This application is based upon and claims priority to Chinese Patent Application No. 202310857773.0, filed on Jul. 13, 2023, the entire contents of which are incorporated herein by reference.
The present invention relates to technical field of image processing, and in particular to an intelligent anesthetization system for ultrasonic transperineal puncturing biopsy of prostate based on multimodal medical image registration.
With the development of science and technology and the popularization of health education, men around the world are paying more and more attention to prostate diseases. Prostate cancer is also the second most common cancer among men in the world which seriously affects men's health. Doctors usually test prostate-specific antigen (PSA), perform multi-parameter magnetic resonance imaging on patients with abnormal PSA levels, and arrange puncturing biopsy to effectively screen for prostate cancer at an early stage and formulate a treatment plan in a timely manner.
Therefore, how to efficiently complete puncturing biopsy and how to improve positive rate of biopsy results has become a goal that medical community continues to pursue. There are two main types of procedure in prostate biopsy:
The first type is the transrectal puncturing method that has been used for years. This method does not have high requirements for anesthetization and is easy to operate. However, disadvantage is that rectal bacteria can easily enter the blood causing fever and infection and even the possibility of sepsis. According to statistics, the infection rate of this method is as high as 5-7%;
The second type is transperineal puncturing method which has been widely used in recent years and is relatively safer. According to statistics, the infection rate is compared with transrectal puncturing reduced to 0.075%. Generally, it can be cured in a short time. However, the method has high requirements for anesthetization. People not only need to accurately find anesthetized area, but also need to choose an anesthetic needle with corresponding length for precise anesthetization. If the anesthetic effect is not ideal, the patient can feel very painful during puncturing process, and it may even lead to the inability to successfully complete the surgery. It is precisely because of this reason that large-scale promotion of this safe as well as effective procedure has encountered certain resistance.
Multi-parameter magnetic resonance imaging (mpMRI) is used as the image that must be obtained before prostate puncturing due to its excellent visualization effect on soft tissue. The area of suspected lesions can be identified with relative accuracy on nuclear magnetic resonance image (MRI), and nerve anesthetized area around prostate can also be accurately identified. Ultrasound imaging has a high degree of real-time characteristics and is usually used as preferred equipment for puncturing. However, due to its low quality in image resolution, it is often relatively difficult to identify the precise target area of anesthetization directly on ultrasonic images.
Therefore, there is urgent need for a system that can project anesthetized area in magnetic resonance imaging into real-time ultrasonic images accurately and in real time.
Purpose of the present invention is to propose an intelligent anesthetization system for the ultrasonic transperineal prostate puncturing based on multimodal medical images in response to current difficulty in identifying precise target area of anesthetization directly on ultrasonic images. The system is simple to operate which uses ultrasonic images to fuse preoperative multi-parameter magnetic resonance images. It accurately integrates anesthetized area and perineum area into high real-time ultrasonic images. At same time, it intelligently recommends anesthetic tools to achieve accurate preoperative anesthetic plans, thereby not only difficulty of transperineal puncturing but also patient's infection rate can be effectively reduced. The technical solution of the present invention is:
An intelligent anesthetization system for the transperineal prostate puncturing based on multimodal medical images, characterized in that the system comprises:
Coordinate system definition module: Define electromagnetic emitter coordinate system CSe based on the ultrasonic imaging plane formed by the electromagnetic field transmitter, define nuclear magnetic imaging coordinate system CSm based on the nuclear magnetic device for taking MRI sequence images and define coordinate system CSs based on electromagnetic sensor which is fixed on ultrasonic probe; obtain transformation matrix TMse of electromagnetic sensor at any position in CSs based on the position and posture of electromagnetic sensor in the electromagnetic emitter coordinate system CSe;
Markup of MRI sequence image and 3D reconstruction module: Receive MRI sequence images of human prostate, mark anesthetized area MRI-VMa and outer contour area of the prostate MRI-VMp; reconstruct 3D anesthetized area and 3D outer contour area of prostate based on the position information of MRI sequence images;
Ultrasonic data extraction module: Receive ultrasonic data of the human prostate, extract image set covering base to apex of prostate in ultrasonic data, and obtain the outer contour area of prostate US-VMp in the electromagnetic emitter coordinate system CSe under ultrasonic images based on the spatial position information of each frame of ultrasonic image;
Registration module: Use iterative closest point (ICP) point cloud registration algorithm to register volume data about the outer contour area of prostate MRI-VMp in nuclear magnetic imaging coordinate system CSm as well as volume data about the outer contour area of prostate US-VMp in electromagnetic emitter coordinate system CSe under ultrasonic image and obtain the spatial transformation matrix TMme between the two;
Anesthetic planning module: Receive the current ultrasonic image acquired by ultrasonic probe, obtain anesthetized area EMTS-Vma mapped in electromagnetic emitter coordinate system based on spatial transformation matrix TMme, and fuse it with current ultrasonic image to obtain the anesthetized area under ultrasonic images.
