Method for predicting thoracic operation result

Abstract

The invention relates to the field of operation scheme effect prediction, in particular to a method for predicting thoracic operation results. The method for predicting the thoracic operation result is characterized by comprising the following steps that a rib contour is constructed or simulated, and a first contour line is obtained; segmenting the first contour line into a first line segment and a second line segment based on a segmentation point on the first contour line; the first line segment and the second line segment respectively rotate around one end far away from the segmentation point, the first line segment and the second line segment intersect to form an intersection point, and the end far away from the segmentation point of the first line segment and the intersection point and the end far away from the segmentation point of the second line segment jointly form a second contour line; based on the second contour line as a postoperative rib contour, a postoperative effect prediction result is determined, the positions, on the first line segment and the second line segment, of the intersection point serve as two cutting points for rib cutting in the thoracic operation, and the rotation angle of the first line segment and the rotation angle of the second line segment serve as the needed rotation angle of the two ribs in the thoracic operation. The method has the advantages that the optimal cutting point and rotation angle can be predicted before an operation, an operation result is indicated, a proper operation scheme is determined, and the optimal operation effect is achieved.

Description

Technical Field

[0001] This invention relates to the field of predicting the outcome of surgical procedures, and in particular to a method for predicting the outcome of thoracic surgery. Background Technology

[0002] Traditional thoracoplasty relies entirely on the surgeon's experience, and because the outcome cannot be accurately predicted, the surgery often fails to achieve the desired results.

[0003] Therefore, it is necessary to study a way to simulate surgical outcomes before surgery and assist surgeons in choosing appropriate surgical plans by predicting the results of thoracic surgery. Summary of the Invention

[0004] The purpose of this invention is to provide a method for simulating rib contours and predicting the results of rib reshaping surgery, so as to solve the problems mentioned in the background art.

[0005] To achieve the above objectives, the present invention provides the following technical solution:

[0006] A method for predicting the outcome of thoracic surgery, characterized by the following steps: constructing or simulating a rib contour to obtain a first contour line; dividing the first contour line into a first line segment and a second line segment based on a dividing point on the first contour line; rotating the first line segment and the second line segment around their ends away from the dividing point, the first line segment and the second line segment intersecting to form an intersection point, the end of the first line segment away from the dividing point to the intersection point and the intersection point to the end of the second line segment away from the dividing point together forming a second contour line; determining the predicted postoperative outcome based on the second contour line as the postoperative rib contour, wherein the position of the intersection point on the first line segment and the second line segment is used as two cutting points for rib cutting during thoracic surgery, and the rotation angle of the first line segment and the second line segment is used as the angle at which the two rib segments need to be rotated during thoracic surgery.

[0007] As a further aspect of the present invention: one endpoint of the first contour line corresponds to the intersection of the rib and the vertebra, and is defined as the rib origin; the other endpoint corresponds to the end of the costal cartilage, and is defined as the rib end; a coordinate system is established with the direction perpendicular to the patient's sagittal plane as the x-direction and the direction perpendicular to the patient's coronal plane as the y-direction, wherein the y-axis passes through the rib origin.

[0008] As a further aspect of the present invention: the segmentation point is determined by scanning or traversing within a range of 5% to 70% of the length of the first contour line.

[0009] As a further aspect of the present invention: the indicators for representing the postoperative effect prediction results calculated based on the second contour line include one or more of the following: lung volume improvement index, chest wall protrusion improvement index, cutting point distance index, and surgical incision location index.

[0010] As a further aspect of the present invention: the lung capacity is represented by the area of ​​the figure enclosed by the starting point, ending point and contour lines of the rib contour, and the difference between the lung capacity corresponding to the second contour line and the lung capacity corresponding to the first contour line is calculated as a value of the lung capacity improvement index.

[0011] As a further aspect of the present invention: using the patient's coronal plane as a reference plane, the distance difference between the farthest points on the first and second contour lines from the reference plane is calculated as a numerical value for the improvement index of thoracic protrusion.

[0012] As a further aspect of the present invention: the cutting point distance index is defined as the reciprocal of the length difference between the first contour line and the second contour line.

[0013] As a further aspect of the present invention: the location index of the surgical incision includes the back, side, and chest; taking the origin of the coordinate system as the starting point, the first and fourth quadrants are divided into three regions, corresponding to the back region, side region, and chest region respectively; the location index of the surgical incision is determined as the prediction result based on the region where the cutting point located on the second line segment is located.

