CN113856068B - Preoperative implantation path planning method - Google Patents
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- A61N2005/1061—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using an x-ray imaging system having a separate imaging source
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Abstract
The invention relates to the technical fields of medical image processing and planning algorithms, in particular to a preoperative implantation path planning method for implantation radiotherapy operation. Comprising the following steps: s1, collecting images through a CT machine, and finally forming a three-dimensional model of tumors and surrounding tissues in a patient; s2, distinguishing tumor and surrounding tissues, and calculating the volume of a tumor area; s3, designing a coverage scheme according to the three-dimensional model of the tumor area, wherein the coverage scheme comprises the steps of estimating the coverage model, perfecting the coverage model and determining the coverage scheme; s4, obtaining a corresponding path plan through projection according to the determined coverage scheme. The transplanting path planning method provided by the invention has the advantages of high transplanting precision and high safety.
Description
Technical Field
The invention relates to the technical fields of medical image processing and planning algorithms, in particular to a preoperative transplanting path planning method.
Background
The prior art does not contemplate precise design of particle positions and particle sequences to enhance the effectiveness and speed of surgery. Because the preoperative planning of the current implanted radiotherapy is still in the original stage, only the approximate curative effect can be ensured, but the pain of the patient can not be reduced as much as possible and the operation effect can not be quantized. And meanwhile, the situation that the position of the non-implanted particles is deviated in the implantation process is rarely considered. The number of particles used in the implantation operation is generally large, the position setting of tens of particles is very complex under the condition of considering the radiation effect, the existing conditions are large, and the quantitative comparison curative effect is difficult; if only the curative effect is considered during the implantation, a plurality of isolated particles can appear, the number of needles to be implanted can be greatly increased, and the position to be implanted can be in dead angle, so that the implantation difficulty is obviously increased; the area covered by the particles is a sphere, and how to cover more areas as much as possible with the same particle count and ensure the radiation effect is also a problem to be explored.
Disclosure of Invention
The invention aims to overcome the defects in the prior art, and provides a preoperative transplanting path planning method which is high in transplanting precision and high in safety performance.
In order to solve the technical problems, the invention adopts the following technical scheme: a preoperative insertion path planning method comprises the following steps:
s1, collecting images through a CT machine, and finally forming a three-dimensional model of tumors and surrounding tissues in a patient;
s2, distinguishing tumor and surrounding tissues, and calculating the volume of a tumor area;
s3, designing a coverage scheme according to the three-dimensional model of the tumor area, wherein the coverage scheme comprises the steps of estimating the coverage model, perfecting the coverage model and determining the coverage scheme;
s4, obtaining a corresponding path plan through projection according to the determined coverage scheme;
further, in the step S2, after a three-dimensional model of the tumor and surrounding tissue is obtained by a CT machine, the volume of the tumor is calculated to be V, and the maximum length corresponding to the projection of the front side of the tumor is l, the maximum width is w, and the maximum height is h.
Further, the estimated coverage model includes: the covering area of the particles is a sphere, and in order to ensure that the covering area among the particles does not leave gaps and maximize the volume covered by a plurality of particles, the inscribed square of the sphere covered by the particles is taken as the volume covered by the particles, and the side length of the inscribed square of the particles is given by the assumption that the effective radiation radius of the particles is r
So that each particle is covered with a volume of +.>
Judging whether l, w and h are +.>
Multiple of (2)If not, the number is increased to the nearest integer multiple to form new l ', W ', h ', and the position point set W of all particles can be obtained.