Furthermore, the markup specifically uses a pre-trained deep learning model for prostate segmentation to segment MRI sequence images and marks the segmented anesthetized area VMa and the outer contour area of prostate VMp.
Furthermore, the deep learning model for prostate segmentation is specifically established as follows:
Extract the cross-sectional and sagittal images of MRI sequence images of the prostate;
Mark and segments the anesthetized area and the outer contour area of prostate on cross-sectional and sagittal images;
Input marked and segmented MRI images of the prostate as samples into artificial neural network model for training to obtain the deep learning model for prostate segmentation.
Furthermore, the transformation matrix TMse is specifically:
Wherein: R is a 3×3 matrix, T is a 3×1 vector, R and T represent the position and posture of electromagnetic sensor in the electromagnetic emitter coordinate system CSe.
Furthermore, the acquisition of outer contour area of prostate US-VMp is specifically:
Extract the image set covering base to apex of the prostate in ultrasonic data, and the frame number is recorded as N;
Extract images containing prostatic organ and segment the outer contour area of prostate to obtain outer contour area of the prostate US-VMp in ultrasonic images, and obtain coordinate PCe of each point within outer contour area in electromagnetic emitter coordinate system CSe using the following formula:
Wherein i represents frame number, (u, v) represents pixel coordinates of contour point in ultrasonic 2D images, TMsei represents transformation matrix of electromagnetic sensor at any position in CSs corresponding to i-th frame image, and TMts represents transformation matrix of the relative positions between vertices of ultrasonic imaging plane and electromagnetic sensor.
Furthermore, the registration is specifically:
Use coordinates PCe(i,u,v) of each point in the outer contour area of prostate US-VMp within ultrasonic image in electromagnetic emitter coordinate system CSe as first set of 3D point clouds and use 3D point cloud corresponding to the 3D outer contour area of prostate MRI-VMp as the second set of 3D point clouds;
Process two sets of point clouds separately;
Register the processed 3D point clouds using ICP point cloud registration algorithm to obtain spatial transformation matrix TMme from the nuclear magnetic imaging coordinate system CSm to the electromagnetic emitter coordinate system CSe.
Furthermore, the anesthetic planning module performs the following steps:
Transform anesthetized area MRI-VMa in nuclear magnetic imaging coordinate system CSm into the electromagnetic emitter coordinate system under current ultrasonic images based on spatial transformation matrix TMme to obtain the mapped anesthetized area EMTS-Vma;
Obtain a slice formed by tangency of plane position of current ultrasonic image and of volume data of anesthetized area EMTS-Vma to obtain slice Sa with outline of anesthetized area;
Fuse and superimpose current ultrasonic image and slice Sa with outline of anesthetized area to obtain a fused image of current ultrasonic image and anesthetized area which displays the anesthetized area under the ultrasonic images.
