CN116473516A - Tumor thermal ablation effect evaluation system and evaluation method based on photoacoustic elastic image - Google Patents
Tumor thermal ablation effect evaluation system and evaluation method based on photoacoustic elastic image Download PDFInfo
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Abstract
A tumor thermal ablation effect evaluation system and method based on photoacoustic elastic images belong to the technical field of medical imaging systems. The effect of tumor treatment can be estimated in an omnibearing manner, more accurately and reasonably. The evaluation system comprises a pulse laser, a laser light path, a photothermal treatment module, a time sequence control circuit, an ultrasonic scanner and a data processing module. The evaluation method comprises the following steps of S1, imaging before thermotherapy: determining the location and size of a tumor; s2, photothermal treatment: establishing a relation between the elastic modulus of the tissue and the hardness of the tissue, and determining an elastic modulus threshold value of the tissue reaching coagulation necrosis; s3, imaging after thermal therapy: drawing the edge of an ablation focus and mapping the edge of the ablation focus to an ultrasonic image before hyperthermia, and evaluating the hardness of a treated tissue; s4, elastography data analysis: comparing with the pre-hyperthermia imaging of S1; s5, judging whether supplementary ablation is needed by the doctor. The invention can generate shear waves with larger bandwidth, thereby obtaining higher imaging spatial resolution and more accurate elastic modulus information of tumor tissues.
Description
Technical Field
The invention belongs to the technical field of medical imaging systems, and particularly relates to a tumor thermal ablation effect evaluation system and method based on photoacoustic elastic images.
Background
Tumor thermal ablation is a safe and effective method for treating tumors, and is a technology for thermally solidifying tumor tissues to a necrotic degree by utilizing heat energy. The tumor tissue is heated to high temperature by using heat energy such as radio frequency current, microwave radiation, laser, ultrasonic sound wave and the like, so that protein and cell nuclei of the tumor tissue are rapidly denatured, coagulation necrosis is generated, and the purpose of treating the tumor is achieved. Compared with the traditional operation, the thermal ablation treatment has the advantages of small wound, quick recovery, repeatability and the like.
Photothermal therapy is a non-invasive method of thermal ablation of tumors, a technique that treats tumors based on the photothermal effect. The basic principle is that a photosensitizer is injected into a patient and irradiated by laser with specific wavelength, so that the photosensitizer generates heat energy to destroy lesion cells in surrounding tissues. The photothermal treatment has the advantages of short time, obvious curative effect, small toxic and side effects and the like.
During the course of treatment, clinicians often need to determine whether ablation is successful immediately after ablation in case they need to perform supplemental ablation therapy. In the tumor thermal therapy process, the power and the irradiation time of the laser are both based on the experience of doctors, and due to uneven distribution of the thermal field, tumor cells at some parts may not be effectively treated, and in order to ensure that pathological tissues can be completely eliminated after the tumor photothermal therapy and can not relapse, the effect of tumor thermal ablation needs to be assessed. Therefore, finding a relatively simple and timely ablation effect judgment method becomes a problem to be solved urgently.
For the evaluation of the thermal ablation effect of tumors, the hardness of the lesion tissues can be obviously changed before and after thermal ablation. After ablation, the tissue may denature and coagulate, which may become stiffer than the surrounding normal tissue. Thus, the success rate of the edge of the ablation zone during the ablation process can be evaluated. In general, when diseased tissue is heated above 60 ℃, the elastic properties of the tissue change, causing cell necrosis, the tissue begins to harden and with increasing thermal ablation time, the non-ablated tissue is relatively soft. Therefore, the method for evaluating the effect of tumor thermal ablation by using elastography has great potential, and the elastography method becomes an effective means for evaluating the thermal ablation curative effect in recent years, and the resolution of elastography and the accuracy of quantitative elastic modulus determine the evaluation effect.
Therefore, the shear wave elastography evaluation system based on the imaging spatial resolution is higher, and can realize non-contact elastography, so that the accuracy of the evaluation effect is improved, and the technical problem to be solved by the person skilled in the art is urgent.
Disclosure of Invention
The invention aims to solve the problems, and further provides a tumor thermal ablation effect evaluation system and a tumor thermal ablation effect evaluation method based on photoacoustic elastic images, which can evaluate the effect of tumor treatment in an omnibearing, more accurate and more reasonable manner.
