Positioning method for percutaneous pulmonary nodule puncture operation

Abstract

The positioning method for the percutaneous pulmonary nodule puncture operation comprises the steps that S10, cone beam computed tomography is conducted on the lung through a movable three-dimensional C-arm X-ray machine in cooperation with a medical bed; s20, adjusting the mobile three-dimensional C-arm X-ray machine and the medical bed according to the result of the cone-beam computed tomography, and aligning the isocenter with the pulmonary nodule; s30, cone-beam computed tomography is conducted on the lung again, whether the isocenter is aligned with the pulmonary nodule or not is judged, if the judgment result of S30 is negative, the step S20 is executed, and if the judgment result of S30 is positive, the following steps are executed: S40, the puncture angle and the puncture distance are determined; and S50, the movable three-dimensional C-arm X-ray machine is adjusted according to the puncture angle, and the puncture angle is positioned through laser. According to the positioning method for the percutaneous pulmonary nodule puncture operation, one-stop positioning of the pulmonary nodule can be achieved at low cost.

Description

Technical Field

[0001] The invention relates to the field of medical imaging, and in particular to a positioning method for percutaneous pulmonary nodule puncture surgery. Background Art

[0002] Percutaneous pulmonary nodule puncture surgery usually uses traditional CT positioning methods or CT fluorescence positioning methods. Traditional CT positioning methods have high spatial resolution and low probability of complications, but this method lacks real-time monitoring of lesions. CT fluorescence positioning can effectively solve this problem and achieve real-time monitoring of target lesions during puncture. CT fluorescence positioning requires that the lesion be located in the CT room and then transferred to the operating room. This non-one-stop solution may bring the risk of pneumothorax, pulmonary hemorrhage or wire detachment during movement. A hybrid operating room equipped with cone beam CT can achieve one-stop positioning of pulmonary nodules, but the site requirements and assembly and maintenance costs of the hybrid operating room are too high. Summary of the invention

[0003] The purpose of the present invention is to provide a positioning method for percutaneous pulmonary nodule puncture surgery, which can achieve one-stop positioning of pulmonary nodules at a low cost.

[0004] The present invention provides a positioning method for percutaneous pulmonary nodule puncture surgery, which is implemented by using a mobile three-dimensional C-arm X-ray machine and a medical bed that adopts an isocenter design and has a laser positioning function. The positioning method for percutaneous pulmonary nodule puncture surgery includes:

[0005] S10: Cone beam computed tomography of the lungs using a mobile three-dimensional C-arm X-ray machine in conjunction with a medical bed;

[0006] S20: Adjust the mobile three-dimensional C-arm X-ray machine and the medical bed according to the results of cone-beam computed tomography to align the isocenter with the lung nodules;

[0007] S30: Perform cone beam computed tomography on the lungs again to determine whether the isocenter is aligned with the lung nodules. If the determination result of S30 is no, return to S20. If the determination result of S30 is yes, proceed to the following steps:

[0008] S40: Determine the puncture angle and puncture distance; and

[0009] S50: adjusting the mobile three-dimensional C-arm X-ray machine according to the puncture angle, and positioning the puncture angle using laser.

[0010] The positioning method for percutaneous pulmonary nodule puncture surgery provided by the present invention realizes the positioning of percutaneous pulmonary nodule puncture surgery by using a mobile three-dimensional C-arm X-ray machine with isocenter design and laser positioning function, thereby realizing one-stop positioning of pulmonary nodules, and has lower site requirements and assembly and maintenance costs.

[0011] In another exemplary embodiment of the positioning method for percutaneous pulmonary nodule puncture surgery, S10 includes:

[0012] S11: Setting a mobile three-dimensional C-arm X-ray machine, so that its C-arm can rotate around a rotation axis parallel to the head and feet direction of the human body, and swing around a swing axis parallel to the left and right direction of the human body;

[0013] S12: Perform basic settings for the mobile three-dimensional C-arm X-ray machine;

[0014] S13: collision test of mobile 3D C-arm X-ray machine; and

[0015] S14: operate the three-dimensional C-arm X-ray machine to start radiation, perform three-dimensional data acquisition and generate a coronal image, a sagittal image and a cross-sectional image where the isocenter is located.

[0016] This prevents possible collisions of equipment during movement and improves positioning accuracy.

[0017] In another exemplary implementation of the positioning method for percutaneous pulmonary nodule puncture surgery, in S14, the three-dimensional data should be collected at the end of inspiration or when the patient is holding his breath during quiet breathing. Selecting to collect the three-dimensional data at the end of inspiration or when the patient is holding his breath during quiet breathing can reduce errors caused by respiratory movement.