Further, the perfect coverage model includes:
the cuboid T with the length, width and height of l ', w ' and h ' can be obtained according to the estimated coverage model to completely cover the whole tumor, and the cuboid T, the tumor and surrounding tissues are placed under the same coordinate system at the moment to obtain a corresponding boundary point set S in 12 sides of the cuboid 1 ……S 12 Wherein S is 1 –S 4 Point set of top 4 sides, S 5 –S 8 Is 4 high point sets, S 9 -S 12 The point set of 4 sides at the bottom is provided with a region formed by surrounding tissues as R and a tumor region as P;
judging according to the following judging conditions: (1) detecting that none of these boundary points is within the range of the surrounding tissue, i.e
This condition is satisfied; (2) detecting that the point set on each side exceeds +.>
Particle location point set W within tumor or on cuboid edge 1 ……W 12 Exceed->
Within the tumor, i.e. S is found i The number of results of n P exceeds S i Is->
Or W i The number of results of n P exceeds W i Is->
If the condition (1) is satisfied, no longer detecting whether the condition (2) is satisfied;
finally, the following steps are executed:
s31, assuming that the condition (1) is not satisfied, the risk of radiating surrounding tissues is necessarily existed if the current coverage scheme is carried out, so that the original cuboid T must be reduced from the viewpoint of reducing innocent damage, at the moment, one surface with the most affected surrounding tissue edges is selected from 6 surfaces of the cuboid T, and the uppermost layer is removed; finally, updating T, S, W three quantities, and judging again;
s32, if the condition (2) is not met, the excessive radiation range is outside the tumor, the radiation effect exerted by the boundary particles in the row is low, the row is removed, and the three amounts of T, S, W are updated, so that the judgment is performed again.
Further, in the above-described step S31, if there are a plurality of sides having the same number of sides, the side having the smaller area is preferentially removed.
Further, the determining the coverage scheme includes:
step S31 and step S32 are circularly executed until the condition (1) and the condition (2) are met, at the moment, whether the points in the W point set are positioned in the tumor region P or not is verified one by one, and the points which are not positioned in the P are discarded, so that a final W point set is obtained;
estimating the volume of T according to the number of W:
the coverage ratio of the current coverage scheme can be estimated as follows:
if the coverage ratio exceeds the threshold, the current W point set, namely W, is reserved 1 As a covering scheme;
if the coverage ratio does not reach the threshold value or still wants to be further optimized, extending outwards on the basis of W1, selecting one particle facing outwards each time, and screening the extended particles according to whether other tissues are damaged or not and whether the particles are in tumors, so that 6 new coverage schemes which only extend to one side can be obtained; if the condition is not satisfied, the number of extended surfaces is further increased, and a scheme with higher coverage ratio is formed.
Further, the step S4 includes planning an insertion path:
according to the coverage scheme determined in the step S3, the insertion path is projected through the x, y and z three axes, and the number of points on the formed plane is the number of pins to be inserted;
and comparing the difficulty and the number of the transplanting paths in three directions, selecting one direction from the paths, and then performing transplanting, wherein each path is a line segment parallel to each other, and the number of the particles in each transplanting is the number of points of the W point set on the line segment.
Further, the step S4 further includes optimizing the implantation path:
because the position of the particles implanted at the back is influenced by the particles implanted at the front, target point position offset is generated, after the corresponding solution is selected, each puncture path is optimized according to the sequence of puncture and the selected particle type, and the position offset of the particles to be implanted from the second time is estimated according to the radius of the particles and the extrusion of the puncture needle to tumor tissues after the puncture needle is inserted; and adjusting the position of the particle to be implanted according to the offset of the position of the particle.
Further, the calculation method of the position offset of the particles includes:
let L be ij For the total offset of the ith and jth particle sub-positions, d is the extrusion distance caused by the average implantation of 1 particle, L ijmn Is the position offset, X, caused by the extrusion of the jth particle of the ith needle to the nth particle of the mth needle ij 、Y ij 、Z ij Corresponding to the offset of X, Y, Z three dimensions, X ijmn 、Y ijmn 、Z ijmn The embodiment of the position offset caused by extrusion of the ith particle to the mth particle of the mth particle is X, Y, Z;
wherein:
L ij ＝[X ij Y ij Z ij ]
L ijmn ＝[X ijmn Y ijmn Z ijmn ]
X ij ＝∑X ijmn Y ij ＝∑Y ijmn Z ij ＝∑Z ijmn
let the coordinate of the jth particle of the ith needle be W ij The coordinate of the nth particle of the mth needle is W mn An included angle formed by the ith particle and the mth particle of the ith needle after being connected with the nth particle of the mth needle is theta, and an included angle formed by a line on the plane and an X axis is alpha, so that the method can be obtained:
calculating the position shift L of the particles to be implanted from the second particles of the first needle according to the above formula and the coordinate information of the implantation of the previous particles ij According to X ij 、Y ij 、Z ij The position of the particles to be implanted is adjusted, and then implantation is performed.