The technical scheme adopted by the invention is as follows:
a tumor thermal ablation effect evaluation system based on photoacoustic elastic images comprises
The pulse laser is used as a laser emitting device for photoacoustic shear wave elastography and is used for emitting short pulse laser capable of exciting tissue to generate shear waves;
a laser light path for collimating and focusing the short pulse laser emitted by the pulse laser, so that the short pulse laser generates transverse propagation shear waves in a target area;
the photothermal treatment module acts on tumor tissues to realize the purpose of photothermal treatment of tumors;
the time sequence control circuit is connected with the pulse laser and used for providing a main trigger signal; the output signal of the time sequence control circuit is connected to the ultrasonic scanner and is used for providing a triggering signal for data acquisition so as to ensure the time sequence synchronization of the emission of the short pulse laser and the data acquisition;
the ultrasonic scanner is connected with the ultrasonic probe and is used for tracking the propagation process of the shear wave in the ablation area;
and the data processing module is used for performing off-line processing on multi-frame ultrasonic data in the process of transmitting the shear waves in the ablation area transmitted by the ultrasonic scanner, so that the elastic distribution of the tissue of the ablation range is visualized, and the shear wave speed and the elastic modulus of the tissue are quantitatively analyzed.
An evaluation method of a tumor thermal ablation effect evaluation system based on photoacoustic elastic images comprises the following steps:
s1, imaging before thermotherapy: determining the location and size of a tumor;
s2, photothermal treatment: in the process, establishing a relation between the elastic modulus of the tissue and the hardness of the tissue, and determining the elastic modulus threshold value of the tissue for achieving coagulation necrosis;
s3, imaging after thermal therapy: drawing the edge of an ablation focus and mapping the edge of the ablation focus to an ultrasonic image before hyperthermia, and evaluating the hardness of a treated tissue;
s4, elastography data analysis: comparing with the pre-hyperthermia imaging of S1;
s5, judging whether supplementary ablation is needed by the doctor.
Compared with the prior art, the invention has the following beneficial effects:
1. the evaluation method of the invention is based on a novel elastography method, namely photoacoustic shear wave elastography. Compared with an ultrasonic elastography method, the photoacoustic shear wave elastography can realize remote excitation of shear waves, and can generate shear waves with larger bandwidth, so that higher imaging spatial resolution is obtained, and the elastic modulus information of tumor tissues is more accurate.
2. The invention can evaluate the effect of tumor treatment in an omnibearing, more accurate and more reasonable way.
Drawings
FIG. 1 is a schematic diagram of an evaluation system according to the present invention;
FIG. 2 is a data processing flow diagram of a data processing module of the present invention;
FIG. 3 is a flow chart of an evaluation method of the present invention;
wherein: 101. a pulsed laser; 102. a laser light path; 103. tumor tissue; 104. a photothermal treatment module; 105. a timing control circuit; 106. an ultrasonic scanner; 107. an ultrasonic probe; 108. and a data processing module.
Detailed Description
For a better understanding of the objects, structures and functions of the present invention, reference should be made to the following detailed description of the invention with reference to the accompanying drawings.
The invention provides a system and a method for evaluating tumor thermal ablation effect based on photoacoustic shear wave elastography, which are mainly used for imaging tissue hardness distribution before and after tumor thermal ablation so as to judge whether ablation is complete or not and whether supplementary ablation is needed or not.
Wherein: photoacoustic shear wave elastography (photoacoustic shear wave elastography, PSWE) is a novel method of quantifying tissue elasticity. The principle is that when pulse light irradiates biological tissue, the light absorber in the tissue absorbs light energy and converts the light energy into heat energy, and the tissue is subjected to tiny displacement change locally, and the displacement change is represented as continuous outward propagation of shear waves. The ultrasonic image of a plurality of frames in the process of transmitting the plane wave to rapidly capture the shear wave propagation is processed by a correlation algorithm, and the two-dimensional elastic modulus distribution is reconstructed.
The method comprises the following steps:
a tumor thermal ablation effect evaluation system based on photoacoustic elastic images comprises
The pulse laser 101 is used as a laser emitting device for photoacoustic shear wave elastography and is used for emitting short pulse laser capable of exciting tumor tissue 103 to generate shear waves, the wavelength of a light source of the pulse laser 101 is 532nm, and the repetition frequency is adjustable at 10Hz, 20Hz and 50 Hz;
a laser light path 102 for collimating and focusing the short pulse laser light emitted from the pulse laser 101, so that the short pulse laser light generates a shear wave propagating laterally in a target region,
the photothermal treatment module 104 acts on the tumor tissue 103 to realize the purpose of photothermal treatment of tumors, and the photothermal treatment module 104 comprises a continuous laser with 808nm wavelength and a laser collimation light path;
a timing control circuit 105 connected to the pulse laser 101 for providing a main trigger signal; the output signal of the time sequence control circuit 105 is connected to the ultrasonic scanner 106 by a cable and is used for providing a triggering signal for data acquisition so as to ensure the time sequence synchronization of the emission of the short pulse laser and the data acquisition;
an ultrasonic scanner 106 connected to the ultrasonic probe 107 for tracking the propagation process of the shear wave in the ablation region; the ultrasonic probe 107 is a linear array probe with a center frequency of 7.5MHz and 128 array elements, and the interval between adjacent array elements is 0.3mm.