[0018] In another exemplary embodiment of the positioning method for percutaneous pulmonary nodule puncture surgery, S20 includes:

[0019] S21: Use software to measure the coronal, sagittal, and transverse images to obtain the offset distance between the isocenter and the lung nodule in the head-to-foot, left-right, and chest-back directions of the human body; and

[0020] S22: Adjust the three-dimensional C-arm X-ray machine and the medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction, the left-right direction, and the chest-back direction.

[0021] In another exemplary embodiment of the positioning method for percutaneous pulmonary nodule puncture surgery, S22 includes:

[0022] S221: adjusting the position of the C-arm of the mobile three-dimensional C-arm X-ray machine according to the offset distance between the isocenter and the lung nodule in the left-right direction and the chest-back direction of the human body; and

[0023] S222: Adjust the position of the bed board of the medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction of the human body.

[0024] In another exemplary implementation of the positioning method for percutaneous pulmonary nodule puncture surgery, in S221, a ruler in millimeters is set on the mobile three-dimensional C-arm X-ray machine, and the ruler is referenced when the position of the C-arm is moved.

[0025] In another exemplary embodiment of the positioning method for percutaneous pulmonary nodule puncture surgery, S40 includes:

[0026] S41: Select a puncture point on the human body surface, and the puncture path from the puncture point to the isocenter can avoid important organs of the human body;

[0027] S42: determining whether the puncture point is located on the cross section where the isocenter is located;

[0028] If the judgment result of S42 is yes, then proceed to S43: calculate a first cross-sectional angle between a line from the puncture point to the isocenter and a sagittal plane where the isocenter is located, and measure the puncture distance using software;

[0029] If the judgment result of S42 is no, enter S44: calculate a second cross-sectional angle between the line connecting the projection of the puncture point on the cross-sectional plane where the isocenter is located and the sagittal plane where the isocenter is located, and calculate a sagittal plane angle between the line connecting the projection of the puncture point on the sagittal plane where the isocenter is located and the isocenter and the cross-sectional angle where the isocenter is located, and use software to measure the puncture distance.

[0030] In another schematic embodiment of the positioning method for percutaneous pulmonary nodule puncture surgery, a mobile three-dimensional C-arm X-ray machine includes a laser transmitter, which is disposed on the C-arm of the mobile three-dimensional C-arm X-ray machine and can emit a positioning laser, and the positioning laser is emitted toward the isocenter perpendicular to the rotation axis and the swing axis. In S50, the C-arm is adjusted to rotate around the rotation axis according to the first cross-sectional angle or the second cross-sectional angle, and the C-arm is adjusted to swing around the swing axis according to the sagittal plane angle, and the positioning laser is directed toward the pulmonary nodule along the puncture angle, thereby ensuring high accuracy of laser positioning.

[0031] In another schematic implementation of the positioning method for percutaneous pulmonary nodule puncture surgery, the mobile three-dimensional C-arm X-ray machine also includes two straight-line lasers, which can emit positioning lasers. The two positioning lasers can irradiate cross lines on the human body, and the positioning lasers are irradiated at the intersection of the cross lines. In S50, the cross lines are used to locate the puncture point. BRIEF DESCRIPTION OF THE DRAWINGS

[0032] The following drawings are only used to schematically illustrate and explain the present invention, and do not limit the scope of the present invention.

[0033] Figure 1 The present invention is a flow chart of a schematic implementation of a positioning method for percutaneous pulmonary nodule puncture surgery.

[0034] Figure 2 A schematic diagram of an implementation method for percutaneous pulmonary nodule puncture surgery.

[0035] Figure 3 This is a partial flow chart of the positioning method for percutaneous pulmonary nodule puncture surgery.

[0036] Figure 4 Results of cone-beam computed tomography of the lungs are shown.

[0037] Figure 5 This is a partial flow chart of the positioning method for percutaneous pulmonary nodule puncture surgery.

[0038] Figure 6 This is a partial flow chart of the positioning method for percutaneous pulmonary nodule puncture surgery.

[0039] Figure 7 Results of cone-beam computed tomography of the lungs are shown.

[0040] Figure 8 This is a partial flow chart of the positioning method for percutaneous pulmonary nodule puncture surgery.

[0041] Fig. 9 Used to illustrate the determination of the puncture angle based on the results of cone-beam computed tomography.

[0042] Description of symbols

[0043] X Human left and right direction

[0044] Y Human chest and back direction

[0045] Z Head and feet direction DETAILED DESCRIPTION

[0046] In order to have a clearer understanding of the technical features, purposes and effects of the invention, the specific embodiments of the present invention are now described with reference to the accompanying drawings. The same reference numerals in the drawings represent components with the same structure or similar structures but the same functions.

