness for calculating the thermal damage's range and target area that get, continuously adjusts input parameter
Until meeting clinical demand.The present invention can difficulty that is more time saving and reducing preoperative planning, while make it is preoperative planning more
It is accurate to add.
Detailed description of the invention
Fig. 1 is the flow diagram of the method for the present invention.
Fig. 2 is ablative surgery inserting needle schematic diagram.
Fig. 3 is the automatic Three Dimensional Thermal injectivity optimizing algorithm flow chart based on simulated annealing.
Specific embodiment
The invention will be further described with reference to the accompanying drawing.
Fig. 1 is the flow diagram of the method for the present invention, including inserting needle path planning process and reverse thermal dose optimization process,
The process of the therapy planning method are as follows:
Step A: patient's medical image sequences are read and are shown, three-dimensional reconstruction is carried out;
Step B: according to three-dimensional visualization as a result, selecting best inserting needle number and inserting needle path.Fig. 2 is of the present invention
Ablative surgery inserting needle schematic diagram, the selection principle of best inserting needle path are that zone of ablation is made to cover tumour most possibly and to disease
The injury of people is minimum.Since in puncture process, there are Soft Tissue Deformations and other random errors to exist, so point of puncture on skin
The shortest distance between target is considered as best inserting needle path.Simultaneously inserting needle path need to avoid big blood vessel, rib cage and
Vitals and there are certain safe distance, cannot interfere between ablation needle.Therefore, inserting needle number and inserting needle path can
It is constantly adjusted according to the three-dimensional reconstruction result of system.
Step C: it according to the geometry of preset inserting needle path and tumour, is calculated using automatic Three Dimensional Thermal injectivity optimizing
Method, it is Converse solved go out optimal input parameter;When doctor only needs to one initial microwave power of every ablation needle and heating
Between, by automatic Three Dimensional Thermal injectivity optimizing algorithm can calculate can complete inactivation tumour simultaneously to patient body damage it is the smallest
Microwave power and heating time.Optimal treatment parameter setting objective function in order to obtain, makes target area thermal dose highest, remaining group
Knit smaller, the objective function that is heated are as follows:
Wherein, NkThe thermal field of the organ covered for k-th by thermal dose calculates the number of point, ωn.kFor k-th by thermit powder
Measure the weight factor of n-th of target spot in the organ of covering, ωn.kSize according to the significance level of the organ covered by thermal dose
Setting.The value of F is smaller, illustrates that the distribution of thermal dose is more reasonable.
Fig. 3 is Three Dimensional Thermal injectivity optimizing algorithm flow chart, the specific steps are as follows:
Step C1: after doctor rule of thumb provides inserting needle number and inserting needle path, setting original state i, initially
Input power P0With heating time t0, annealing temperature Ti, calculate objective function FiValue.
Step C2: adding current state and disturb, and changes microwave power, treatment time or needle position of cusp, will obtain one
A new state j.
Step C3: the objective function F of state j is calculatedj, and the size of new and old two objective functions;Δ T=Fj-Fi,
If Δ T < 0, input parameter and needle position of cusp are adjusted to j state;If Δ T > 0, parameter or needle point are inputted at this time
Point position can be with exp (- Δ T/Ti) probability be adjusted.
Step C4: annealing temperature T is calculatedi+1=α Ti, α is the coefficient for controlling annealing temperature decrease speed, if annealing temperature
Ti+1Not up to minimum temperature then continues step C2.If annealing temperature Ti+1Reach minimum temperature, judges whether there is and do not go out
Target spot living.If so, carrying out step C2 starts new round iteration;If it is not, exporting the input power P after optimization and adding
Hot time t.
Step D: the range of display three-dimensional tissue thermal damage and temperature field, to treatment plan outcome evaluation.The three of display
Dimension tissue thermal damage is the maximum ablation boundary that can inactivate tumour, and melting boundary by maximum can be seen that preoperative plan is imitated
The quality of fruit, to treatment plan outcome evaluation.Select volume larger in specific implementation process and tumour in irregular shape, root
It needs to evade bone tissue according to the location and shape where tumour, uses two ablation needles to reach ablation purpose.According to inserting needle road
The selection principle of diameter is that two ablation needles select reasonable inserting needle path.According to optimization algorithm proposed above, finally acquire
Optimal entry point position, input power P and time t.
The present invention is not limited to embodiments described above.Above the description of specific embodiment is intended to describe and say
Bright technical solution of the present invention, the above mentioned embodiment is only schematical, is not restrictive.This is not being departed from
In the case of invention objective and scope of the claimed protection, those skilled in the art may be used also under the inspiration of the present invention
The specific transformation of many forms is made, within these are all belonged to the scope of protection of the present invention.
Claims (2)
1. a kind of Microwave Coagulation Therapy method of planning based on ct images, for assisting doctor to formulate surgical planning, including inserting needle
Path, depth of needle and microwave input parameter, which comprises the following steps:
(1) patient's medical image sequences are read and are shown, three-dimensional reconstruction is carried out;
(2) according to three-dimensional visualization as a result, selecting best inserting needle number and inserting needle path, which can avoid vital tissue device
Official and there are safe distances, while the path is the shortest path on skin between entry point and target area;
(3) according to the geometry of preset inserting needle path and tumour, using automatic Three Dimensional Thermal injectivity optimizing algorithm, inversely
Solve optimal input parameter;
(4) range of display three-dimensional tissue damage field and temperature field, to treatment plan outcome evaluation.
2. a kind of Microwave Coagulation Therapy method of planning based on ct images according to claim 1, which is characterized in that step
(3) in, to obtain optimal treatment parameter setting objective function, make target area thermal dose highest, remaining tissue is heated smaller, target
Function are as follows:
Wherein, NkThe thermal field of the organ covered for k-th by thermal dose calculates the number of point, ωn.kIt is covered for k-th by thermal dose
Organ in n-th of target spot weight factor, ωn.kSize according to the significance level of the organ covered by thermal dose set, F
Value it is smaller indicate thermal dose distribution it is more reasonable;
Automatic Three Dimensional Thermal injectivity optimizing algorithm flow is as follows:
A. after providing inserting needle number and inserting needle path, original state i, initial input power P are set0With heating time t0,
Annealing temperature Ti, calculate objective function FiValue;
B. current state is added and is disturbed, changed microwave power, treatment time or needle position of cusp, a new state j will be obtained;
C. the objective function F of state j is calculatedj, and the size of new and old two objective functions: Δ T=Fj-Fi;If Δ T <
0, then input parameter and needle position of cusp are adjusted to j state;If Δ T > 0, inputting parameter or needle position of cusp at this time can be with
exp(-ΔT/Ti) be adjusted;
D. annealing temperature T is calculatedi+1=α Ti, α is the coefficient for controlling annealing temperature decrease speed, if annealing temperature Ti+1Not up to most
Low temperature then continues step b, if annealing temperature Ti+1Reach minimum temperature, judges whether there is the target spot not inactivated;Such as
Fruit has, and carries out step b and starts new round iteration;If it is not, input power P and heating time t after output optimization.
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Application publication date: 20181225 |