CN112043377B - Ultrasound visual field simulation auxiliary ablation path planning method and system for any section of CT - Google Patents

Ultrasound visual field simulation auxiliary ablation path planning method and system for any section of CT Download PDF

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CN112043377B
CN112043377B CN202011085287.4A CN202011085287A CN112043377B CN 112043377 B CN112043377 B CN 112043377B CN 202011085287 A CN202011085287 A CN 202011085287A CN 112043377 B CN112043377 B CN 112043377B
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CN112043377A (en
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梁萍
于杰
董立男
程志刚
刘方义
韩治宇
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Fifth Medical Center of PLA General Hospital
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Abstract

The ultrasound visual field simulation auxiliary ablation path planning method and system for any section of CT comprises the following steps: (1) acquiring a CT image, and reconstructing data of bones, body surfaces, livers, tumors and blood vessels; (2) selecting the position of an ultrasonic probe parallel to the right intercostal space to generate a CT section passing through the center of the tumor and ensure that the section does not intersect with the ribs; (3) cutting and converting the CT section to simulate the actual abdominal ultrasonic visual field range; (4) generating a needle insertion path in an ultrasonic visual field plane, wherein the path needs to meet a constraint condition not intersecting with a blood vessel; (5) generating a simulated thermal field; and (4) judging the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, acquiring the parallel section of the plane along the long axis direction of the coronary tumor, and executing the step (3) until the thermal field completely covers the tumor.

Description

Ultrasound visual field simulation auxiliary ablation path planning method and system for any section of CT
Technical Field
The invention relates to the technical field of medical image processing, in particular to a CT arbitrary section ultrasonic visual field simulation auxiliary ablation path planning method and a CT arbitrary section ultrasonic visual field simulation auxiliary ablation path planning system.
Background
Compared with the operation, the ultrasonic guided microwave and radio frequency ablation therapy is a new local treatment means for liver cancer, the technology converts electromagnetic waves into heat energy through ultrasonic guidance through a microwave or radio frequency needle, and transmits the energy to a tumor region to realize local complete coagulative necrosis of the tumor, and the technology is recommended as a first-line treatment method for small liver cancer by a plurality of international guidelines such as NCCN, BCLC and the like. However, ultrasound-guided ablation of liver cancer is a comprehensive process involving many knowledge and technical links, and although the technology is widely applied, there are still some important basic scientific problems to be researched and solved.
Precision is the ultimate goal pursued by tumor ablation therapy. The individual three-dimensional space needle insertion path planning is a necessary means for realizing accurate ablation. At present, three-dimensional ablation path planning is based on CT or MR images before a patient operation, a three-dimensional model is established, so that a planner can clearly observe adjacent relation around a tumor in a three-dimensional space, an accurate needle insertion path is designed to avoid blood vessels and other important structures, and the optimal treatment effect is realized with the lowest damage and the least needle insertion times. However, preoperative planning based on CT images often has a large deviation from the puncture path during operation under ultrasound guidance, and this defect has become one of the challenges of precise ablation.
The three-dimensional space display is an advantage of three-dimensional space needle insertion planning, but has great limitations, and particularly, the difference between a CT observation visual field range and an intraoperative real-time ultrasonic visual field range is great, so that the path planning only through a CT image is not consistent with the needle insertion operability under actual ultrasonic guidance, and finally the operation planning is disjointed from the actual execution process. At present, a multi-modal image fusion intraoperative navigation technology based on a magnetic positioning technology can realize the fusion of a CT and an ultrasonic image, but a combined magnetic positioning device is needed, and the intraoperative needle insertion process still needs to depend on preoperative needle insertion path planning. In addition, the simulation ultrasonic method can establish three-dimensional volume ultrasound according to the real ultrasonic acquisition of the region of interest, and display a tomographic image according to the position of the virtual probe, but the volume ultrasound acquisition process is complex and is not easy to obtain, so that the practicability is poor. In recent years, ultrasound image simulation methods based on CT data, such as ultrasound reflex modeling, have focused on the simulation of an image imaging mode and image resolution. Therefore, based on the above problems, there is a need for a visualized preoperative planning system that can integrate CT and intraoperative ultrasound image visual field display characteristics in a three-dimensional space based on CT, and improve performability and accuracy of preoperative planning.