[0014] As a further aspect of the present invention: a dataset of second contour lines with different rotation angles for the first and second line segments is constructed by rotating the first and second line segments; by adjusting the dividing point, the rotation operation of the first and second line segments is repeated to form a dataset of second contour lines based on the dividing point, the two cutting points, the rotation angle of the first line segment, and the rotation angle of the second line segment.

[0015] As a further aspect of the present invention: for each of the second contour lines in the dataset of the second contour lines, the postoperative effect prediction result is calculated for the selection of surgical plan, the corresponding second contour line is determined, and then the two cutting points, the rotation angle of the first line segment and the rotation angle of the second line segment corresponding to the second contour line are determined.

[0016] As a further aspect of the present invention, a method for obtaining a second contour line includes the following steps: after determining the rotation angle of the first line segment, rotating the second line segment to form a dataset of second contour lines with a determined angle for the first line segment and different rotation angles for the second line segment; adjusting the rotation angle of the first line segment and repeating the above steps to obtain a dataset of second contour lines with different rotation angles for the first line segment and the second line segment.

[0017] As a further aspect of the present invention: when rotating the second line segment, if the second line segment does not intersect with the first line segment, the rotation of the second line segment is terminated, and the addition of data to the dataset of the second contour line of the second line segment at different rotation angles under the determined angle of the first line segment is stopped.

[0018] As a further aspect of the present invention: an initial rotation angle and a maximum rotation angle are respectively set for the first line segment and the second line segment; the rotation angle range of the first line segment and the second line segment is respectively set between the initial rotation angle and the maximum rotation angle.

[0019] As a further aspect of the present invention: when the first line segment and the second line segment rotate, a preset rotation angle increment is set for each of them; when rotating the first line segment and the second line segment, the preset rotation angle increment is increased each time.

[0020] As a further aspect of the present invention, it also includes a step of configuring requirements, wherein the configuration requirements include setting weights for the indicators of the prediction results and / or setting exclusion conditions.

[0021] As a further aspect of the present invention, the exclusion criteria include the distance to the cutting point and / or the location of the surgical incision.

[0022] As a further aspect of the present invention: the surgical outcome prediction score is calculated based on the weights, wherein the surgical outcome prediction score is the sum of the specific values ​​of the selected indicators and the weighting coefficients.

[0023] As a further aspect of the present invention: before calculating the postoperative effect prediction results, a step of configuring requirements is performed.

[0024] Compared with the prior art, the beneficial effects of the present invention are: it can predict the optimal cutting point and rotation angle before surgery, determine the appropriate surgical plan, and achieve the best surgical results.

[0025] Other features and advantages of the present invention will be disclosed in detail in the following detailed description and accompanying drawings. Attached Figure Description

[0026] Figure 1 This is a flowchart of a method for predicting the outcome of thoracic surgery according to the present invention;

[0027] Figure 2 This is a flowchart of a method for simulating and predicting the outcome of thoracic surgery according to the present invention;

[0028] Figure 3 This is a flowchart of a method for optimizing the angle of a rib fixation plate according to the present invention;

[0029] Figure 4 Is adopted Figure 1 , Figure 2 and Figure 3 A schematic diagram of the ribs before thoracic surgery corresponding to the method;

[0030] Figure 5 Is Figure 4 Based on this, a schematic diagram is drawn to determine the rib portion to be cut and removed, where the gray rib portion in the diagram represents the rib portion to be cut and removed.

[0031] Figure 6 Is Figure 5 A diagram illustrating the joining of two rib sections based on the given structure;

[0032] Figures 7-1 to 7-4 This is the invention Figure 1 , Figure 2 and Figure 3 A schematic diagram of the rotation of the first and second segments of the ribs in the thoracic surgery corresponding to the method, where the dashed part represents the position of the first and second segments before rotation, and the solid part represents the position of the first and second segments after rotation;

[0033] Figure 8 This is a method for indicating lung volume corresponding to one embodiment of the present invention;

[0034] Figure 9 , Figure 11 This is a schematic diagram of the first contour line of a method for simulating and predicting the outcome of thoracic surgery.