[0047] In this document, “exemplary” means “serving as an example, instance or illustration”, and any diagram or implementation described in this document as “exemplary” should not be interpreted as a more preferred or more advantageous technical solution.

[0048] In this article, "first", "second", etc. do not indicate their importance or order, but are only used to indicate the difference between each other for the convenience of document description.

[0049] In order to simplify the drawings, each figure only schematically shows the parts related to the present invention, which do not represent the actual structure of the product.

[0050] Figure 1 The present invention is a flow chart of a schematic implementation of a positioning method for percutaneous pulmonary nodule puncture surgery. Figure 2 A schematic diagram of a positioning method for percutaneous pulmonary nodule puncture surgery. Figure 1 and Figure 2 The positioning method of percutaneous pulmonary nodule puncture surgery is implemented by using a mobile three-dimensional C-arm X-ray machine and a medical bed with isocenter design and laser positioning function. In the present invention, the Siemens Healthineer CiosSpin mobile three-dimensional C-arm X-ray machine is taken as an example. The positioning method of percutaneous pulmonary nodule puncture surgery includes the following steps S10 to S50.

[0051] S10: Use a mobile three-dimensional C-arm X-ray machine in conjunction with a medical bed to perform cone beam computed tomography imaging of the lungs. Specifically, Figure 3 As shown, S10 includes the following steps S11 to S14.

[0052] S11: A mobile three-dimensional C-arm X-ray machine is set up so that its C-arm can rotate around a rotation axis parallel to the head-foot direction Z of the human body, and swing around a swing axis parallel to the left-right direction X of the human body. The frame of the mobile three-dimensional C-arm X-ray machine with isocenter design is designed so that when it rotates and swings along the track, the motion trajectory is a perfect circle, and the center of the motion trajectory is the isocenter, so that the subject is always kept at the center of the ray beam.

[0053] S12: Perform basic settings for the mobile 3D C-arm X-ray machine. Specifically, the operator needs to select 3D acquisition in the Siemens Healthineer CiosSpin program, and set the patient's position, such as supine, prone, left side or right side, and the direction of the Siemens Healthineer CiosSpin relative to the medical bed, such as left side or right side.

[0054] S13: Perform a collision test on the mobile 3D C-arm X-ray machine. Siemens Healthineer CiosSpin has a collision test function that can simulate the movement of the C-arm before actual startup to detect whether there is a collision risk. After the collision test is completed, you can proceed to the next step.

[0055] S14: Operate the 3D C-arm X-ray machine to start radiation, perform 3D data acquisition and generate coronal images, sagittal images and cross-sectional images where the isocenter is located. Figure 4As shown in Figure 1, since the isocenter was not aligned with the pulmonary nodule during the initial cone-beam computed tomography imaging, the pulmonary nodule did not appear in the coronal and sagittal images, and it was necessary to search for it in multiple cross-sectional images until it was found. Figure 4 As shown in , the lung nodules appear in cross-sectional images

[0056] In S14, 3D data acquisition should be performed at the end of the patient's inspiration. If the patient cannot hold his breath at the end of inspiration, 3D data acquisition can also be performed when the patient is breathing calmly and holding his breath. 3D data acquisition should be avoided at the end of the patient's expiration phase because bronchial convergence and volume effect will affect the display of lung nodules.

[0057] S20: Adjust the mobile 3D C-arm X-ray machine and the medical bed according to the results of cone beam computed tomography, and align the isocenter with the lung nodules. Figure 5 , S20 includes the following steps S21 and S22.

[0058] S21: Use software to measure the coronal, sagittal and cross-sectional images to obtain the offset distance between the isocenter and the lung nodule in the head-foot direction Z, the left-right direction X and the chest-back direction Y. Figure 4 , the marking lines used to represent the coronal plane, sagittal plane and cross-section are displayed in the coronal image, sagittal image and cross-section image respectively. The software of Siemens Healthineer CiosSpin can calculate the distance between the lung nodule and the cross-section where the isocenter is located, which is the deviation distance between the isocenter and the lung nodule in the head-foot direction Z of the human body. By marking the lung nodules in the cross-sectional image, the distance between the lung nodule and the sagittal plane where the isocenter is located and the distance between the lung nodule and the coronal plane where the isocenter is located can also be calculated, which are the deviation distance between the isocenter and the lung nodule in the left-right direction X of the human body and the offset distance between the isocenter and the lung nodule in the chest-back direction Y of the human body.