Disclosure of Invention
In order to overcome the defects of the prior art, the invention aims to provide a CT arbitrary section ultrasonic visual field simulation auxiliary ablation path planning method, which focuses more on the simulation of CT image resolution and ultrasonic imaging visual field at the same time, so that the needle insertion is planned based on the CT image and referring to the actual visual angle of a doctor in operation in the preoperative three-dimensional planning process, the reasonable planning of the operation is facilitated for a non-ultrasonic imaging doctor, and the performability and the accuracy of preoperative planning are improved.
The technical scheme of the invention is as follows: the ultrasound visual field simulation auxiliary ablation path planning method for any section of the CT comprises the following steps:
(1) acquiring a CT image, and reconstructing data of bones, body surfaces, livers, tumors and blood vessels;
(2) selecting the position of an ultrasonic probe in the intercostal space parallel to the right season, generating a CT section passing through the center of the tumor, and ensuring that the section does not intersect with the ribs;
(3) cutting and converting the CT section to simulate the actual abdominal ultrasonic visual field range;
(4) generating a needle insertion path in an ultrasonic visual field plane, wherein the path needs to meet a constraint condition not intersecting with a blood vessel;
(5) generating a simulated thermal field; and (4) judging the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, acquiring the parallel section of the plane along the long axis direction of the coronary tumor, and executing the step (3) until the thermal field completely covers the tumor.
The invention acquires CT images, carries out three-dimensional reconstruction, generates CT sections passing through the center of a tumor, carries out cutting transformation on the CT sections, simulates the actual abdominal ultrasonic visual field range, generates a needle insertion path in an ultrasonic visual field plane, generates a simulated thermal field, and focuses more on the simulation of CT image resolution and ultrasonic imaging visual field at the same time, so that the needle insertion is planned based on CT images and referring to the actual visual angle in the operation of a doctor in the preoperative three-dimensional planning process, thereby being beneficial to the reasonable planning of the operation of a non-ultrasonic imaging doctor and improving the performability and the accuracy of preoperative planning.
Also provided is a system for simulating and assisting ablation path planning in an ultrasonic field of view of any section of CT, which comprises:
a data import module configured to acquire a CT image;
a reconstruction module configured to reconstruct bone, body surface, liver, tumor, vascular data;
a CT section generation module, which is configured to select the position of the ultrasonic probe in parallel with the right intercostal space, generate a CT section passing through the center of the tumor and ensure that the section does not intersect with the ribs;
a simulated ultrasound field of view module configured to crop CT cross-sections to simulate an actual abdominal ultrasound field of view;
a needle insertion path generation module configured to generate a needle insertion path within an ultrasound field of view plane, the path being required to satisfy a constraint condition not intersecting with a blood vessel;
and the simulated thermal field generation module is configured to judge the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, the parallel section of the plane is acquired along the long axis direction of the coronal tumor, and the simulated ultrasonic visual field module is executed until the thermal field completely covers the tumor.
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Fig. 1 is a flow chart of a CT arbitrary section ultrasound field of view simulation assisted ablation path planning method according to the present invention.
Fig. 2 is a flowchart of an embodiment of a CT arbitrary section ultrasound field of view simulation assisted ablation path planning method according to the present invention.
Fig. 3 is a schematic diagram of path planning according to the present invention.
Detailed Description
The image-guided minimally invasive technology has become one of the hot spots of tumor treatment, and in order to achieve accurate tumor inactivation under the guidance of ultrasonic images, three-dimensional visualization preoperative planning is a necessary means, but preoperative planning based on CT images is often not consistent with intraoperative paths under the guidance of ultrasonic images, and the significance of improving treatment accuracy through preoperative planning is lost, so that the CT three-dimensional image with the ultrasonic field of view is a key method for solving the problem.