[0035] Figure 10 This is a schematic diagram of another first contour line for simulating and predicting the outcome of thoracic surgery;

[0036] Figure 12-1 yes Figure 11 A schematic diagram showing the intersection point obtained after rotating the first and second line segments of the first contour line;

[0037] Figure 12-2 This is a schematic diagram of an implementation method that divides the area into front, side, and rear regions;

[0038] Figure 13 is a schematic diagram showing the two cutting points determined by the intersection point on the first contour line;

[0039] Figure 14 It was invented Figure 1 , Figure 2 and Figure 3 A schematic diagram of another implementation method of rib surgery corresponding to this method, which uses two circles to fit the ribs. Detailed Implementation

[0040] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0041] like Figures 1 to 14 As shown, a method for predicting the outcome of thoracic surgery includes the following steps:

[0042] Step 1: Construct or simulate the rib contour to obtain the first contour line;

[0043] Step 2: Based on the dividing points on the first contour line, divide the first contour line into a first line segment and a second line segment;

[0044] Step 3: The first line segment and the second line segment rotate around their ends away from the dividing point. The first line segment and the second line segment intersect to form an intersection point. The end of the first line segment away from the dividing point to the intersection point and the intersection point to the end of the second line segment away from the dividing point together form the second contour line.

[0045] Step 4: Calculate the postoperative effect prediction result based on the second contour line as the postoperative rib contour. The position of the intersection point on the first line segment and the second line segment is used as the two cutting points for rib cutting in the thoracic surgery. The rotation angle of the first line segment and the second line segment is used as the angle that the two rib segments need to be rotated in the thoracic surgery.

[0046] To facilitate the explanation, a coordinate system is established for the rib contour in step 1: the direction perpendicular to the sagittal plane of the patient's body is the x-direction, and the direction perpendicular to the coronal plane of the patient is the y-direction.

[0047] Optionally, one endpoint of the first contour line corresponds to the intersection of the rib and the vertebra, and is defined as the rib origin; the other endpoint corresponds to the end of the costal cartilage, and is defined as the rib end; wherein the y-axis of the coordinate system passes through the rib origin.

[0048] The dividing point in step 2 is actually a virtual point, not an actual cutting point. Since thoracic surgery typically involves dividing a rib into at least two segments and altering the position / angle of these segments to achieve the desired effect, this dividing point serves as an endpoint to simulate at least two rib segments in the software.

[0049] The aforementioned dividing point has practical significance; that is, for a specific surgical plan, the actual cutting points on the first and second line segments will not exceed the dividing point. For example, for the middle ribs (4th to 6th ribs) of an adult, assuming an average length of approximately 20cm, if the dividing point is drawn 8cm from the rib's starting point, then the length of the first line segment is 8cm, and the length of the second line segment is 12cm. Therefore, for this dividing point, the algorithm involved in this invention simulates the actual cutting points including a first cutting point on the first line segment and a second cutting point on the second line segment. The first cutting point can only be located between the rib's starting point and the dividing point (i.e., 0-8cm), and the second cutting point can only be located between the dividing point and the rib's ending point (i.e., 8-20cm).

[0050] If the length of the target rib is defined as 100%, then the incision point in step 1 is located between 5% and 70% of the rib's length (measured from the rib's origin). This setting ensures that each segment of the rib has sufficient length for rib fixation after cutting, and allows the surgical incision to be located as far as possible on the patient's back for a more aesthetically pleasing result. Furthermore, since the incision point only needs to consider the middle 65% of the rib, the overall computational load is reduced by 35%, significantly improving the calculation speed for predicting surgical outcomes.

[0051] As a specific implementation method, based on the obtained lung volume improvement index and chest wall protrusion improvement index, a second contour line as a surgical recommendation is obtained from multiple second contour lines using a weighted scoring algorithm, radar chart / quadrant analysis algorithm, Pareto frontier algorithm, or TOPSIS algorithm (approximation of ideal solution ranking method). One or more surgical recommendation plans can be generated by the algorithm for the doctor to choose from. If the doctor has a preference for the lung volume improvement index and chest wall protrusion improvement index, for example, if the patient wants to focus on optimizing the degree of chest wall protrusion, the weight of each index in the algorithm can be preset as needed, thereby outputting a surgical plan that better meets the patient's preferences and is more scientifically sound.

[0052] As a specific implementation, in step 3, a dataset of second contour lines for different rotation angles of the first and second line segments is constructed by rotating the first and second line segments.