Further, according to the path planned in the step S4, the effect is estimated through the ratio of the covered volume to the tumor volume; when determining the coverage scheme, if a plurality of coverage schemes exist, evaluating the radiation effect after implementing the corresponding schemes according to the coverage ratio sequence, and selecting a scheme with larger coverage and smaller radiation to surrounding irrelevant tissues; meanwhile, taking the number of the inserted pins into consideration, if a plurality of schemes with similar effects exist, a covering scheme with the small number of the inserted pins is selected as much as possible.
Compared with the prior art, the beneficial effects are that:
1. the accuracy is high: the position of each particle can be accurately set, the radiation range of each particle can be utilized as much as possible, meanwhile, the radiation area of each particle is represented by a cube, partial areas can be effectively avoided from being missed, the planned particle position is adjusted by calculating the offset caused by particle extrusion, and the position of the particle to be implanted is dynamically adjusted according to actual conditions in an operation, so that more accurate implantation and better effect are achieved;
2. the safety is high: the radiation condition of irrelevant tissues is used as the most important judgment condition, so that the coverage area is reduced rather than the influence on healthy tissues is avoided;
3. full automation: the whole flow can be realized fully automatically, and a feasible scheme can be quickly obtained and a corresponding path can be planned only by inputting three-dimensional model data of the tumor and surrounding tissues at the beginning;
4. the options are as follows: multiple schemes can be selectively generated, and the multiple schemes are displayed in sequence according to the number of the inserting needles and the coverage ratio, and judgment and selection are performed;
5. providing an evaluation criterion: a coverage ratio is provided that can be used to estimate and evaluate the effect.
Drawings
FIG. 1 is a schematic flow chart of the method of the present invention.
Detailed Description
As shown in fig. 1, a method for planning a preoperative insertion path includes the following steps:
and 1, collecting images through a CT machine, and finally forming a three-dimensional model of the tumor and surrounding tissues in the patient.
Step 2, distinguishing tumor and surrounding tissues, and calculating the volume of a tumor area; after a three-dimensional model of the tumor and surrounding tissues is obtained through a CT machine, calculating to obtain the volume V of the tumor, and obtaining the maximum length l, the maximum width w and the maximum height h corresponding to the projection of the front side surface of the tumor.
Step 3, designing a coverage scheme according to the three-dimensional model of the tumor area, wherein the coverage scheme comprises the steps of estimating the coverage model, perfecting the coverage model and determining the coverage scheme;
the estimated coverage model comprises the following steps: the covering area of the particles is a sphere, and in order to ensure that the covering area among the particles does not leave gaps and maximize the volume covered by a plurality of particles, the inscribed square of the sphere covered by the particles is taken as the volume covered by the particles, and the particles are assumedThe effective radiation radius of the particle is r, the side length of the inscribed cube of the particle is
So that each particle is covered with a volume of +.>
Judging whether l, w and h are +.>
If not, the number of the position points W is increased to the nearest integer multiple to form new l ', W ', h ', and the position point W of all particles can be obtained.