Furthermore, the system which includes a puncture planning module as well performs the following steps:
Extract point cloud data of perineum in electromagnetic emitter coordinate system CSe from ultrasonic data and fits plane position of perineum PP as the initial plane position of the needle into human body, which its normal vector of this plane is consistent with the direction of the ultrasonic probe entering the human body;
Calculate the distance from center point of mapped anesthetized area EMTS-Vma under ultrasonic image to puncture starting plane PP, and recommend the anesthetic needle with suitable length based on distance from anesthetized area to puncture starting plane.
Furthermore, the fitting of plane position PP of perineum comprises:
Extract the ultrasonic data sequence of perineum, and obtain a series of coordinate points PPi(x, y, z, 1) on ultrasonic imaging plane wherein i represents serial number of coordinate points, x, y, z represent coordinate values of ultrasonic imaging plane respectively, and use the following formula to obtain real coordinates PPsi of each point in electromagnetic emitter coordinate system CSs;
PPsi=TMse×TMts×PPi
Wherein: TMts represents transformation matrix of relative positions between vertices of ultrasonic imaging plane and electromagnetic sensor;
Fit plane position PP of perineum as puncture starting plane by the singular value decomposition (SVD) method based on discrete points according to real coordinates PPsi of each point;
Furthermore, the distance from center point of mapped anesthetized area EMTS-Vma to puncture the starting plane PP is calculated using the following formula:
Wherein (xm, ym, zm) is the center point of the anesthetized area in electromagnetic emitter coordinate system CSe of ultrasonic imaging plane, and a, b, c, d are plane parameters of PP.
The beneficial effects of the present invention are as follows:
The system of present invention transforms the images in preoperative nuclear magnetic imaging coordinate system and target area of anesthetization into real-time electromagnetic emitter coordinate system via multimodal medical image registration, thereby realizing the comprehensive fusion of target area of anesthetization in nuclear magnetic resonance imaging and ultrasonic image which can be used for medical teaching or surgical guidance and can help to achieve the precise positioning of anesthetized area for the transperineal prostate biopsy.
The present invention realizes intelligent recommendation of model of anesthetic needle by calculating and analyzing distance between target area and starting position of needle insertion, making the working progress of anesthetization more smoothly as well as efficiently and playing effective role in promoting procedure in transperineal prostate biopsy.
Other features and advantages of present invention will become apparent from following detailed description of the embodiments of the invention.
The above and other objects, features and advantages of present invention will be better understood from following detailed description taken in conjunction with accompanying drawings, wherein like reference numerals generally represent like parts in the exemplary embodiment of the present invention.
The present invention will be described more fully hereinafter with the reference to the accompanying drawings, in which a preferred embodiment of invention is shown. This invention may, however, be embodied in many different forms and should not be limited to the embodiments set forth herein.
An intelligent anesthetization system for transperineal prostate puncturing based on the multimodal medical images which comprises:
Coordinate system definition module: Define electromagnetic emitter coordinate system CSe based on ultrasonic imaging plane formed by the electromagnetic field transmitter, define the nuclear magnetic imaging coordinate system CSm based on the nuclear magnetic device for taking MRI sequence images and define coordinate system CSs based on electromagnetic sensor which is fixed on the ultrasonic probe; obtain transformation matrix TMse of electromagnetic sensor at any position and posture in CSs based on position of electromagnetic sensor in the electromagnetic emitter coordinate system CSe. As shown in
The transformation matrix TMse is specifically:
Wherein: R is a 3×3 matrix, T is a 3×1 vector, R and T represent the position and posture of electromagnetic sensor in the electromagnetic emitter coordinate system CSe.
Markup of MRI sequence images and 3D reconstruction module: Receive MRI sequence images of the human prostate, mark anesthetized area MRI-VMa and outer contour area of prostate MRI-VMp; reconstruct 3D anesthetized area and 3D outer contour area of prostate based on the position information of MRI sequence images;
Ultrasonic data extraction module: Receive ultrasonic data of the human prostate, extract image set covering base to apex of the prostate in ultrasonic data, and obtain outer contour area of prostate US-VMp in the electromagnetic emitter coordinate system CSe under ultrasonic images based on the spatial position information of each frame of ultrasonic image;
Registration module: Use ICP point cloud registration algorithm to register volume data about the outer contour area of prostate MRI-VMp in nuclear magnetic imaging coordinate system CSm as well as volume data about the outer contour area of prostate US-VMp in electromagnetic emitter coordinate system CSe under ultrasonic images and obtain spatial transformation matrix TMme between the two;
Anesthetic planning module: Receive the current ultrasonic images acquired by ultrasonic probe, obtain the anesthetized area EMTS-Vma mapped under electromagnetic emitter coordinate system based on the spatial transformation matrix TMme, and fuse it with current ultrasonic image to obtain the anesthetized area under ultrasonic images.
