WO2014175608A1

WO2014175608A1 - Method for comparing preoperative respiratory level with intraoperative respiratory level

Info

Publication number: WO2014175608A1
Application number: PCT/KR2014/003431
Authority: WO
Inventors: 서준범; 박창민; 김남국
Original assignee: 재단법인 아산사회복지재단; 서울대학교병원
Priority date: 2013-04-26
Filing date: 2014-04-18
Publication date: 2014-10-30

Abstract

The present disclosure relates to a method for comparing a preoperative respiratory level with an intraoperative respiratory level. The method comprises the steps of: obtaining a three-dimensional image including a surgical target; setting at least one reference path from the three-dimensional image; generating a preoperative image template corresponding to the at least one reference path from the three-dimensional image; generating an intraoperative image template to conform to the at least one reference path; and comparing a respiratory level in the step of obtaining a three-dimensional image with an intraoperative respiratory level using the preoperative image template and the intraoperative respiratory level.

Description

How to compare preoperative breathing level with operating room breathing level

DISCLOSURE This disclosure relates generally to a method of comparing preoperative respiratory level and operating room respiratory level (METHOD OF COMPARING PREOPERATIVE RESPIRATORY LEVEL WITH INTRAOPERATIVE RESPIRATORY LEVEL). It is about how to compare levels.

This section provides background information related to the present disclosure which is not necessarily prior art.

Computer Graphics is primarily used to present a two-dimensional or three-dimensional graphical representation of an object on a two-dimensional display screen. Volume graphics is a field of computer graphics that deals with the visualization of objects represented by sample data having three or more dimensions. These samples, called volume elements or voxels, contain digital information representing the physical characteristics of the object. For example, the voxel data of a particular object may represent density, type of material, temperature, speed, or other property in discrete points, in space, throughout the interior and surroundings of the object.

In recent years, a volume graphics method called Volume Rendering has been introduced, which is a form of digital signal processing, which gives each voxel of a voxel-based representation color and transparency. to be. Each of these voxels, given their color and transparency, is projected onto a two-dimensional viewing surface, such as a computer screen, where the background voxels are applied to the foreground opaque voxels. It is hidden by the form. This accumulation of projected voxels results in a visual image of the object.

In summary, Volume Rendering renders a volume or volume data set, which is the volume of data points called volume elements or voxels. It consists of a 3-D array of data points, a voxel is a three-dimensional counterpart of a pixel that contains color and transparency information, and changes the color and transparency of the object to You can see the outside and inside in different forms, for example, a doctor who wants to look at the ligaments, tendons, and bones of a knee before surgery can make blood, skin, and muscles appear completely transparent in a tomography scan of the knee. .

In another aspect, in the medical field, three-dimensional volume data sets or three-dimensional volume data such as CT images, MRI images, PET images, etc. can be utilized using this volume rendering technique (not necessarily limited to volume rendering techniques, It is usefully used.), Displayed on a monitor, and using the displayed image, it is possible to use a variety of methods, such as preparing for surgery, planning a surgery, using a surgical navigation apparatus, or using during surgery.

When planning surgery that requires the insertion of a surgical instrument, such as a biopsy, medical 3D imaging is also needed. However, since such medical three-dimensional images are obtained in a specific breathing state of the patient, the patient needs the help of several processes to use the medical three-dimensional images in the operating room where breathing continues.