The perfect coverage model comprises the following steps:
the cuboid T with the length, width and height of l ', w ' and h ' can be obtained according to the estimated coverage model to completely cover the whole tumor, and the cuboid T, the tumor and surrounding tissues are placed under the same coordinate system at the moment to obtain a corresponding boundary point set S in 12 sides of the cuboid 1 ……S 12 Wherein S is 1 –S 4 Point set of top 4 sides, S 5 –S 8 Is 4 high point sets, S 9 -S 12 The point set of 4 sides at the bottom is provided with a region formed by surrounding tissues as R and a tumor region as P;
judging according to the following judging conditions: (1) detecting that none of these boundary points is within the range of the surrounding tissue, i.e
This condition is satisfied; (2) detecting that the point set on each side exceeds +.>
Particle location point set W within tumor or on cuboid edge 1 ……W 12 Exceed->
Within the tumor, i.e. S is found i The number of results of n P exceeds S i Is->
Or W i The number of results of n P exceeds W i Is->
If the condition (1) is satisfied, no longer detecting whether the condition (2) is satisfied;
finally, the following steps are executed:
s31, assuming that the condition (1) is not satisfied, the risk of radiating surrounding tissues is necessarily existed if the current coverage scheme is carried out, so that the original cuboid T must be reduced from the viewpoint of reducing innocent damage, at the moment, one surface with the most affected surrounding tissue edges is selected from 6 surfaces of the cuboid T, and the uppermost layer is removed; if a plurality of surfaces affect the same edge number, preferentially removing the surface with smaller area; finally, updating T, S, W three quantities, and judging again;
s32, if the condition (2) is not met, the excessive radiation range is outside the tumor, the radiation effect exerted by the boundary particles in the row is low, the row is removed, and the three amounts of T, S, W are updated, so that the judgment is performed again.
The coverage scheme determination comprises the following steps:
step S31 and step S32 are circularly executed until the condition (1) and the condition (2) are met, at the moment, whether the points in the W point set are positioned in the tumor region P or not is verified one by one, and the points which are not positioned in the P are discarded, so that a final W point set is obtained;
estimating the volume of T according to the number of W:
the coverage ratio of the current coverage scheme can be estimated as follows:
if the coverage ratio exceeds the threshold, the current W point set, namely W, is reserved 1 As a means ofA covering scheme;
if the coverage ratio does not reach the threshold value or still wants to be further optimized, extending outwards on the basis of W1, selecting one particle facing outwards each time, and screening the extended particles according to whether other tissues are damaged or not and whether the particles are in tumors, so that 6 new coverage schemes which only extend to one side can be obtained; if the condition is not satisfied, the number of extended surfaces is further increased, and a scheme with higher coverage ratio is formed.
Step 4, obtaining a corresponding path plan through projection according to the determined coverage scheme;
firstly, planning an transplanting path: according to the coverage scheme determined in the step S3, the insertion path is projected through the x, y and z three axes, and the number of points on the formed plane is the number of pins to be inserted; and comparing the difficulty and the number of the transplanting paths in three directions, selecting one direction from the paths, and then performing transplanting, wherein each path is a line segment parallel to each other, and the number of the particles in each transplanting is the number of points of the W point set on the line segment.
Then, the implantation path is optimized: because the position of the particles implanted at the back is influenced by the particles implanted at the front, target point position offset is generated, after the corresponding solution is selected, each puncture path is optimized according to the sequence of puncture and the selected particle type, and the position offset of the particles to be implanted from the second time is estimated according to the radius of the particles and the extrusion of the puncture needle to tumor tissues after the puncture needle is inserted; and adjusting the position of the particle to be implanted according to the offset of the position of the particle.
The calculation method of the position offset of the particles comprises the following steps:
let L be ij For the total offset of the ith and jth particle sub-positions, d is the extrusion distance caused by the average implantation of 1 particle, L ijmn Is the position offset, X, caused by the extrusion of the jth particle of the ith needle to the nth particle of the mth needle ij 、Y ij 、Z ij Corresponding to the offset of X, Y, Z three dimensions, X ijmn 、Y ijmn 、Z ijmn The position offset caused by the extrusion of the ith particle to the nth particle of the mth particle is X, Y, Z threeThe dimension is embodied;
wherein:
L ij ＝[X ij Y ij Z ij ]
L ijmn ＝[X ijmn Y ijmn Z ijmn ]
X ij ＝∑X ijmn Y ij ＝∑Y ijmn Z ij ＝∑Z ijmn
let the coordinate of the jth particle of the ith needle be W ij The coordinate of the nth particle of the mth needle is W mn An included angle formed by the ith particle and the mth particle of the ith needle after being connected with the nth particle of the mth needle is theta, and an included angle formed by a line on the plane and an X axis is alpha, so that the method can be obtained:
calculating the position shift L of the particles to be implanted from the second particles of the first needle according to the above formula and the coordinate information of the implantation of the previous particles ij According to X ij 、Y ij 、Z ij The position of the particles to be implanted is adjusted, and then implantation is performed.