In this embodiment, images in preoperative nuclear magnetic imaging coordinate system and target area of anesthetization are transformed into real-time electromagnetic emitter coordinate system via multimodal medical image registration, thereby realizing comprehensive fusion of target area of anesthetization in nuclear magnetic resonance image and ultrasonic images which can be used for medical teaching or surgical guidance and can help to achieve precise positioning of anesthetized area for transperineal prostate biopsy.
In the present invention, steps of markup of MRI sequence images and 3D reconstruction module are specifically: Use the pre-trained deep learning model for the prostate segmentation to segment MRI sequence images and mark the segmented anesthetized area VMa and outer contour area of prostate VMp. As shown in
Among them, deep learning model for prostate segmentation is specifically established as follows:
Extract the cross-sectional and sagittal images of MRI sequence images of the prostate;
Mark and segment anesthetized area and outer contour area of prostate on cross-sectional and sagittal images;
Input marked and segmented MRI images of prostate as samples into the artificial neural network model for training to obtain the deep learning model for prostate segmentation.
In this embodiment, prostate is segmented and marked based on the deep learning model which effectively improves the accuracy of segmentation and recognition.
In present invention, acquisition of outer contour area of prostate US-VMp is specifically:
Extract image set covering base to apex of the prostate in ultrasonic data, and the frame number is recorded as N;
Extract images containing prostatic organ and segment the outer contour area of prostate to obtain outer contour area of prostate US-VMp in the ultrasonic images, and obtain coordinate PCe of each point within outer contour area in electromagnetic emitter coordinate system CSe using the following formula:
Wherein i represents frame number, (u, v) represents pixel coordinates of contour point in ultrasonic 2D images, TMsei represents transformation matrix of electromagnetic sensor at any position in CSs corresponding to i-th frame image, and TMts represents transformation matrix of the relative positions between vertices of ultrasonic imaging plane and electromagnetic sensor.
In this embodiment, among the N frames of images collected, not only image containing prostatic organ is found but also outer contour area of prostate is segmented and outlined area as well as outer contour area of prostate in ultrasonic image is obtained. The coordinates of each point in the outer contour within electromagnetic emitter coordinate system CSe are obtained by formula transformation as shown in the first point cloud in
In the present invention, registration module uses coordinates PCe(i,u,v) of each point in the outer contour area of prostate US-VMp within the ultrasonic image in electromagnetic emitter coordinate system CSe as first set of 3D point clouds and uses 3D point cloud corresponding to the 3D outer contour area of prostate MRI-VMp as the second set of 3D point clouds;
Process two sets of the point clouds separately, including: triangulating and smoothing two sets of point clouds, restoring them into point clouds, downsampling to reduce the number of 3D point clouds, and obtaining two sets of downsampled 3D point clouds;
Register processed 3D point clouds using ICP point cloud registration algorithm to obtain spatial transformation matrix TMme from the nuclear magnetic imaging coordinate system CSm to the electromagnetic emitter coordinate system CSe.