[0053] Based on the natural growth pattern of ribs, abnormally shaped ribs typically protrude towards the back or side of the patient. In routine rib reduction surgery, the surgeon makes at least one incision point on the rib to be corrected, dividing the rib into at least two segments with the rib's origin and end points as endpoints and the incision point as the other endpoint. Adhesive ribs are then separated using scissors or similar tools. Next, the two segments are rotated around the origin and end points, respectively. For the segment with the origin as the endpoint, the rotation direction is usually away from the patient's back to reduce the rib's protrusion towards the back; for the segment with the end point as the endpoint, the rotation direction is usually away from the patient's chest to align with the other rib segment.

[0054] In the method of this invention, the rotation direction of the ribs in actual surgery is also simulated. The first line segment is rotated clockwise, and the second line segment is rotated counterclockwise. As an optional implementation, for rib morphology with "concave deformity", the rotation directions of the two line segments can be opposite.

[0055] Referring to Figure 7, during the rotation of the first and second line segments, an intersection point will be generated between the first and second line segments for a specific rotation angle. The new contour formed based on the "rib origin - intersection point - rib end point" is the rib contour corresponding to the surgical prediction result simulated by this invention at a specific cutting point and a specific rotation angle.

[0056] Figure 7-1 The diagram shows the rib contour AC simulated using a rib contour simulation method, where A is the starting point of the rib contour and C is the ending point. Based on a dividing point M on the rib contour AC, the rib contour is divided into two line segments AM and MC.

[0057] In step 3, points A and C are used as rotation centers, and line segments AM and MC are rotated to obtain intersection point N. The contour line composed of line segments AN and NC is the contour line corresponding to one of the surgical outcome predictions. Figures 7-2 to 7-4 A method for rotating line segments AM and MC is shown.

[0058] In this method, such as Figure 7-2 As shown, the AM line segment remains unchanged at first, and the MC line segment is rotated by a certain angle with C as the rotation center. The AM and MC line segments intersect at point N1. At this time, the rotation angle α of the AM line segment is 0, and the rotation angle of the MC line segment is β1. The line segment formed by points A, N1, and C is the contour line corresponding to a surgical prediction result.

[0059] Next, continue rotating the MC segment, as follows: Figure 7-3As shown, line segments AM and MC intersect at point N2. At this point, the rotation angle α of line segment AM is 0, and the rotation angle of line segment MC is β2. The line segment formed by points A, N2, and C is the contour line corresponding to another surgical prediction result... and so on, until the rotation of line segment MC can no longer intersect with line segment AC.

[0060] like Figure 7-4 As shown, rotate segment AM by an angle α, and use the rotated segment AM as the new first line segment. Repeat the above steps, that is, continue to rotate segment MC by multiple angles to obtain multiple new contour lines as prediction results.

[0061] By adjusting the segmentation points, repeat step 3 (or repeat the steps shown in Figure 7) to form a dataset of a second contour line based on the segmentation points, the two cutting points, the rotation angle of the first line segment, and the rotation angle of the second line segment. This dataset contains at least the following parameters: rib cutting point location and rib rotation angle. These two parameters serve as surgical instructions.

[0062] Typically, there are two rib cutting points, corresponding to the intersection points on the first and second line segments, respectively. As an optional implementation, the specific cutting point locations are output. For example, the distance from the rib's starting point to the intersection point is calculated and output. During surgery, the operator can measure the specific location of the first cutting point based on these distances and perform the cutting; the distance from the rib's ending point to the intersection point is calculated and output, allowing the operator to measure the specific location of the second cutting point on the rib.

[0063] After the cutting is completed, the first rib segment and the second rib segment are rotated by a specific angle according to the rib rotation angle in the parameter set.

[0064] The dataset also includes data indicating surgical outcomes, including, optionally: lung volume improvement indicators, chest wall protrusion improvement indicators, incision point distance indicators, and surgical incision location indicators.

[0065] Lung capacity refers to the maximum lung volume limited by the shape of the ribs. As a method of indicating lung capacity, the specific numerical value is determined by the area formed by the starting and ending points of the rib contours and the outer contours of the ribs (see reference). Figure 8The area of ​​the space enclosed by points A, N, and C represents lung capacity. This invention does not limit the calculation of this area using methods such as boundary curve integration, polygon decomposition, and pixel calculation. Other methods for indicating lung capacity, such as obtaining the largest circle tangent to the rib contour and calculating its area, are also not limited in this invention, as long as they reflect the lung capacity index. The difference between the area of ​​the space enclosed by the rib contour as the surgical prediction result and the area of ​​the space enclosed by the initial rib contour is calculated and used as a numerical indicator of lung capacity improvement.