In the invention, according to the path planned in the step S4, the surgical curative effect is estimated by the ratio of the covered volume to the tumor volume; when determining the coverage scheme, if a plurality of coverage schemes exist, evaluating the radiation effect after implementing the corresponding schemes according to the coverage ratio sequence, and selecting a scheme with larger coverage and smaller radiation to surrounding irrelevant tissues; meanwhile, taking the number of the inserted pins into consideration, if a plurality of schemes with similar effects exist, a covering scheme with the small number of the inserted pins is selected as much as possible.
While embodiments of the present invention have been shown and described above, it will be understood that the above embodiments are illustrative and not to be construed as limiting the invention, and that variations, modifications, alternatives and variations may be made to the above embodiments by one of ordinary skill in the art within the scope of the invention.
It is to be understood that the above examples of the present invention are provided by way of illustration only and not by way of limitation of the embodiments of the present invention. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. Any modification, equivalent replacement, improvement, etc. which come within the spirit and principles of the invention are desired to be protected by the following claims.
Claims (6)
1. The preoperative transplanting path planning method is characterized by comprising the following steps of:
s1, collecting images through a CT machine, and finally forming a three-dimensional model of tumors and surrounding tissues in a patient;
s2, distinguishing tumor and surrounding tissues, and calculating the volume of a tumor area;
s3, designing a coverage scheme according to the three-dimensional model of the tumor area, wherein the coverage scheme comprises the steps of estimating the coverage model, perfecting the coverage model and determining the coverage scheme;
s4, obtaining a corresponding path plan through projection according to the determined coverage scheme;
in the step S2, after a three-dimensional model of the tumor and surrounding tissues is obtained through a CT machine, calculating to obtain the volume V of the tumor, and obtaining the maximum length l, the maximum width w and the maximum height h corresponding to the projection of the front side surface of the tumor;
the estimated coverage model comprises the following steps: the covering area of the particles is a sphere, and in order to ensure that the covering area among the particles does not leave gaps and maximize the volume covered by a plurality of particles, the inscribed square of the sphere covered by the particles is used as the volume covered by the particles,assuming that the effective radiation radius of the particle is r, the inscribed square of the particle has a side length of
So that each particle is covered with a volume of +.>
Judging whether l, w and h are +.>
If not, increasing to the nearest integer multiple to form new l ', W ', h ', and obtaining a position point set W of all particles;
the perfect coverage model comprises the following steps:
the cuboid T with the length, width and height of l ', w ' and h ' can be obtained according to the estimated coverage model to completely cover the whole tumor, and the cuboid T, the tumor and surrounding tissues are placed under the same coordinate system at the moment to obtain a corresponding boundary point set S in 12 sides of the cuboid 1 ……S 12 Wherein S is 1 –S 4 Point set of top 4 sides, S 5 –S 8 Is 4 high point sets, S 9 -S 12 The point set of 4 sides at the bottom is provided with a region formed by surrounding tissues as R and a tumor region as P;
judging according to the following judging conditions: (1) detecting that none of these boundary points is within the range of the surrounding tissue, i.e
This condition is satisfied; (2) detecting that the point set on each side exceeds +.>
Particle location point set W within tumor or on cuboid edge 1 ……W 12 Exceed->
Within the tumor, i.e. S is found i The number of results of n P exceeds S i Is->
Or W i The number of results of n P exceeds W i Is->
If the condition (1) is satisfied, no longer detecting whether the condition (2) is satisfied;
finally, the following steps are executed:
s31, assuming that the condition (1) is not satisfied, the risk of radiating surrounding tissues is necessarily existed if the current coverage scheme is carried out, so that the original cuboid T must be reduced from the viewpoint of reducing innocent damage, at the moment, one surface with the most affected surrounding tissue edges is selected from 6 surfaces of the cuboid T, and the uppermost layer is removed; finally, updating T, S, W three quantities, and judging again;
s32, assuming that the condition (2) is not met, indicating that the excessive radiation range is outside the tumor, removing the row of boundary particles with lower radiation effect, updating T, S, W three quantities, and judging again;
the coverage scheme determination comprises the following steps:
step S31 and step S32 are circularly executed until the condition (1) and the condition (2) are met, at the moment, whether the points in the W point set are positioned in the tumor region P or not is verified one by one, and the points which are not positioned in the P are discarded, so that a final W point set is obtained;
estimating the volume of T according to the number of W:
the coverage ratio of the current coverage scheme can be estimated as follows:
if the coverage ratio exceeds the threshold, then reserveThe current W point set is W 1 As a covering scheme;
if the coverage ratio does not reach the threshold value or still wants to be further optimized, then at W 1 Extending outwards on the basis, selecting one particle facing outwards each time, and screening the extended particles according to whether other tissues are damaged or not and whether the particles are in tumors, so that 6 new coverage schemes which only extend one side can be obtained; if the condition is not satisfied, the number of extended surfaces is further increased, and a scheme with higher coverage ratio is formed.