In this embodiment, the ICP algorithm is used to complete registration of two sets of point clouds, and transformation matrix TMme from nuclear magnetic imaging coordinate system to electromagnetic emitter coordinate system can be obtained. It can be seen that the prostate point cloud in the nuclear magnetic resonance is transformed by TMme to obtain the point cloud shown in schematic diagram
In the present invention, anesthetic planning module performs the following steps:
Transform the anesthetized area MRI-VMa under nuclear magnetic imaging coordinate system CSm into electromagnetic emitter coordinate system under current ultrasonic image based on spatial transformation matrix TMme to obtain the mapped anesthetized area EMTS-Vma;
Obtain a slice formed by tangency of plane position of current ultrasonic image and of volume data of anesthetized area EMTS-Vma to obtain the slice Sa with outline of the anesthetized area;
Fuse and superimpose current ultrasonic image and slice Sa with outline of anesthetized area to obtain a fused image of current ultrasonic image and the anesthetized area which displays the anesthetized area under the ultrasonic images.
In this embodiment, as shown in
The system which includes a puncture planning module as well performs the following steps:
Extract point cloud data of perineum in electromagnetic emitter coordinate system CSe from ultrasonic data, and obtain a series of coordinate points PPi(x, y, z, 1) on ultrasonic imaging plane wherein i represents serial number of coordinate points, x, y, z represent coordinate values of ultrasonic imaging plane respectively, and use the following formula to obtain real coordinates PPsi of each point in electromagnetic emitter coordinate system CSs;
PPsi=TMse×TMts×PPi
Wherein: TMts represents transformation matrix of relative positions between vertices of ultrasonic imaging plane and electromagnetic sensor;
Fit plane position of perineum PP as puncture starting plane by the SVD method based on discrete points according to real coordinates PPsi of each point. The normal vector of this plane is consistent with the direction of the ultrasonic probe entering the human body;
Calculate the distance from center point of mapped anesthetized area EMTS-Vma under ultrasonic image to puncture starting plane PP using the following formula:
Wherein (xm, ym, zm) is the center point of the anesthetized area in electromagnetic emitter coordinate system CSe of ultrasonic imaging plane, and a, b, c, d are plane parameters of PP.
Recommend anesthetic needle with suitable length based on distance from anesthetized area to puncture starting plane.
In this embodiment, as shown in
The application method for system of the present invention is as follows:
To extract the image containing prostatic organ and to segment the outer contour area of prostate to obtain outer contour area of prostate US-VMp in the ultrasonic image;
To process the two sets of point clouds separately;
To register processed 3D point clouds using ICP point cloud registration algorithm to obtain spatial transformation matrix TMme from the nuclear magnetic imaging coordinate system CSm to the electromagnetic emitter coordinate system CSe;
To obtain a slice formed by tangency of plane position of current ultrasonic image and of volume data of anesthetized area EMTS-Vma to obtain the slice Sa with outline of anesthetized area;
To fuse and superimpose the current ultrasonic image and the slice Sa with the outline of anesthetized area to obtain a fused image of the current ultrasonic image and the anesthetized area which displays the anesthetized area under the ultrasonic image;
PPsi=TMse×TMts×PPi
Wherein: TMts represents transformation matrix of relative positions between vertices of ultrasonic imaging plane and electromagnetic sensor;
To fit plane position PP of perineum as puncture starting plane by the SVD method based on discrete points according to the real coordinates PPsi of each point;
To calculate the distance d from center point of anesthetized area EMTS-Vma mapped under current ultrasonic image to puncture starting plane PP, and recommends anesthetic needle with suitable length based on distance from anesthetized area to puncture starting plane.
When system of the present invention is applied, it realizes comprehensive fusion of the target area of anesthetization in MRI and ultrasonic image which can be used for medical teaching or surgical guidance and can help to achieve the precise positioning of anesthetized area for the transperineal prostate biopsy. It also realizes intelligent recommendation of model of the anesthetic needle by calculating and analyzing distance between target area and starting position of needle insertion, making the working progress of the anesthetization more smoothly as well as efficiently and playing effective role in promoting procedure in transperineal prostate biopsy.
The embodiments of present invention have been described above, and above description is exemplary, not exhaustive, and is not limited to the disclosed embodiments. Without departing from scope and spirit of the embodiments described, many of the modifications as well as changes are obvious to the average technician in the field of technology.
Number | Date | Country | Kind |
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202310857773.0 | Jul 2023 | CN | national |