The ultrasonic scanner 106 receives the trigger signal from the time sequence control circuit 105, and immediately controls the ultrasonic probe 107 to emit plane waves to acquire images, so as to acquire ultra-fast ultrasonic imaging data.
The ultrasonic scanner 106 can realize an ultra-fast ultrasonic imaging technology, and the principle is that the ultrasonic probe 107 is controlled to emit plane waves, 32 frames of ultrasonic images in the process of propagation of shear waves are rapidly acquired at a frame frequency of 5kHz, and micro displacement of tissues in the process of propagation of the shear waves can be captured.
In order to increase the signal-to-noise ratio, a multi-angle compounding manner is adopted, that is, plane waves of three different angles (-2 °, 0 °, 2 °) are transmitted through the ultrasonic probe 107, and then data acquired by the plane waves of the three angles are averaged.
The data processing module 108 is an upper computer for offline data processing and image display, and the data processing module 108 performs offline processing on multiple frames of ultrasonic data in the process of transmitting shear waves in an ablation area transmitted by the ultrasonic scanner 106, so that the elastic distribution of tissues of an ablation range is visualized, and the shear wave velocity and the elastic modulus of the tissues are quantitatively analyzed.
The data processing flow of the data processing module 108 specifically includes: and calculating the displacement change of the tissues of every two adjacent frames of images by using an autocorrelation estimation algorithm, finally obtaining a three-dimensional tissue displacement field, and then converting the tissue displacement field data of a time domain into a frequency domain for directional filtering to filter the interference of reflected shear waves. The shear wave velocity for each pixel of the selected region is calculated using a Time-of-flight (TOF) wave velocity estimation algorithm. It should be noted that the selected area is intended to cover the entire tumor area. There is a positive correlation between shear wave velocity and elastic modulus of tissue, and the elastic modulus of tissue can be deduced by a formula.
The assessment of the thermal ablation effect of a tumor requires consideration of a number of factors: tumor size, location, morphology. After photothermal treatment of the tumor, the evaluation method of the invention evaluates the thermal ablation effect of the tumor from two aspects: the change of the elastic images before and after the thermal ablation of the tumor determines the range of the ablation range; the thickness of the tumor ablation margin (the distance the ablation zone extends beyond the tumor); the hardness of the tumor is measured by using the elastography technology, so that the change of the tumor after thermal ablation of the tumor can be judged.
The assessment criteria for complete tumor elimination mainly include: the range of the ablation range is required to completely cover the range of the tumor, and the distance from the ablation area to the outside of the tumor is 5-10mm; the tissue in the ablation focus is required to reach the degree of cell necrosis. The two aspects are completely satisfied, so that the tumor can be judged to have reached the radical cure effect, otherwise, the thermal ablation is insufficient, and further ablation is needed to achieve the purpose of radical cure of the tumor.
And acquiring elastic images before and after tumor hyperthermia by using an evaluation system, and then preprocessing the acquired elastic images. A pre-operative tumor region and a post-operative ablation region are obtained. The tumor thermal ablation effect evaluation method comprises the following steps:
s1, imaging before thermotherapy: determining the location and size of a tumor;
the method includes the steps of imaging tumor tissue 103 of a patient with an evaluation system prior to photothermal therapy to determine the location and size of the tumor, including ultrasound images and photoacoustic elastography (photoacoustic elastography is a method of rapidly acquiring a number of frames of ultrasound images during the propagation of shear waves, with small differences between the ultrasound images, reflecting changes in tissue displacement, and then processing by an algorithm to obtain elastography.