[0066] The improvement index for rib prominence refers to the degree of improvement in the prominence of the rib contour from the patient's back after surgery. For example... Figure 12-1 As shown, the calculation method for the chest wall protrusion index is as follows: The highest point of the protrusion before surgery is used as the baseline. A reference line passes through this baseline and is parallel to the patient's coronal plane; this reference line is used as the baseline. A reference line corresponding to the highest point of the protrusion in the simulated surgical result contour is obtained; this reference line is also parallel to the coronal plane and is used as the improvement line. The distance between the baseline and the improvement line is calculated, and this distance is used as the chest wall protrusion improvement index. Figure 12-1 In the diagram, point A represents the connection point between the vertebra and the rib. The dashed line AD, passing through point A and parallel to the patient's coronal plane, is defined as the correction line. If the improvement line is lower than the correction line AD corresponding to point A, it indicates overcorrection, resulting in a "sunken" appearance in the patient's back. As an alternative implementation, overcorrection can be highlighted using prominent methods, such as bold or red font. Alternatively, surgical prediction data indicating overcorrection can be discarded.

[0067] Thoracic surgery is an invasive procedure that requires incisions in the patient's skin to expose and cut the ribs. The fewer the incisions, the better, whether for infection prevention, aesthetics, or ease of operation. In this invention, the distance between the first and second cutting points on the original rib contour indicates the number of incisions. This value is calculated by subtracting the predicted rib contour length from the original rib contour length. The original rib contour length is the distance from the rib's starting point along the original rib contour to its ending point. The predicted rib contour length is the predicted rib length determined by the rib's starting point, intersection point, and ending point. This length corresponds to the distance between the two actual cutting points. For infection control and wound healing considerations, the maximum incision size in minimally invasive surgery is generally no more than 2 cm. If the distance between the cutting points is greater than 4 cm, the surgeon will have to operate through two incisions. This value may vary depending on different surgical conditions and patient circumstances; for example, it could be 2 cm, 5 cm, or even larger. Optionally, the operator can pre-define this distance manually. If the distance between the incision points is less than the aforementioned value, the surgeon can make two different incisions on the rib through a single wound. Furthermore, the greater the distance between the incision points, the shorter the corresponding rib length after surgery, essentially discarding a longer portion of body tissue. Therefore, the smaller the distance between the incision points, the better, a factor considered by many patients and doctors.

[0068] The surgical incision location indicator shows whether the incision is located on the patient's chest, side, or back. An incision on the back or side is generally considered more aesthetically pleasing.

[0069] In one embodiment, in the rib contour corresponding to the present invention, the correction line AD corresponding to the starting point of the rib is used as the dividing line (reference). Figure 12-1 (The horizontal dashed line in the diagram represents the incision point.) If the incision point is above the dividing line, the corresponding surgical incision will be located on the patient's back. If the incision point is below the dividing line, the corresponding surgical incision will be located on the patient's chest or side. The terms "chest," "side," and "back" mentioned in this disclosure are for ease of description only. In actual surgery, the doctor or patient can request the location of the surgical incision based on their own needs.

[0070] Specifically, when the distance between the cutting points is less than a certain value, the surgeon can perform cutting operations on the first and second rib cutting points through a single surgical incision. In this case, as long as the first cutting point is above the dividing line, the surgeon can make cuts on both cutting points on the rib through the surgical incision on the patient's back.

[0071] When the distance between the incision points exceeds a certain value, the surgeon has to make more than one incision to cut the rib. In this case, since the second incision point is farther from the vertebra than the first incision point, if the second incision point is located below the dividing line, there will inevitably be a surgical incision located on the patient's chest (or side).

[0072] The "certain value" here varies depending on the patient's age, physical condition, underlying medical history, surgical instruments, surgical conditions, etc., and is determined by the doctor performing the surgery. This invention does not impose any restrictions on this.

[0073] As another alternative implementation method, such as Figure 12-2 As shown, the rib contour is located in the first and fourth quadrants of the coordinate system. The 180-degree angle range in the first and fourth quadrants is divided into three regions, ab, as, and af, by dividing lines D1 and D2. Region ab corresponds to the patient's back, region as corresponds to the patient's side, and region af corresponds to the patient's chest (front). For example, in this embodiment, the angle corresponding to region ab is 30°, the angle range corresponding to region as is 90°, and the angle range corresponding to region af is 60°, with the sum of the angles of the three regions being 180°.