1 and 2 are diagrams illustrating an example of conventional interventional surgery. First, a specific breathing level A of a patient before surgery (eg, a state in which the patient inhales or exhales as much as possible) is described. In operation S100, a 3D image 100 of the patient is obtained. In order to acquire the 3D image 100, a medical 3D image acquisition device such as a CT device, a Cone-beam CT (CBCT) device, or an MRI device may be used. Next, the surgery is planned using the obtained three-dimensional image 100 (S200). In the case of a biopsy, a path 300 is inserted to insert a biopsy needle into the patient's target 200. Next, when the patient enters the operating room, and the operation is started, the image acquisition device (eg, Fluoroscopy device, CBCT device; 400) placed in the operating room is moved to the path 300 planned in step S200, that is, the biopsy needle ( 500 is aligned with the same orientation as the orientation 300 to be inserted (S300). If the affected part is affected by the patient's breathing, for the operation to proceed as planned, the patient's breathing level (A) when acquiring the preoperative 3D image 100 is the patient's breathing level at the current operating room. The patient should be breathed at a specific breathing level (A: the patient inhales or exhales as much as possible), and then includes the affected part using the image acquisition device 400 in the operating room. By acquiring an image 600 of the patient, the patient's breathing level (B) should be matched with the patient's breathing level (A) when acquiring a preoperative 3D image (S400). The doctor's intuition is used here. In a method that does not depend on the physician's intuition, the respiratory level (A) when acquiring the pre-operative 3D image 100 is recorded on a computer, and then the respiratory level of the patient is continuously recorded at the operating room, and the two are compared When the patient's respiratory level (B) is the same as the respiratory level (A), it can be notified by an alarm sound, or the biopsy needle 500 can be configured to operate automatically. Respiration level (A, B) can be applied to the conventional method of measuring the breath (for example, pressure belt type, breath meter using the InfraRed marker, etc.). In this state, by inserting the biopsy needle 500 into the human body, it is possible to insert the surgical tool in the human body in the planned orientation (300) (S500). The three-dimensional image 100 and the patient's image 600 used in FIG. 2 are for illustrative purposes and will be easily understood by those skilled in the art. As a prior art related to respiratory level measurement, US Patent No. 5,368,844 is mentioned.

This will be described later in the section on Embodiments of the Invention.

This section provides a general summary of the disclosure and is not a comprehensive disclosure of its full scope or all, provided that this is a summary of the disclosure. of its features).

According to an aspect of the present disclosure, the method comprises: acquiring a three-dimensional image including an According to one aspect of the present disclosure and a surgical target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; Generating an intraoperative image template according to at least one reference path; And, using the pre-operative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image; and the preoperative respiratory level characterized in that it comprises a; A method of comparing operating room respiration levels is provided.

According to another aspect of the present disclosure (According to another aspect of the present disclosure), obtaining a three-dimensional image including a Surgical Target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; Generating an intraoperative image template continuously provided over time according to at least one reference path; and, the comparison line provided in the preoperative image template and the operating room image template Comparing the respiratory level at the operating room and the respiratory level in the step of obtaining a three-dimensional image using a comparison line; Is provided.

According to still another aspect of the present disclosure, acquiring a three-dimensional image including a Surgical Target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; wherein the preoperative image template includes a plurality of medical images, the preoperative image template Generating a; Generating an intraoperative image template continuously provided over time according to at least one reference path in the operating room; And, using the pre-operative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image; including, in the comparing step, Among the plurality of medical images of the template, a method of comparing the preoperative breathing level and the operating room breathing level, characterized by finding the medical image closest to the operating room image template and displaying the affected part on the medical image together with the operating room image template. Is provided.

This will be described later in the section on Embodiments of the Invention.

1 and 2 are views for explaining an example of conventional interventional surgery (intervention surgery),

3 and 4 are views for explaining an example of a method of comparing the preoperative respiratory level and the operating room respiratory level according to the present disclosure,

5 is a view showing an example of a method of creating a pre-operative image template,

6 is a diagram illustrating an example of a display screen according to the present disclosure;

7 is a view showing an example of a method of comparing the pre-operative image template and the operating room image template,

8 is a diagram illustrating an example of a method of generating a comparison line from an operating room image template;

9 is a diagram illustrating an example of an edge detection method according to the present disclosure;

10 illustrates an example of a display screen according to the present disclosure.

The present disclosure will now be described in detail with reference to the accompanying drawing (s).

3 and 4 are diagrams illustrating an example of a method of comparing the preoperative breathing level and the operating room breathing level according to the present disclosure. First, a three-dimensional image 10 including the affected part 20 is obtained. (S10). Next, at least one

reference path

30, 31 is set in the 3D image 10 (S20). Next, a preoperative image template 11 corresponding to at least one

reference path

30, 31 is generated from the 3D image 10 (S30). Next, an intraoperative image template 12 is generated in accordance with at least one

reference path

30 or 31 at the operating room (S40). Next, using the preoperative image template 11 and the operating room image template 12, the respiratory level at step S10 of obtaining the three-dimensional image 10 is compared with the respiratory level at the operating room ( S50).