As shown in FIG. 1, the method for simulating and assisting in planning the ablation path in the CT arbitrary section ultrasonic field of view comprises the following steps:
(1) acquiring a CT image, and reconstructing data of bones, body surfaces, livers, tumors and blood vessels;
(2) selecting the position of an ultrasonic probe in the intercostal space parallel to the right season, generating a CT section passing through the center of the tumor, and ensuring that the section does not intersect with the ribs;
(3) cutting and converting the CT section to simulate the actual abdominal ultrasonic visual field range;
(4) generating a needle insertion path in an ultrasonic visual field plane, wherein the path needs to meet a constraint condition not intersecting with a blood vessel;
(5) generating a simulated thermal field; and (4) judging the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, acquiring the parallel section of the plane along the long axis direction of the coronary tumor, and executing the step (3) until the thermal field completely covers the tumor.
The invention acquires CT images, carries out three-dimensional reconstruction, generates CT sections passing through the center of a tumor, carries out cutting transformation on the CT sections, simulates the actual abdominal ultrasonic visual field range, generates a needle insertion path in an ultrasonic visual field plane, generates a simulated thermal field, and focuses more on the simulation of CT image resolution and ultrasonic imaging visual field at the same time, so that the needle insertion is planned based on CT images and referring to the actual visual angle in the operation of a doctor in the preoperative three-dimensional planning process, thereby being beneficial to the reasonable planning of the operation of a non-ultrasonic imaging doctor and improving the performability and the accuracy of preoperative planning.
Preferably, in the step (1), a CT apparatus is used to perform an abdominal scan, obtain DICOM (Digital Imaging and Communications in Medicine) images of preoperative CT, segment and three-dimensionally reconstruct a relevant region of interest.
Preferably, the step (2) comprises the following substeps:
(2.1) calculating the geometric center coordinates of the tumor based on the three-dimensional tumor model;
(2.2) selecting two points p1 in the space between the right body surface and the parallel ribs, using p2 as the initial position of the probe, and determining a CT section by combining the tumor center point.
Preferably, in step (2.1), the calculation is performed by: calculating the coordinate mean value of the tumor body data points, or iteratively searching the maximum value point of the tumor diameter through double-section circulation.
Preferably, said step (2.2) is realized by a multi-planar reconstruction method.
Preferably, the step (3) comprises the following substeps:
(3.1) taking the model of the probe as an input parameter, and acquiring the width L of an ultrasonic transduction array in the probe, a conventional imaging angle theta in an ultrasonic operation, depth information H and CT image resolution p;
(3.2) generating an initial two-dimensional matrix M1(H, W) in the CT section according to the position coordinates of the two points of the initial probe, wherein W is 2 × H sin (θ/2) + L tan (θ/2), the origin of the straight boundary on the left side of the ultrasonic sector a [1, a ], where a ═ int [ H × sin (θ/2) -L (1-tan (θ/2))/2)/p ], left of the right starting point b [1, b ], where b is int [ a + L/p ], ultrasonic left-side straight line boundary end point coordinates c [ c,1], wherein c ═ int [ (H × cos (θ/2) -L · (1-tan (θ/2))/tan (θ/2)/2)/p ], ultrasound right side boundary end point coordinates d [ c, d1], wherein d1 ═ int [ W/p ];
(3.3) the boundary coordinate of the fan-shaped deep part left side radian is [ int [ (h + k × radian (θ)/s/2)/p ], k ], wherein k is 1,2,3 … … w/p/2, the boundary coordinate of the right side radian is obtained through symmetrical information, and the fan-shaped shallow part radian is calculated in the same way;
(3.4) the pixel values outside the sector boundary of the M1 matrix are replaced by 0, and a matrix M2 is generated, which is an ultrasound field of view simulation matrix.