[0074] Specifically, since the second incision point is farther from the origin of the ribs than the first incision point, its location is used as the basis for judgment. If the second incision point is located in region ab, it indicates that the surgical incision is located on the patient's back; if the second incision point is located in region as, it indicates that the surgical incision is located on the patient's side; and if the second incision point is located in region af, it indicates that the surgical incision is located on the patient's chest (front).

[0075] The division of the back, side, and chest regions can be done in other ways, not necessarily based on angles, as long as the area formed by the first and fourth quadrants of the coordinate system can be divided into three regions.

[0076] Due to differences in skin elasticity and individual patient conditions, the final choice of surgical incision location should be determined by the surgeon based on the specific circumstances. Before predicting the surgical outcome using the method of this invention, the surgeon may have already selected the incision location based on the patient's condition. In this case, the surgeon can use the range of the second incision point as a constraint, then predict the surgical outcome using the method of this invention, and select a surgical plan from the various predictions. This setup reduces the overall computational load and ensures that the surgical plan corresponding to the predicted result is one that the surgeon has autonomously chosen.

[0077] Alternatively, the surgical outcome can be predicted first using the method of this invention, and the surgeon can then select a surgical plan based on the location of the surgical incision and / or the location of the second incision point indicated in the prediction results. This setup allows for the prediction of surgical outcomes to be maximized, thereby enabling the selection of the optimal surgical plan.

[0078] The dataset may contain one or more, or even all, of the above-mentioned indicators of surgical outcome.

[0079] As an alternative implementation, a method for predicting the outcome of thoracic surgery further includes a step of configuring requirements.

[0080] Optionally, configuration requirements include assigning weights to various surgical outcome indicators. Different patients have different priorities regarding surgical outcomes. For example, some patients only consider the cosmetic effect of the surgery and completely disregard the improvement in lung volume. Other patients may have the opposite needs. For instance, some patients may tolerate a certain degree of rib protrusion but consider lung volume improvement a more important indicator. Based on these different patient needs, weights are assigned to the lung volume improvement indicator (L), the chest wall protrusion improvement indicator (H), and the incision point distance indicator (S) to reflect the patient's level of attention to different indicators. As a weighting method, each of the three indicators is multiplied by coefficients a, b, and c, such that the sum of a + b + c equals 1. For example, for a patient who prioritizes lung volume improvement, requires the discarded ribs to be as short as possible, and has the least concern about chest wall protrusion improvement, a is defined as 0.5, b as 0.2, and c as 0.3, resulting in the predicted surgical outcome weight: 0.5*L + 0.2*H + 0.3*S. Alternatively, the weights of each indicator can be assigned as long as they reflect the different levels of attention from patients or doctors. The three indicators L, H, and S here can be dedimensionalized and normalized. For specific operation methods, please refer to existing technologies. This invention does not limit them.

[0081] Here, since the distance to the cutting point is a negative indicator, meaning the smaller the distance, the better, the indicator S can be represented by the reciprocal of the distance to the cutting point.

[0082] Optionally, the dataset includes predicted surgical outcome scores as part of the predicted surgical outcomes. Doctors can directly select the corresponding surgical plan from the highest scores, eliminating the need to sift through a large dataset, thus improving selection efficiency while also considering the individualized needs of patients.

[0083] Optional configuration options include setting exclusion criteria. For example, for elderly patients with weakened immune systems who cannot tolerate excessively long surgical incisions or more than two incisions, the distance to the incision point can be used as an exclusion criterion. If the distance to the incision point corresponding to the predicted result of a specific surgical plan is greater than a certain value, then the dataset corresponding to that surgical plan will not be recommended. Optionally, when calculating the surgical result, the distance to the incision point can be calculated first; if the distance to the incision point is greater than the exclusion criterion, further calculations are not performed. This setting ensures that the surgical plan corresponds to the patient's actual physical condition while reducing the system's computational load and improving prediction speed.

[0084] The location of the surgical incision can also be used as an exclusion criterion. For example, if the incision location is limited to the patient's back, then all surgical predictions corresponding to chest incisions will not be recommended. Optionally, when calculating surgical results, the location of the incision point can be calculated first; if the incision point corresponds to a surgical incision on the patient's chest, then no further calculations are performed. This setting ensures that the surgical plan corresponds to the actual patient's physical condition while also reducing the system's computational load and improving prediction speed.

[0085] Optionally, the requirement configuration step can be interspersed between any of steps 1 to 4 above, or it can be set before step 1 or after step 4. Optionally, requirement configuration can be performed before calculating the postoperative effect prediction results in step 4, and the configured requirements include exclusion conditions. This setting can reduce the computational load of the system and improve the prediction speed.