[0059] S22: Adjust the three-dimensional C-arm X-ray machine and medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction Z, the left-right direction X, and the chest-back direction Y. For details, refer to Figure 6 , S22 includes the following steps S221 and S222.

[0060] S221: adjusting the position of the C-arm of the mobile three-dimensional C-arm X-ray machine according to the offset distance between the isocenter and the lung nodule in the left-right direction X and the chest-back direction Y of the human body: since the movement accuracy of the mobile three-dimensional C-arm X-ray machine may not reach the required millimeter level, a ruler in millimeters can be set on the mobile three-dimensional C-arm X-ray machine during specific operations, and the ruler can be used as a reference when moving the position of the C-arm to achieve millimeter-level positioning.

[0061] S222: Adjust the position of the bed board of the medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction Z of the human body.

[0062] S30: Perform cone beam computed tomography on the lungs again to determine whether the isocenter is aligned with the lung nodules. If the determination result of S30 is no, return to S20. If the determination result of S30 is yes, Figure 7 As shown in the figure, if the center points in the coronal, sagittal, and transverse images are aligned with the pulmonary nodules, proceed to the following steps:

[0063] S40: Determine the puncture angle and puncture distance. Figure 8 , S40 includes the following steps S41 to S44.

[0064] S41: A puncture point is selected on the human body surface, and the puncture path from the puncture point to the isocenter can avoid important organs of the human body, such as large blood vessels, ribs and spine.

[0065] S42: Determine whether the puncture point is located on the cross section.

[0066] If the judgment result of S42 is yes, that is, the puncture point is located on the cross-section and the puncture path has avoided the important organs of the human body, the puncture angle can be directly determined at this time, and then enter S43: calculate a first cross-sectional angle between the line connecting the puncture point to the isocenter and the sagittal plane where the isocenter is located, and use software to measure the puncture distance.

[0067] If the judgment result of S42 is no, the punctum point cannot be located on the cross section where the isocenter is located. Fig. 9 , then enter S44: calculate a second cross-sectional angle between the projection of the puncture point on the cross-sectional plane where the isocenter is located and the line connecting the isocenter and the sagittal plane where the isocenter is located, Fig. 9 Medium Indicates, and calculates the sagittal angle between the projection of the puncture point on the sagittal plane where the isocenter is located and the line connecting the isocenter and the cross section where the isocenter is located. Fig. 9 Medium Indicates that the absolute values ​​of the second cross-sectional angle and the sagittal plane angle are both less than or equal to 180 degrees. After determining the first cross-sectional angle or the second cross-sectional angle and the sagittal plane angle, the puncture distance is measured using software.

[0068] S50: Adjust the mobile three-dimensional C-arm X-ray machine according to the puncture angle and use laser to locate the puncture angle. Figure 2The mobile three-dimensional C-arm X-ray machine includes a laser transmitter, which is arranged on the C-arm of the mobile three-dimensional C-arm X-ray machine and can emit a positioning laser, which is perpendicular to the rotation axis and the swing axis and is emitted to the isocenter. The C-arm is adjusted to rotate around the rotation axis according to the first cross-sectional angle or the second cross-sectional angle, and the C-arm is adjusted to swing around the swing axis according to the sagittal plane angle, and the positioning laser is directed toward the lung nodule along the puncture angle, thereby realizing the laser positioning of the lung nodule, and then the doctor can perform surgery according to the laser guidance.

[0069] The positioning method for percutaneous pulmonary nodule puncture surgery provided by the present invention realizes the positioning of percutaneous pulmonary nodule puncture surgery by using a mobile three-dimensional C-arm X-ray machine with isocenter design and laser positioning function, thereby realizing one-stop positioning of pulmonary nodules, and has lower site requirements and assembly and maintenance costs.

[0070] In an exemplary embodiment, referring to Figure 2 The mobile three-dimensional C-arm X-ray machine also includes two straight line lasers, which can emit positioning lasers, and the two positioning lasers can irradiate cross lines on the human body, and the positioning lasers are irradiated at the intersection of the cross lines, and the cross lines are used to locate the puncture point in S50. This makes it easier for doctors to find the puncture point.

[0071] It should be understood that although this specification is described according to various embodiments, not every embodiment contains only one independent technical solution. This narrative method of the specification is only for the sake of clarity. Those skilled in the art should regard the specification as a whole. The technical solutions in each embodiment may also be appropriately combined to form other implementation methods that can be understood by those skilled in the art.

[0072] The series of detailed descriptions listed above are only specific descriptions of feasible embodiments of the present invention. They are not intended to limit the scope of protection of the present invention. Any equivalent implementation scheme or changes that do not deviate from the technical spirit of the present invention, such as combination, division or repetition of features, should be included in the scope of protection of the present invention.