The affected part 20 is not limited to a person, but may extend to an animal that breathes.

The 3D image 10 may be a CT image, an MRI image, a PET image, a 3D ultrasound image, or the like. Via the device, it can be acquired in advance, stored in the computer 70, displayed via the monitor 71, and used by the user through the computer 70. Preferably, the CT image and the CBCT image are used as the 3D image 10. This is because the CT image is suitable for imaging the internal organs that interlock with the breath. The concept of preoperative is a relative time concept, which can be obtained before the patient enters the operating room, but within the operating room, the CT device, the CBCT device, etc. can be obtained, and the surgical plan can be made. In addition, one volume data set may be created before entering the operating room, and another volume data set may be created at the operating room.

Reference paths

30 and 31 are established in the course of planning the surgery.

Reference paths

30 and 31 may be, for example, insertion paths of surgical instruments (eg, biopsy needles; see FIG. 2). In this case, the

reference paths

30 and 31 can be determined by setting the entry point 32 and the orientation (the direction of the surgical tool, the vector) at which the surgical instrument enters the patient's body. The present disclosure can also be applied to surgery in which the surgical instrument is not inserted into the human body. For example, as a starting point 32, a point at which the patient is to be incised with a surgical instrument is set, and the

reference paths

30 and 31 can be determined by setting the line with the point and the lesion. In addition, the present disclosure may be applied not only to surgical operations and surgical intervention procedures, but also to medical treatment and laser treatment. For example, the method of the present disclosure can be applied to set the orientation to which the laser will be irradiated in the preoperative 3D image 10 and to check the breathing level of the patient at the operating room. Therefore, in the present disclosure, the term surgery should be understood as a comprehensive medical act including a surgical operation, a surgical intervention procedure, a diagnostic act, and the like. In the case where a plurality of

reference paths

30 and 31 are set, the accuracy of the respiration level comparison can be further improved. In addition, when the intraoperative image was taken with the reference path 30 set before the operation, it is possible to have various advantages, such as being able to use the reference path 31 that is well visible, in case the lesion is not easily seen.

The preoperative image template 11 includes at least one medical image corresponding to the at least one

reference path

30, 31. Also, the preoperative image template 11 may include a plurality of medical images obtained from one reference path 30. The pre-operative image template 11 preferably has a similar shape to that obtained by the image acquisition device 40. For example, when the image acquired by the image acquisition device 40 is a two-dimensional fluoroscopy image and the three-dimensional image 10 is a CT image, a parallel or perspective ray summ algorithm (Ray) Sum Algorithm) By using the Maximum Intensity Projection (MIP) or Minimum Intensity Projection (MinIP), it is possible to obtain an image similar to a perspective image with respect to at least one reference path (30, 31), which is a known technique. .

The operating room image template 12 also includes at least one medical image corresponding to the at least one

reference path

30, 31. In order to align the operating room image acquisition device 40 to at least one

reference path

30, 31, devices such as C-arm, Cone-beam can be used, but are not limited to this, and adjust the orientation to the patient. Any device may be used as long as the device can be used. Preferably, Fluoroscopy images are used which allow the generation of continuous two-dimensional images. The operating room image template 12 may be an image 13 obtained by the image acquisition device 40 or may be generated by processing the image 13 as necessary. The image 13 or operating room image template 12 is acquired by the image acquisition device 40, stored and processed in the computer 80, and displayed on the monitor 81. The computer 80 and the computer 70 may interwork. In this case, the computer 80 may use the preoperative image template 11 without storing it separately. The computer 80 also performs a function of comparing the preoperative image template 11 and the operating room image template 12. This process can be displayed on the monitor 81. In addition, when the two

templates

11 and 12 coincide with each other to some extent, it is also possible to sound an alarm or display the degree of the match numerically. You can simply use the expression image, but we use the term image template in the sense that two images are compared, in the sense that two images are the basis for this comparison, and in the sense that multiple images can be included. As a method for determining the similarity between the preoperative image template 11 and the operating room image template 12, methods such as Mean Squares Difference, Normalized Correlation, Pattern Intensity, and Mutual Information may be used.