Preferably, the step (4) comprises the following sub-steps:
(4.1) generating an initial needle inserting path by taking the boundary point on the right side of the probe as a needle inserting point and taking the tumor center as a target point;
(4.2) judging whether the path intersects with the blood vessel by taking the blood vessel V as a constraint condition, if so, rotating a certain angle to the right by taking the tumor center as the center until the path does not intersect with the blood vessel, and determining the plane needle insertion path N1.
Preferably, the certain angle in step (4.2) is 5 °.
Preferably, in the step (5), according to the type of the ablation needle, the intersection point of the path and the tumor distal end boundary is used as a long-axis boundary point of the thermal field to generate a simulated thermal field, and parameters of the thermal field are set according to the type of the ablation needle.
It will be understood by those skilled in the art that all or part of the steps in the method of the above embodiments may be implemented by hardware instructions related to a program, the program may be stored in a computer-readable storage medium, and when executed, the program includes the steps of the method of the above embodiments, and the storage medium may be: ROM/RAM, magnetic disks, optical disks, memory cards, and the like. Therefore, corresponding to the method of the invention, the invention also comprises a CT arbitrary section ultrasonic visual field simulation auxiliary ablation path planning system which is generally expressed in the form of functional modules corresponding to the steps of the method. The system comprises:
a data import module configured to acquire a CT image;
a reconstruction module configured to reconstruct bone, body surface, liver, tumor, vascular data;
a CT section generation module, which is configured to select the position of the ultrasonic probe in parallel with the right intercostal space, generate a CT section passing through the center of the tumor and ensure that the section does not intersect with the ribs;
a simulated ultrasound field of view module configured to crop CT cross-sections to simulate an actual abdominal ultrasound field of view;
a needle insertion path generation module configured to generate a needle insertion path within an ultrasound field of view plane, the path being required to satisfy a constraint condition not intersecting with a blood vessel;
and the simulated thermal field generation module is configured to judge the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, the parallel section of the plane is acquired along the long axis direction of the coronal tumor, and the simulated ultrasonic visual field module is executed until the thermal field completely covers the tumor.
One embodiment of the present invention is explained below.
As shown in fig. 2 and 3, the path planning method of the present invention includes:
s1, acquiring a CT image;
and (4) carrying out abdominal scanning by using CT equipment to obtain DICOM images of preoperative CT.
S2, segmenting and reconstructing bones, body surfaces, livers, tumors and blood vessel data;
the relevant region of interest is segmented and reconstructed in three dimensions.
S3, selecting the position of the ultrasonic probe in a right-season parallel to the intercostal space to generate a CT section passing through the center of the tumor and ensure that the section is not intersected with the ribs;
firstly, calculating the geometric center coordinate of the tumor based on a three-dimensional tumor model, wherein the calculation can be realized by various methods, such as calculating the coordinate mean value of tumor body data points, or searching the maximum value point of the tumor diameter through double-section loop iteration; two points p1 are selected in the space between the parallel ribs on the right body surface, p2 is used as the probe initialization position, the CT section is determined by combining the tumor center point, and the calculation can be realized by a multi-plane reconstruction algorithm.
S4, transforming the CT section to simulate the abdominal ultrasonic sector visual field range;
taking the model of the probe as an input parameter, and acquiring the width L of an ultrasonic transduction array in the probe, a conventional imaging angle theta in an ultrasonic operation, depth information H and CT image resolution p; generating an initial two-dimensional matrix M1(H, W) in the CT section according to the position coordinates of the two points of the initial probe, wherein W is 2 × H sin (θ/2) + L tan (θ/2), the origin of the straight boundary on the left side of the ultrasonic sector a [1, a ], where a ═ int [ H × sin (θ/2) -L (1-tan (θ/2))/2)/p ], left of the right starting point b [1, b ], where b is int [ a + L/p ], ultrasonic left-side straight line boundary end point coordinates c [ c,1], wherein c is int [ (H ═ cos (θ/2) -L · (1-tan (θ/2))/tan (θ/2)/2)/p ], ultrasound right-side boundary end point coordinates d [ c, d1], wherein d1 is int [ W/p ]. The boundary coordinates of the left radian at the deep part of the sector are [ int [ (h + k × radian (θ)/s/2)/p ], k ], wherein k is 1,2,3 … … w/p/2, the boundary coordinates of the right radian are obtained through symmetrical information, and the radian at the shallow part of the sector is calculated in the same way. Then, the pixel values outside the sector boundary of the M1 matrix are replaced with 0, and a matrix M2, which is an ultrasound field simulation matrix, is generated.