[0086] As a specific implementation method, postoperative effect prediction results are calculated for each second contour line in the dataset of second contour lines to facilitate the selection of surgical plans, determine the corresponding second contour line, and then determine the two cutting points, the rotation angle of the first line segment, and the rotation angle of the second line segment corresponding to the second contour line.

[0087] As a specific implementation method, the method for obtaining the second contour line in step 3 includes the following steps:

[0088] Step 3.1 After determining the rotation angle of the first line segment, rotate the second line segment to form a dataset of second contour lines with a determined angle for the first line segment and different rotation angles for the second line segment.

[0089] Step 3.2 Adjust the rotation angle of the first line segment and repeat step 3.1 to obtain a dataset of second contour lines with different rotation angles for the first and second line segments.

[0090] As a specific implementation method, when rotating the second line segment, once the second line segment no longer intersects with the first line segment, the rotation of the second line segment is terminated, and the addition of data to the dataset of the second contour line of the second line segment at different rotation angles under the determined angle of the first line segment is stopped.

[0091] In one specific implementation, an initial rotation angle and a maximum rotation angle are set for the first line segment and the second line segment, respectively; the rotation angle range of the first line segment and the second line segment is set between their initial rotation angle and maximum rotation angle, respectively.

[0092] As a specific implementation method, when the first line segment and the second line segment are rotated, their preset rotation angle increments are set respectively; when rotating the first line segment and the second line segment, their preset rotation angle increments are increased each time.

[0093] In one specific implementation, a pre-defined segmentation point candidate area is set on the first contour line; subsequent operations are performed based on the segmentation points located within the segmentation point candidate area on the first contour line. The distances from the start and end points of the segmentation point candidate area to the two ends of the first contour line can be determined by a preset size or a preset percentage of the length of the first contour line. Optionally, the segmentation point candidate area is a region between 5% and 70% of the length of the first contour line; alternatively, the segmentation point candidate area is a region between 10% and 60% of the length of the first contour line. If the area exceeds the above range, the remaining rib length corresponding to the actual cutting point cannot meet the requirements for rib fixation.

[0094] Regarding the specific method for constructing or simulating the rib contour in step 1, the rib shape can be obtained by capturing images of the ribs, thereby constructing the rib contour. Specifically, existing methods for simulating skeletal contours can be used, including 3D reconstruction based on medical images (CT / MRI thresholding), point cloud surface modeling via laser scanning / structured light scanning, statistical shape models (SSM), finite element analysis modeling, etc., and this invention does not limit these methods. Using the actual rib contour for subsequent surgical outcome prediction results in more accurate predictions.

[0095] Due to the complexity of the actual rib contour, the computational load is relatively large. Therefore, line segments with certain patterns can be used to simulate the rib contour. These simulated line segments are obtained by closely matching the rib shape to the actual contour, thus achieving a simulated rib contour. For example, the simulated line segments can be obtained using functions, either global functions or piecewise functions. Piecewise functions use several line segments as simulated line segments to replace the rib shape. The higher the complexity of the function, the more accurate the fit and the more accurate the prediction results, but the corresponding computational load is also relatively large.

[0096] The predicted surgical outcome disclosed herein includes a second contour line corresponding to the surgical outcome. This second contour line can relatively accurately reflect the rib morphology of the patient after the surgeon completes the surgery according to the surgical parameters such as the position of the cutting point, the rib rotation angle, the distance between the cutting points, and the position of the surgical incision.

[0097] After the ribs are cut and rotated, the cut ribs are in a broken state. At this point, the cut ribs need to be fixed with a rib fixation plate.

[0098] The rib fixation plate is strip-shaped and extends along the contour of the rib, fixing it to the rib to stabilize it and prevent it from shifting or deforming under external forces. The rib fixation plate has a certain degree of rigidity to provide fixation, while also having a certain degree of plasticity, allowing it to better conform to the shape of the rib.

[0099] Because rib fixation plates have a certain degree of rigidity, they require significant force to deform. Therefore, in typical surgical procedures, surgeons first reshape the fixation plate according to the patient's rib shape to ensure a better fit. However, in experience-based surgical procedures, surgeons cannot accurately predict the post-operative rib shape, often resulting in the reshaped rib fixation plate still not fitting the patient's ribs well and failing to provide adequate fixation. Alternatively, the surgeon may need to continuously reshape the rib fixation plate during the procedure, prolonging the surgery time and increasing the risk of infection for the patient.