FIG. 5 is a diagram illustrating an example of a method for creating a preoperative image template, in which the preoperative image template 11 includes five

medical images

11a, 11b, 11c, 11d, and 11e. The five

medical images

11a, 11b, 11c, 11d, and 11e consist of at least one actual medical image and at least one predictive medical image. For example, the medical image 11a is generated along the reference path 30 from the actually photographed three-dimensional image 10 and the remaining

medical images

11b, 11c, 11d, and 11e are based on the medical image 11a. By predicting the movement of the affected part 20 according to the breath can be generated based on the experience of the doctor. Through this pre-operative image template 11, when used with the operating room image template 12 in the operating room, it is possible to more easily determine the breathing level of the patient. Also, for example, two

medical images

11a and 11e can be generated from an actual medical image. In this case, two three-dimensional images 10 are required, and once the CT image is taken in a fully inhaled state and the CT image is taken in a fully exhaled state, two three-dimensional images 10 may be obtained. From each of these two

medical images

11a and 11e can be obtained along the reference path 30. By using two actual captured

medical images

11a and 11e, that is, using at least two or more actual captured

medical images

11a and 11e, the accuracy of the predicted

medical images

11b, 11c and 11d is increased. It becomes possible. In particular, in the case of obtaining the

medical images

11a and 11e for the upper and lower limits of the breathing level, the accuracy of the prediction can be further improved. If necessary, the medical image 11c may be generated through actual imaging. For example, by including about 20 actual and predictive medical images in the pre-operative image template 11, the movement of the affected part 20 according to the respiration level can be represented very accurately, and the operating room image template 12 is In the case of an image representing a continuously moving lesion, the comparison between each other can be made easier. For example, it is also possible to represent all images in the preoperative image template 11 as a background image and then to the operating room image template 12. This is also an example of a comparison between the preoperative image template 11 and the operating room image template 12. In addition, it is also possible to find an image most similar to a specific operating room image template 12 using the mutual information and the like in the preoperative image template 12 and display it together. In addition, the preoperative image template 11 may be made using thin plate warping, bspline warping, or the like.

FIG. 6 is a diagram illustrating an example of a display screen according to the present disclosure and may be understood as one graphical user interface (GUI). It is possible to display the preoperative image template 11 and the operating room image template 12 simultaneously, but depending on the performance of the computer and in terms of time consumption, there are cases where it is difficult or unnecessary. As shown in FIG. 6, in the state where only the operating room image template 12 is shown, the similarity with the preoperative image template 11 is calculated by a computer internal process, and as the similarity increases on the display, the color of the screen becomes darker. In other words, it can be expressed in a visual or audible manner intuitively, such as by expressing through a color, or by giving a flickering. In addition, by selecting a portion that can be compared from the pre-image template 11 to be displayed as a comparison line (L1, L2, L3, L4, L5), it helps to understand the similarity between the two intuitively Can be. As the degree of similarity increases, it is also possible to change the color of the comparison lines L1, L2, L3, L4, and L5 to increase the intuitive power. It is also possible to display the pre-operative image template 11 and to obtain and display the required portion of the operating room image template 12. As a part to be compared, it is also possible to use an organ such as a diaphragm. In addition, it is possible to assist the operator by showing at least one of the compass 1000, the starting point 32, and the reference path 30 indicating the orientation. In addition, according to the method according to the present disclosure, the patient can adjust the breathing level by himself. Surgery or interventional procedures (e.g. biopsies, endoscopic procedures) using medical robots using a master-slave system will leave the doctor at the operating room, but even in this case, by using the method according to the present disclosure, the patient will be able to breathe on their own You will have the advantage of matching them.