S5, generating a needle insertion path in an ultrasonic visual field plane, wherein the path needs to meet a constraint condition of not intersecting with a blood vessel;
taking the boundary point on the right side of the probe as a needle insertion point, and taking the tumor center as a target point to generate an initial needle insertion path; and (3) judging whether the path intersects with the blood vessel by taking the blood vessel V as a constraint condition, if so, rotating the path rightwards by a certain angle by taking the tumor center as the center, setting the rotation step length as 5 degrees until the path does not intersect with the blood vessel, and determining the planar needle insertion path N1.
S6, generating a simulated thermal field;
and generating a simulated thermal field by taking the intersection point of the path and the tumor distal boundary as a thermal field long axis boundary point according to the type of the ablation needle, wherein the thermal field parameters can be set according to the type of the ablation needle.
S7, judging the coverage relation between the thermal field of the layer and the tumor space, if not, translating a path meeting the constraint condition on the plane until the thermal field completely covers the tumor
And judging the covering relation between the thermal field and the tumor according to the boundary coordinate of the thermal field and the space coordinate of the tumor, if the thermal field and the tumor are not completely covered, translating a path Nn meeting the constraint condition on the plane, and setting the translation stepping distance as the length of the short-axis radius of the thermal field until the thermal field completely covers the tumor.
Compared with ultrasonic simulation methods such as multi-modal image fusion based on a magnetic positioning technology, an ultrasonic simulation technology and the like, the method is simpler, convenient and easy to execute, realizes three-dimensional space planning combining two image visual field characteristics only based on CT images, is more suitable for the application purpose of the invention, focuses on ultrasonic imaging visual field range simulation rather than ultrasonic image space resolution simulation, and is beneficial to non-ultrasonic imaging doctors to carry out reasonable space planning and treatment on tumors.
The above description is only a preferred embodiment of the present invention, and is not intended to limit the present invention in any way, and all simple modifications, equivalent variations and modifications made to the above embodiment according to the technical spirit of the present invention still belong to the protection scope of the technical solution of the present invention.

Claims (5)

  1. The ultrasound visual field simulation auxiliary ablation path planning method for any section of CT is characterized by comprising the following steps: which comprises the following steps:
    (1) acquiring a CT image, and reconstructing data of bones, body surfaces, livers, tumors and blood vessels;
    (2) selecting the position of an ultrasonic probe in the intercostal space parallel to the right season, generating a CT section passing through the center of the tumor, and ensuring that the section does not intersect with the ribs;
    (3) cutting and converting the CT section to simulate the actual abdominal ultrasonic visual field range;
    (4) generating a needle insertion path in an ultrasonic visual field plane, wherein the path needs to meet a constraint condition not intersecting with a blood vessel;
    (5) generating a simulated thermal field; judging the spatial coverage relation between the thermal field and the tumor, if not, acquiring the parallel section of the plane along the long axis direction of the coronary tumor, and executing the step (3) until the thermal field completely covers the tumor;
    in the step (1), abdominal scanning is performed by using CT equipment to obtain DICOM images of preoperative CT, and relevant interested areas are segmented and three-dimensionally reconstructed;
    the step (2) comprises the following sub-steps:
    (2.1) calculating the geometric center coordinates of the tumor based on the three-dimensional tumor model;
    (2.2) selecting two points p1 in the space between the right body surface and the parallel ribs, taking p2 as the probe initialization position, and determining a CT section by combining the tumor center point;