Claims

1. A method for positioning a percutaneous pulmonary nodule puncture surgery, characterized in that: It is achieved by using a mobile three-dimensional C-arm X-ray machine and a medical bed that adopts an isocenter design and has a laser positioning function. The positioning method of the percutaneous pulmonary nodule puncture surgery includes: S10: performing cone beam computed tomography imaging of the lungs using the mobile three-dimensional C-arm X-ray machine in conjunction with the medical bed; S20: adjusting the mobile three-dimensional C-arm X-ray machine and the medical bed according to the result of the cone-beam computed tomography to align the isocenter with the lung nodule; S30: Perform cone beam computed tomography on the lungs again to determine whether the isocenter is aligned with the lung nodules. If the determination result of S30 is no, return to S20. If the determination result of S30 is yes, proceed to the following steps: S40: Determine the puncture angle and puncture distance; and S50: adjusting the mobile three-dimensional C-arm X-ray machine according to the puncture angle, and positioning the puncture angle using laser.

2. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 1, characterized in that: S10 includes: S11: Setting the mobile three-dimensional C-arm X-ray machine so that its C-arm can rotate around a rotation axis parallel to the head and feet direction of the human body, and swing around a swing axis parallel to the left and right direction of the human body; S12: Performing basic settings on the mobile three-dimensional C-arm X-ray machine; S13: performing a collision test on the mobile three-dimensional C-arm X-ray machine; and S14: operating the three-dimensional C-arm X-ray machine to start radiation, perform three-dimensional data acquisition and generate a coronal image, a sagittal image and a transverse image where the isocenter is located.

3. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 2, characterized in that: In S14, 3D data acquisition should be performed at the end of inspiration or when the patient is holding his breath during quiet breathing.

4. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 2, characterized in that: The S20 includes: S21: Use software to measure the coronal, sagittal, and transverse images to obtain the offset distance between the isocenter and the lung nodule in the head-to-foot, left-right, and chest-back directions of the human body; and S22: adjusting the three-dimensional C-arm X-ray machine and the medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction, the left-right direction, and the chest-back direction of the human body.

5. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 4, characterized in that: S22 includes: S221: adjusting the position of the C arm of the mobile three-dimensional C arm X-ray machine according to the offset distance between the isocenter and the lung nodule in the left-right direction of the human body and in the chest-back direction of the human body; and S222: adjusting the position of the bed board of the medical bed according to the offset distance between the isocenter and the lung nodule in the head-foot direction of the human body.

6. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 5, characterized in that: In the S221, a ruler in millimeters is set on the mobile three-dimensional C-arm X-ray machine, and the ruler is referred to when the position of the C-arm is moved.

7. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 2, characterized in that: S40 includes: S41: selecting a puncture point on the human body surface, wherein a puncture path from the puncture point to the isocenter can avoid important organs of the human body; S42: Determine whether the puncture point is located on the cross section where the isocenter is located; If the judgment result of S42 is yes, then proceed to S43: calculate a first cross-sectional angle between the line connecting the puncture point to the isocenter and the sagittal plane where the isocenter is located, and measure the puncture distance using software; If the judgment result of S42 is no, enter S44: calculate a second cross-sectional angle between the projection of the puncture point on the cross-sectional plane where the isocenter is located and the line connecting the isocenter and the sagittal plane where the isocenter is located, and calculate a sagittal plane angle between the projection of the puncture point on the sagittal plane where the isocenter is located and the line connecting the isocenter and the cross-sectional plane where the isocenter is located, and use software to measure the puncture distance.

8. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 7, characterized in that: The mobile three-dimensional C-arm X-ray machine includes a laser emitter, which is arranged on the C-arm of the mobile three-dimensional C-arm X-ray machine and can emit a positioning laser, and the positioning laser is emitted toward the isocenter perpendicular to the rotation axis and the swing axis. In S50, the C-arm is adjusted to rotate around the rotation axis according to the first cross-sectional angle or the second cross-sectional angle, and the C-arm is adjusted to swing around the swing axis according to the sagittal plane angle, so that the positioning laser is directed toward the lung nodule along the puncture angle.

9. The positioning method for percutaneous pulmonary nodule puncture surgery according to claim 8, characterized in that: The mobile three-dimensional C-arm X-ray machine also includes two straight line lasers, which can emit positioning lasers. The two positioning lasers can irradiate cross lines on the human body. The positioning lasers are irradiated at the intersection of the cross lines. In S50, the cross lines are used to locate the puncture point.

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