FIG. 7 is a diagram illustrating an example of a method of comparing a preoperative image template and an operating room image template, in which a comparison line 11-1 taken from the preoperative image template is displayed, and on the operating room image template 12. The comparison line 12-1 is shown. 20 is affected. By using the comparison line 11-1 and the comparison line 12-1, when a continuous image is provided to the operating room image template 12, the comparison between the two is more easily performed as the patient proceeds to breathe. You can do it. The comparison line 11-1 may be generated automatically or manually in the process of forming the preoperative image template. By displaying the patient's breathing signals together, the comparison between the two can be helped. A diaphragm can be used for the comparison line 11-1 and the comparison line 12-1.

FIG. 8 is a diagram illustrating an example of a method of generating a comparison line from an operating room image template, and a C-arm fluoroscopy image is illustrated as the operating room image template 12. The diaphragm is used for the comparison line 12-1. In order to enhance the boundary of the diaphragm, for example, the edge detection method such as the enhancement method using the Hessian Matrix, as shown in FIG. A method of finding the whole diaphragm by detecting and detecting the diaphragm edge portion may be used. This is done through the internal process of the computer. As the comparative line 12-1, in addition to the diaphragm, contrast-enhanced kidney, pulmonary vessels, bronchus, bone, or the like can be used. The operating room image template 12 thus formed may be used to determine the breathing level of the patient in the operating room without the help of the preoperative image template 11. In addition, by identifying the movement of the comparison line 12-1 on the operating room image template 12, it is a matter of course that the movement of the affected area or organ near the comparison line 12-1 can be predicted.

The examples described in FIGS. 6 to 9 can be used integrated with each other. For example, the comparison line 11-1 obtained from the preoperative image template 11 is used as the target respiration level, and the diaphragm is extracted from the operating room image template 12 using the comparison line 12-1, and the image is displayed on the display. As the patient sees this display, the patient can adjust his or her breathing level while intuiting a change in color density, a change in the degree of flickering, an alarm sound, and the like. More preferably, in addition to adjusting the breathing level intuitively using visual and / or auditory, by quantifying and displaying the similarity evaluated through Mutual Information, etc., the patient can adjust the breathing level more comfortably (Fig. 7). Reference).

FIG. 10 is a diagram illustrating an example of a display screen according to the present disclosure, in which an affected part 20 obtained from a preoperative image template is displayed together on the operating room image template 12. In the operating room, there may be a problem such that the affected part 20 is not reflected in the operating room image template 12 due to various instruments or the operator's hand in the operating room, etc. It becomes possible. Even if the operating room image template 12 is changed in real time (provided continuously in the course of time), a plurality of pre-operated image templates 11 are operated at the current respiration level through a computer internal process. It is possible to match the intestinal image template 12, and for each image in the pre-operative image template 11, by separating the affected part 20 manually or automatically, the pre-operative image template 11 as necessary It is possible to display the affected part 20 obtained in the present invention on the operating room image template 12. Preferably, the affected part 20 may be augmented to be visually well represented using a known volume rendering technique, such as a specific color. The affected area 20 may be obtained directly from the three-dimensional image 10, rather than from each image in the preoperative image template 11, but is not preferred.

Hereinafter, various embodiments of the present disclosure will be described.

(1) obtaining a three-dimensional image including a surgical target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; Generating an intraoperative image template according to at least one reference path; And, using the pre-operative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image; and the preoperative respiratory level characterized in that it comprises a; How to compare the operating room breathing level.

(2) at least one reference path is a plurality, and a plurality of preoperative image templates are generated for the plurality of reference paths.

(3) at least one reference path is a path for insertion of a biopsy needle to compare the preoperative breathing level with the operating room breathing level.

(4) The preoperative image template includes at least one of a fully inhaled medical image and a fully exhaled medical image.

(5) a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the pre-operative image template comprises a plurality of medical images.

(6) the preoperative respiratory level comprising at least one real medical image generated from a three-dimensional image and at least one predictive medical image predicted and generated from the at least one real medical image; To compare the respiratory level with the operating room.

(7) at least one actual medical image comprises at least one of a fully inhaled medical image and a fully exhaled medical image.

(8) comparing the preoperative breathing level and the operating room breathing level, characterized in that in the comparing step, the preoperative image template is background, displaying the operating room image template.

(9) comparing the preoperative breathing level and the operating room breathing level, characterized in that in the step of comparing, finding and displaying together the medical image most similar to the operating room image template from the preoperative image template.