2. The method according to claim 1, wherein in the step S31, if there are a plurality of sides with the same number of sides, the side with the smaller area is preferentially removed.
3. The method of claim 1, wherein the step S4 includes planning an insertion path:
according to the coverage scheme determined in the step S3, the insertion path is projected through the x, y and z three axes, and the number of points on the formed plane is the number of pins to be inserted;
and comparing the difficulty and the number of the transplanting paths in three directions, selecting one direction from the paths, and then performing transplanting, wherein each path is a line segment parallel to each other, and the number of the particles in each transplanting is the number of points of the W point set on the line segment.
4. The method of claim 3, wherein the step S4 further comprises optimizing the implantation path:
because the position of the particles implanted at the back is influenced by the particles implanted at the front, target point position offset is generated, after the corresponding solution is selected, each puncture path is optimized according to the sequence of puncture and the selected particle type, and the position offset of the particles to be implanted from the second time is estimated according to the radius of the particles and the extrusion of the puncture needle to tumor tissues after the puncture needle is inserted; and adjusting the position of the particle to be implanted according to the offset of the position of the particle.
5. The method of claim 4, wherein the calculating the position offset of the particles comprises:
let L be ij For the total offset of the ith and jth particle sub-positions, d is the extrusion distance caused by the average implantation of 1 particle, L ijmn Is the position offset, X, caused by the extrusion of the jth particle of the ith needle to the nth particle of the mth needle ij 、Y ij 、Z ij Corresponding to the offset of X, Y, Z three dimensions, X ijmn 、Y ijmn 、Z ijmn The embodiment of the position offset caused by extrusion of the ith particle to the mth particle of the mth particle is X, Y, Z;
wherein:
L ij ＝[X ij Y ij Z ij ]
L ijmn ＝[X ijmn Y ijmn Z ijmn ]
X ij ＝∑X ijmn Y ij ＝∑Y ijmn Z ij ＝∑Z ijmn
let the coordinate of the jth particle of the ith needle be W ij The coordinate of the nth particle of the mth needle is W mn An included angle formed by the ith particle and the mth particle of the ith needle after being connected with the nth particle of the mth needle is theta, and an included angle formed by a line on the plane and an X axis is alpha, so that the method can be obtained:
calculating the position shift L of the particles to be implanted from the second particles of the first needle according to the above formula and the coordinate information of the implantation of the previous particles ij According to X ij 、Y ij 、Z ij The position of the particles to be implanted is adjusted, and then implantation is performed.
6. The method according to any one of claims 1 to 5, wherein the effect is estimated from the ratio of the covered volume to the tumor volume according to the path planned in step S4; when determining the coverage scheme, if a plurality of coverage schemes exist, evaluating the radiation effect after implementing the corresponding schemes according to the coverage ratio sequence, and selecting a scheme with larger coverage and smaller radiation to surrounding irrelevant tissues; meanwhile, taking the number of the inserted pins into consideration, if a plurality of schemes with similar effects exist, selecting a coverage scheme with a small number of inserted pins.
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