S2, photothermal treatment: in the process, establishing a relation between the elastic modulus of the tissue and the hardness of the tissue, and determining the elastic modulus threshold value of the tissue for achieving coagulation necrosis;
the specific process of photothermal treatment is as follows: injecting a thermosensitive agent into a patient, carrying out photo-thermal treatment on a tumor area by using a continuous laser of a photo-thermal treatment module 104, monitoring the temperature by using a thermocouple in the photo-thermal treatment process, carrying out elastography at different temperatures, obtaining a relation curve of elastic modulus and hardness by offline treatment, obtaining a temperature-elastic curve, establishing a relation between the elastic modulus of tissue and the hardness of the tissue, and determining an elastic modulus threshold value of the tissue reaching coagulation necrosis.
In photothermal therapy, elasticity data is acquired with the ultrasound scanner 106 evaluating tissue when the temperature of the tumor region reaches 40 ℃, 45 ℃, 50 ℃, 55 ℃, 60 ℃, respectively.
S3, imaging after thermal therapy: drawing the edge of an ablation focus and mapping the edge of the ablation focus to an ultrasonic image before hyperthermia, and evaluating the hardness of a treated tissue;
after tumor hyperthermia, the patient is imaged again using elastography techniques to assess the hardness of the treated tissue. Imaging after hyperthermia may be performed immediately after surgery or at a later point in time.
After the tumor hyperthermia is completed, the pulse laser 101 is utilized to focus at a proper position to excite shear waves, the ultrasonic probe 107 tracks the shear waves to obtain ultra-fast ultrasonic imaging data, and the ultra-fast ultrasonic imaging data are processed by the data processing module 108 to obtain the distribution of the elastic modulus of the whole tumor area; the ultrasound scanner 106 obtains elastic modulus data of the tissue and a determined threshold value of cell coagulation necrosis, draws the edge of the lesion and maps onto an ultrasound image before hyperthermia, and measures the transverse and longitudinal diameters of the lesion.
S4, elastography data analysis: comparing with the pre-hyperthermia imaging of S1;
firstly, establishing a standard that the tumor is completely ablated, wherein the standard is as follows: the tumor boundary in the gray-scale ultrasonic image is completely contained in the boundary of the tissue coagulation necrosis; there are no pixels below the elastic modulus threshold within the boundary of the coagulative necrosis.
Comparing with pre-hyperthermia imaging of S1: and measuring the transverse diameter and the longitudinal diameter of the tumor before treatment, and the edge of the tumor and the edge of the ablation range according to the image before heat treatment, comparing the range of the ablation range after heat treatment with the range of the tumor before heat treatment, judging whether the range of the ablation range completely covers the tumor area, and judging whether the distance extending out of the tumor exceeds 5mm, and judging the degree of necrosis of cells in the ablation range according to the threshold value of coagulative necrosis reached by the cells.
S5, judging whether supplementary ablation is needed by a doctor,
and the doctor judges whether the tumor is completely ablated according to the data processing result, and determines whether supplementary ablation is needed.
It will be understood that the invention has been described in terms of several embodiments, and that various changes and equivalents may be made to these features and embodiments by those skilled in the art without departing from the spirit and scope of the invention. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof. Therefore, it is intended that the invention not be limited to the particular embodiment disclosed, but that the invention will include all embodiments falling within the scope of the appended claims.
Claims (10)
1. A tumour thermal ablation effect evaluation system based on photoacoustic elastic images is characterized in that: comprises a pulse laser (101) as a laser emitting device for photoacoustic shear wave elastography, for emitting a short pulse laser capable of exciting a tumor tissue (103) to generate a shear wave;
a laser light path (102) for collimating and focusing the short pulse laser emitted by the pulse laser (101) so that the short pulse laser generates a transverse propagating shear wave in the target area;
the photothermal treatment module (104) acts on the tumor tissue (103) to realize the purpose of photothermal treatment of tumors;
a time sequence control circuit (105) connected with the pulse laser (101) and used for providing a main trigger signal; the output signal of the time sequence control circuit (105) is connected to the ultrasonic scanner (106) and is used for providing a triggering signal for data acquisition so as to ensure the time sequence synchronization of the emission of the short pulse laser and the data acquisition;
an ultrasonic scanner (106) connected with the ultrasonic probe (107) and used for tracking the propagation process of the shear wave of the ablation area;
and the data processing module (108) is used for performing off-line processing on multi-frame ultrasonic data in the process of propagating the shear wave in the ablation area transmitted by the ultrasonic scanner (106), so that the elastic distribution of the tissue of the ablation focus is visualized, and the shear wave velocity and the elastic modulus of the tissue are quantitatively analyzed.
2. The photoacoustic elastography-based tumor thermal ablation effect evaluation system of claim 1, wherein: the ultrasonic probe (107) emits three plane waves of different angles, and then averages the data acquired by the three angle plane waves.