(10) In the comparing step, in the state of displaying the operating room image template, comparing the similarity with the pre-operative image template, and visually expressing on the display the preoperative breathing level and the operating room breathing level How to compare.

(11) acquiring a 3D image including a surgical target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; Generating an intraoperative image template continuously provided over time according to at least one reference path; And comparing the breathing level at the step of obtaining the 3D image with the breathing level at the operating room by using the comparison line provided in the preoperative image template and the comparison line provided in the operating room image template. Method for comparing the preoperative breathing level and the operating room breathing level, characterized in that. An example of an operating room image template provided continuously over time may be a fluoroscopy image. Any type of image may be used as long as the image is obtained in real time.

(12) comparing the preoperative breathing level and the operating room breathing level, characterized in that visually displaying the proximity of the comparison line provided in the pre-operative image template of the comparison line provided in the operating room image template How to.

(13) The method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the comparison line provided in the operating room image template is the inside of the edge-enhanced patient.

(14) The comparison line provided in the operating room image template is a diaphragm, the method of comparing the preoperative breathing level and the operating room breathing level.

(15) A method of comparing the preoperative breathing level and the operating room breathing level, characterized in that in the comparing step, the breathing signal is displayed together.

(16) The method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the operating room image template is a continuous fluoroscopic image provided.

(17) in the comparing step, the preoperative breathing level and the operating room breathing level characterized in that it informs the proximity of the comparison line provided in the pre-operative image template of the comparison line provided in the operating room image template How to compare.

(18) acquiring a three-dimensional image including a surgical target; Setting at least one reference path in the three-dimensional image; Generating a preoperative image template corresponding to the at least one reference path from the 3D image; wherein the preoperative image template includes a plurality of medical images, the preoperative image template Generating a; Generating an intraoperative image template continuously provided over time according to at least one reference path in the operating room; And, using the pre-operative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image; including, in the comparing step, A method of comparing a preoperative respiratory level and a surgical respiratory level comprising finding a medical image closest to an operating room image template from among a plurality of medical images of the template and displaying the affected area on the medical image with the operating room image template. An example of an operating room image template provided continuously over time may be a fluoroscopy image. Any type of image may be used as long as the image is obtained in real time.

According to the method of comparing the preoperative breathing level and the operating room breathing level according to the present disclosure, it is possible to guide the breathing level of the patient using a medical image without the help of a separate breathing apparatus.

In addition, according to the method of comparing the preoperative breathing level and the operating room breathing level according to the present disclosure, even if there is no operator in the operating room (for example, surgery, intervention, diagnosis, etc. by a medical robot using a master-slave system) The patient can easily adjust his breathing level.

In addition, according to the method of comparing the preoperative breathing level and the operating room breathing level according to the present disclosure, by guiding the breathing level using the patient's internal organs, it is easier for the patient to adjust the breathing level.

In addition, according to the method of comparing the preoperative breathing level and the operating room breathing level according to the present disclosure, it is possible to provide an augmented reality visualized operating room image.

Claims

Obtaining a three-dimensional image including a wound target;

Setting at least one reference path in the three-dimensional image;

Generating a preoperative image template corresponding to the at least one reference path from the 3D image;

Generating an intraoperative image template according to at least one reference path; And,

Using the preoperative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image; the preoperative breathing level and operating room comprising a How to compare breathing levels.
The method according to claim 1,

At least one reference path is plural,

A method for comparing preoperative breathing level and operating room breathing level, characterized in that a plurality of preoperative image templates are generated for a plurality of reference paths.
The method according to claim 1,

Wherein at least one reference path is the path of insertion of the biopsy needle.
The method according to claim 1,

And the preoperative image template comprises at least one of a fully inhaled medical image and a fully exhaled medical image.
The method according to claim 1,

The pre-operative image template comprises a plurality of medical images to compare the preoperative breathing level and the operating room breathing level.
The method according to claim 5,

The preoperative image template comprises at least one real medical image generated from a three-dimensional image and at least one predictive medical image predicted and generated from the at least one real medical image. How to compare breathing levels.
The method according to claim 6,