    in the step (2.1), the calculation is realized by the following method: calculating the coordinate mean value of the tumor body data points, or iteratively searching the maximum point of the tumor diameter through double-section circulation;
    the step (2.2) is realized by a multi-plane reconstruction method;
    the step (3) comprises the following sub-steps:
    (3.1) taking the model of the probe as an input parameter, and acquiring the width L of an ultrasonic transduction array in the probe, a conventional imaging angle theta in an ultrasonic operation, depth information H and CT image resolution p;
    (3.2) generating an initial two-dimensional matrix M1(H, W) in the CT section according to the initial two-point probe position coordinates, wherein W =2 × H × sin (θ/2) + L × tan (θ/2), the ultrasonic fan-shaped left-side straight-line boundary starting point a [1, a ], wherein a = int [ ((H × sin (θ/2) -L [ (1-tan (θ/2))/2)/p ], the right-side starting point left side b [1, b ], wherein b = int [ a + L/p ], the ultrasonic left-side straight-line boundary end point coordinates c [ c,1], wherein c = int [ ((H × cos (θ/2) -L [ (1-tan (θ/2))/tan (θ/2)/p ], the ultrasonic right-side boundary end point coordinates d [ c, d1], wherein d1= int [ W/p ];
    (3.3) calculating the boundary coordinate of the left radian at the deep part of the sector, wherein the boundary coordinate of the right radian is obtained through symmetrical information, and the radian at the shallow part of the sector is calculated in the same way;
    (3.4) the pixel values outside the sector boundary of the M1 matrix are replaced by 0, and a matrix M2 is generated, which is an ultrasound field of view simulation matrix.
  2. 2. The CT arbitrary-section ultrasound field of view simulation aided ablation path planning method of claim 1, wherein: the step (4) comprises the following sub-steps:
    (4.1) generating an initial needle inserting path by taking the boundary point on the right side of the probe as a needle inserting point and taking the tumor center as a target point;
    (4.2) judging whether the path intersects with the blood vessel by taking the blood vessel V as a constraint condition, if so, rotating a certain angle to the right by taking the tumor center as the center until the path does not intersect with the blood vessel, and determining the plane needle insertion path N1.
  3. 3. The CT arbitrary-section ultrasound field of view simulation aided ablation path planning method of claim 2, wherein: the certain angle in the step (4.2) is 5 degrees.
  4. 4. The CT arbitrary-section ultrasound field of view simulation aided ablation path planning method of claim 3, wherein: and (5) generating a simulated thermal field by taking the intersection point of the path and the tumor far-end boundary as a thermal field long-axis boundary point according to the type of the ablation needle, wherein the parameters of the thermal field are set according to the type of the ablation needle.
  5. 5. The system for planning an ultrasound-field-of-view simulated ablation path for any tangent plane of CT according to claim 1, wherein: it includes:
    a data import module configured to acquire a CT image;
    a reconstruction module configured to reconstruct bone, body surface, liver, tumor, vascular data;
    a CT section generation module, which is configured to select the position of the ultrasonic probe in parallel with the right intercostal space, generate a CT section passing through the center of the tumor and ensure that the section does not intersect with the ribs;
    a simulated ultrasound field of view module configured to crop CT cross-sections to simulate an actual abdominal ultrasound field of view;
    a needle insertion path generation module configured to generate a needle insertion path within an ultrasound field of view plane, the path being required to satisfy a constraint condition not intersecting with a blood vessel;
    and the simulated thermal field generation module is configured to judge the spatial coverage relation between the thermal field and the tumor, if the thermal field and the tumor are not completely covered, the parallel section of the plane is acquired along the long axis direction of the coronal tumor, and the simulated ultrasonic visual field module is executed until the thermal field completely covers the tumor.
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