College of Biomedical Engineering, Sichuan University, Chengdu 610065, China.
Department of Radiology, Zigong First People's Hospital, Zigong 643000, China.
Comput Med Imaging Graph. 2024 Oct;117:102426. doi: 10.1016/j.compmedimag.2024.102426. Epub 2024 Aug 31.
Lung cancer has the highest mortality rate among cancers. The commonly used clinical method for diagnosing lung cancer is the CT-guided percutaneous transthoracic lung biopsy (CT-PTLB), but this method requires a high level of clinical experience from doctors. In this work, an automatic path planning method for CT-PTLB is proposed to provide doctors with auxiliary advice on puncture paths. The proposed method comprises three steps: preprocessing, initial path selection, and path evaluation. During preprocessing, the chest organs required for subsequent path planning are segmented. During the initial path selection, a target point selection method for selecting biopsy samples according to biopsy sampling requirements is proposed, which includes a down-sampling algorithm suitable for different nodule shapes. Entry points are selected according to the selected target points and clinical constraints. During the path evaluation, the clinical needs of lung biopsy surgery are first quantified as path evaluation indicators and then divided according to their evaluation perspective into risk and execution indicators. Then, considering the impact of the correlation between indicators, a path scoring system based on the double spherical constraint Pareto and the importance-correlation degree of the indicators is proposed to evaluate the comprehensive performance of the planned paths. The proposed method is retrospectively tested on 6 CT images and prospectively tested on 25 CT images. The experimental results indicate that the method proposed in this work can be used to plan feasible puncture paths for different cases and can serve as an auxiliary tool for lung biopsy surgery.
肺癌是癌症中死亡率最高的一种。临床上常用的诊断肺癌的方法是 CT 引导经皮肺穿刺活检术(CT-PTLB),但这种方法需要医生具备较高的临床经验。本工作提出了一种用于 CT-PTLB 的自动路径规划方法,为医生提供穿刺路径的辅助建议。所提出的方法包括三个步骤:预处理、初始路径选择和路径评估。在预处理阶段,对后续路径规划所需的胸部器官进行分割。在初始路径选择阶段,提出了一种根据活检采样要求选择活检样本的目标点选择方法,该方法包括一种适用于不同结节形状的下采样算法。根据选择的目标点和临床约束选择进入点。在路径评估阶段,首先将肺活检手术的临床需求量化为路径评估指标,然后根据其评估视角分为风险和执行指标。然后,考虑到指标之间相关性的影响,提出了一种基于双球约束 Pareto 和指标重要度相关度的路径评分系统,用于评估规划路径的综合性能。该方法在 6 张 CT 图像上进行了回顾性测试,并在 25 张 CT 图像上进行了前瞻性测试。实验结果表明,该方法可以为不同病例规划可行的穿刺路径,可作为肺活检手术的辅助工具。