基于CT图像的肺穿刺术路径规划系统

A Path Planning System for CT-guided Lung Biopsy

  • 摘要: 为了解决传统肺穿刺手术路径规划方法手术并发症风险大、受医师熟练度影响大、无法量化分析手术路径风险等特有的临床问题,设计了一套肺穿刺术最优路径规划方案。首先,基于胸部CT图像对胸部重要器官进行图像分割。然后,将手术风险量化为3个约束性条件和6个目标性条件,用于衡量手术路径的优劣与风险。3个约束性条件为穿刺深度、重要器官避障、入刺角度,6个目标性条件为胸壁厚度、肺内穿刺长度、重要器官之间的距离、路径延长线与重要器官之间的距离、皮肤入刺角、胸膜入刺角。最后,设计自适应凝聚层次聚类算法将路径聚类为“簇”,并利用多目标优化方案对聚类中心点进行量化分析,确定肺穿刺最优路径。实验结果表明,自动规划得到的最优路径经医生确认均符合手术要求,且计算得到的最优路径在医生排序中排名均为前3,证明了本文路径规划方法的合理性与有效性,满足肺穿刺手术路径规划临床需求,可以为医生提供有效的3维可视化穿刺路径指导。

     

    Abstract: Traditional path planning methods for lung biopsy are facing the unique clinical problems, such as the high risk of surgical complications, the large impact of physician proficiency, and the inability to quantitatively analyze the risk of surgical path. In order to solve the problems, a set of optimal path planning programs for lung biopsy are designed. Firstly, image segmentation for vital organs of chest is accomplished based on the chest CT images. Then, the surgical risk is quantified into 3 constraint conditions and 6 target conditions, to measure the pros and cons of different paths, and to evaluate the surgery risk of different paths. 3 constraint conditions are the puncture depth, the obstacle avoidance of vital organs and the puncture angle, and 6 target conditions are the thickness of the chest wall, the puncture length in the lung, the distance between vital organs, the distance between the extension line of the path and the vital organs, the skin penetration angle and the pleural penetration angle. Finally, the planning system selects the optimal path by using an adaptive agglomerative nesting (AGNES) algorithm to cluster the paths into clusters and a multi-objective optimization formulation to quantitatively analyze the cluster center points. The experiment results show that the optimal path obtained by automatic planning is confirmed by the doctors to meet the surgical requirements, and all calculated optimal paths rank among the top three in the doctors' ranking. This proves the rationality and effectiveness of the path planning method, which can meet the clinical needs of path planning for lung biopsy, and can provide doctors with effective 3-dimensional visual puncture path guidance.

     

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