The at least one actual medical image comprises at least one of a fully inhaled medical image and a fully exhaled medical image.
The method according to claim 1,

And comparing the preoperative respiratory level with the preoperative respiratory level characterized by displaying the operating room image template in the background.
The method according to claim 1,

In the comparing step, the preoperative breathing level and the operating room breathing level, characterized in that to find and display together the medical image most similar to the operating room image template from the preoperative image template.
The method according to claim 1,

In the comparing step, the method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the visual representation on the display by comparing the similarity with the pre-operative image template while the operating room image template is displayed .
Obtaining a three-dimensional image including a wound target;

Setting at least one reference path in the three-dimensional image;

Generating a preoperative image template corresponding to the at least one reference path from the 3D image;

Generating an intraoperative image template continuously provided over time according to at least one reference path; And,

Comparing the respiratory level at the step of obtaining the three-dimensional image with the respiratory level at the operating room by using a comparison line provided in the preoperative image template and a comparison line provided in the operating room image template. To compare the preoperative breathing level with the operating room breathing level.
The method according to claim 11,

In the comparing step, comparing the preoperative breathing level and the operating room breathing level characterized in that the visual display of the proximity to the comparison line provided in the preoperative image template of the comparison line provided in the operating room image template.
The method according to claim 11,

The comparison line provided in the operating room image template is a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the interior of the edge-enhanced patient.
The method according to claim 11,

The comparison line provided in the operating room image template is a diaphragm, the method of comparing the preoperative breathing level and the operating room breathing level.
The method according to claim 11,

In the comparing step, the respiratory signal is displayed together with the preoperative breathing level and the operating room breathing level.
The method according to claim 11

The operating room image template is a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the continuous fluoroscopic images provided.
The method according to claim 16,

The comparison line provided in the operating room image template is a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the interior of the edge-enhanced patient.
The method according to claim 17,

The comparison line provided in the operating room image template is a diaphragm, the method of comparing the preoperative breathing level and the operating room breathing level.
The method according to claim 11,

In the comparing step, the method of comparing the preoperative breathing level and the operating room respiratory level characterized in that it informs the proximity of the comparison line provided in the pre-operative image template of the comparison line provided in the operating room image template .
The method according to claim 11,

At least one reference path is plural.
Obtaining a three-dimensional image including a wound target;

Setting at least one reference path in the three-dimensional image;

Generating a preoperative image template corresponding to the at least one reference path from the 3D image; wherein the preoperative image template includes a plurality of medical images, the preoperative image template Generating a;

Generating an intraoperative image template continuously provided over time according to at least one reference path in the operating room; And,

Comprising: using the pre-operative image template and the operating room image template, comparing the respiratory level in the operating room and the respiratory level in the step of obtaining a three-dimensional image;

In the comparing step, the preoperative breathing level and the surgery, characterized by finding a medical image closest to the operating room image template among the plurality of medical images of the preoperative image template and displaying the affected part on the medical image together with the operating room image template. How to compare intestinal breathing levels.
The method according to claim 21,

At least one reference path is plural,

A method for comparing preoperative breathing level and operating room breathing level, characterized in that a plurality of preoperative image templates are generated for a plurality of reference paths.
The method according to claim 21,

Wherein at least one reference path is the path of insertion of the biopsy needle.
The method according to claim 21,

The preoperative image template comprises at least one real medical image generated from a three-dimensional image and at least one predictive medical image predicted and generated from the at least one real medical image. How to compare breathing levels.
The method of claim 24,

The at least one actual medical image comprises at least one of a fully inhaled medical image and a fully exhaled medical image.
The method according to claim 21

The operating room image template is a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the continuous fluoroscopic images provided.
The method according to claim 21,

The preoperative image template is a method for comparing the preoperative breathing level and the operating room breathing level, characterized in that the CT image.
The method of claim 24,

The operating room image template is a method of comparing the preoperative breathing level and the operating room breathing level, characterized in that the continuous fluoroscopic images provided.
The method according to claim 28,

The preoperative image template is a method for comparing the preoperative breathing level and the operating room breathing level, characterized in that the CT image.
The method of claim 29,

Wherein at least one reference path is the path of insertion of the biopsy needle.