肝肿瘤热消融治疗穿刺路径规划算法研究综述

    Review of Needle Trajectory Planning Algorithms for Liver Tumor Thermal Ablation

    • 摘要: 经皮介入热消融治疗已成为继手术切除、肝移植后的肝癌第三大根治性措施.热消融治疗是在医学影像引导下,将消融器械即消融针经皮刺入病灶区域,对癌细胞进行原位灭杀的微创治疗.准确有效的穿刺路径规划是肝肿瘤微波/射频消融治疗的关键,但在临床热消融治疗中,消融针的穿刺路径规划仍然依赖于医生的个人经验.因此近年来,计算机辅助穿刺路径规划成为肿瘤热消融领域的一个研究热点,其目标是辅助医生制定个性化的手术策略,以期实现肝肿瘤的“适形”治疗,提高热消融治疗的安全性和有效性.系统综述计算机辅助肝肿瘤微波/射频消融治疗穿刺路径规划算法.从单项临床约束条件到多项临床约束条件、从单消融针介入到多消融针协同介入、从刚性路径规划到弹性路径规划,多层次阐述并讨论消融针穿刺路径规划算法的研究进展和存在的局限,并对未来的发展进行展望.

       

      Abstract: Percutaneous interventional thermal ablation has become the third major radical treatment for liver tumors, following surgical resection and liver transplantation. Thermal ablation therapy is a minimally invasive treatment in which the ablation applicator (ablation needle) is percutaneously inserted into the lesion area under the guidance of medical imaging, so as to kill cancer cells in situ. Accurate and effective needle trajectory planning is the key to microwave/radiofrequency ablation of liver tumors. However, in clinical thermal ablation treatment, the needle trajectory planning still depends on the personal experience of doctors. Therefore, in recent years, computer-aided needle trajectory planning has become a research hotspot in the field of thermal tumor ablation. Its goal is to assist doctors to develop personalized surgical strategies to achieve "conformal" treatment of liver tumors and improve the safety and efficacy of thermal ablation therapy. This paper systematically reviewed the computer-assisted needle trajectory planning algorithms for microwave/radiofrequency ablation of liver tumors. The research progress and limitations of ablation needle trajectory planning algorithm were introduced and discussed at multiple levels, from single clinical constraint to multiple clinical constraints, from single ablation applicator intervention to multiple ablation applicator collaborative intervention, and from rigid trajectory planning to elastic trajectory planning. Future developments are suggested.

       

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