3. The photoacoustic elastography-based tumor thermal ablation effect evaluation system of claim 1, wherein: the data processing flow of the data processing module (108) is as follows:
step one: the tissue displacement is estimated and,
calculating the displacement change of the tissues of every two adjacent frames of images by using an autocorrelation estimation algorithm, and finally obtaining a three-dimensional tissue displacement field;
step two: the direction of the wave is filtered and,
converting the tissue displacement field data of the time domain into the frequency domain for directional filtering, and filtering out the interference of the reflected shear wave;
step three: the shear wave velocity is estimated and,
calculating the shear wave velocity of each pixel point of the selected area by using a wave velocity estimation algorithm;
step four: the modulus of elasticity is reconstructed and,
there is a positive correlation between shear wave velocity and elastic modulus of tissue, and the elastic modulus of tissue is deduced by a formula.
4. An evaluation method using the photoacoustic elastic image-based tumor thermal ablation effect evaluation system according to any one of claims 1 to 3, characterized in that: the method comprises the following steps:
s1, imaging before thermotherapy: determining the location and size of a tumor;
s2, photothermal treatment: in the process, establishing a relation between the elastic modulus of the tissue and the hardness of the tissue, and determining the elastic modulus threshold value of the tissue for achieving coagulation necrosis;
s3, imaging after thermal therapy: drawing the edge of an ablation focus and mapping the edge of the ablation focus to an ultrasonic image before hyperthermia, and evaluating the hardness of a treated tissue;
s4, elastography data analysis: comparing with the pre-hyperthermia imaging of S1;
s5, judging whether supplementary ablation is needed by the doctor.
5. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 4, wherein: the imaging before thermotherapy of S1 specifically comprises: the tumor tissue (103) of the patient is imaged with an evaluation system prior to photothermal therapy to determine the location and size of the tumor, including an ultrasound image and a photoacoustic elastography image, and the lateral and longitudinal diameters of the tumor are measured based on the ultrasound image and elastography image information delineating the boundary of the tumor.
6. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 4, wherein: the specific process of the photothermal treatment of S2 is as follows: injecting a thermosensitive agent into a patient, carrying out photo-thermal treatment on a tumor area by using a continuous laser of a photo-thermal treatment module (104), monitoring the temperature by using a thermocouple in the photo-thermal treatment process, carrying out photo-acoustic elastography at different temperatures, establishing a relation between the elastic modulus of the tissue and the hardness of the tissue, and determining the elastic modulus threshold value of the tissue reaching coagulation necrosis.
7. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 6, wherein: in the photothermal therapy of S2, elasticity data is acquired by an ultrasound scanner (106) for evaluating tissue when the temperatures of the tumor region reach 40 ℃, 45 ℃, 50 ℃, 55 ℃, 60 ℃ respectively.
8. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 4, wherein: the imaging after thermotherapy of S3 specifically comprises: after the tumor thermal therapy is completed, a pulse laser (101) is used for focusing at a proper position to excite shear waves, an ultrasonic probe (107) tracks the shear waves to obtain ultra-fast ultrasonic imaging data, and the ultra-fast ultrasonic imaging data are processed by a data processing module (108) to obtain the distribution of the elastic modulus of the whole tumor area; the method comprises the steps of obtaining elastic modulus data of tissue and a determined threshold value of cell coagulation necrosis according to an ultrasonic scanner (106), drawing the edge of an ablation focus and mapping the edge onto an ultrasonic image before hyperthermia, and measuring the transverse diameter and the longitudinal diameter of the ablation focus.
9. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 4, wherein: before the elastography data analysis of S4, establishing a standard that the tumor is completely ablated, the standard being: the tumor boundary in the gray-scale ultrasonic image is completely contained in the boundary of the tissue coagulation necrosis; there are no pixels below the elastic modulus threshold within the boundary of the coagulative necrosis.
10. The evaluation method of the tumor thermal ablation effect evaluation system based on the photoacoustic elastic image according to claim 4, wherein: the elastography data analysis of S4 specifically includes: comparing with pre-hyperthermia imaging of S1: and measuring the transverse diameter and the longitudinal diameter of the tumor before treatment, and the edge of the tumor and the edge of the ablation range according to the image before heat treatment, comparing the range of the ablation range after heat treatment with the range of the tumor before heat treatment, judging whether the range of the ablation range completely covers the tumor area, and judging whether the distance extending out of the tumor exceeds 5mm, and judging the degree of necrosis of cells in the ablation range according to the threshold value of coagulative necrosis reached by the cells.
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