[0100] The surgical prediction method disclosed in this invention can relatively accurately predict the outcome of a patient's rib surgery before the surgeon's operation. Based on the predicted surgical outcome, this invention provides a method for predicting the shape of a rib fixation plate:

[0101] The surgical prediction method of the present invention predicts one of the surgical outcomes, or the surgeon selects one of the predicted surgical outcomes to obtain the postoperative rib contour corresponding to the rib fixation plate.

[0102] Determine or specify the size of the rib fixation plate. Methods for determining the rib fixation plate size include generating a rib fixation plate size based on one or more parameters such as the patient's age, gender, height, and weight; methods for specifying the rib fixation plate size include having the physician input or select the rib fixation plate size as a parameter.

[0103] Postoperatively, the placement of the rib fixation plate is determined or specified on the rib contour. Methods for determining the rib fixation plate placement include determining the start and / or end points of the rib fixation plate at a specific distance from the rib's origin, or determining the placement by placing the rib's interruption point in the middle of the rib fixation plate. Placing the rib's interruption point in the middle of the rib fixation plate results in a more stable connection between the rib fixation plate and the rib, and more even stress distribution on both sides. Specifically, "placing the interruption point in the middle of the rib fixation plate" means that the rib cutting point is located at 40% to 60% of the rib fixation plate's length. Methods for specifying the rib fixation plate's origin include the surgeon determining the position of the rib fixation plate's origin on the second contour line. This surgeon-specified placement of the rib fixation plate allows for adjustments based on the actual stress on the rib, thereby optimizing the fixation effect.

[0104] A predicted rib fixation plate is generated based on the second contour line, rib fixation plate size, and rib fixation plate position, which are the surgical outcome.

[0105] Doctors can shape the rib fixation plate before surgery based on the predicted shape. Rib fixation plates for surgery can also be directly printed using methods such as 3D printing, ensuring the plate's stability on the ribs. Alternatively, molds or rigid reference parts can be 3D printed based on the predicted rib shape to create the rib fixation plate, or the shape of the plate can be adjusted according to the rigid reference parts.

[0106] As an optional implementation, when the size and position of the rib fixation plate are determined, the length and position of the rib fixation plate can be included in the predicted surgical outcome in the dataset. Optionally, the length of the rib fixation plate is determined based on the patient's gender, age, height, etc. Alternatively, the length of the rib fixation plate is related to the overall length of the rib after surgery. The length of the rib fixation plate should account for 30% to 70% of the total length of the second contour line corresponding to the rib after surgery. If the length of the rib fixation plate is too short, it will be unable to stably fix the rib after surgery; if the length of the rib fixation plate is too long, it may increase the risk of rejection or infection.

[0107] As one implementation method for simulating rib contours, a two-piece function is used as the simulated line segment. More specifically, a two-circular arc method is used to reduce the computational load while maintaining relatively accurate prediction results, thus balancing the accuracy of the prediction results and the computational load.

[0108] Specifically, such as Figure 2 , Figures 9-14 As shown, a method for simulating and predicting the outcome of thoracic surgery includes the following steps:

[0109] Step 1: Take an image of the ribs to obtain their shape;

[0110] Step 2 involves fitting a first circle and a second circle to the shape of the rib, where the first and second circles have a tangent / intersection point, and the area of ​​the first circle is smaller than the area of ​​the second circle. Since circles can be represented by relatively simple functions, using two fitted circles to represent the rib contour involves fewer parameters compared to traditional methods based on actual rib images, significantly improving computational speed and allowing for the acquisition of as many accurate calculation results as possible within a limited surgical time.

[0111] To determine the matching relationship between the circles and the rib shapes, the percentage of overlap between the first and / or second circles and the pixels of the rib image along the length of the rib is calculated. If the percentage reaches a preset value, the first and / or second circles are determined to fit the rib shape. By adjusting the position and size of the circles, the overlap percentage will change accordingly.

[0112] The first and second circles can be either perfect circles or ellipses, or one can be a perfect circle and the other an ellipse. Preferably, both the first and second circles are perfect circles. The following description uses the example of both the first and second circles being perfect circles. As an alternative implementation, the first and second circles can be conic sections.

[0113] Optional, such as Figure 9 , Figure 11 As shown, the first circle passes through point A, the intersection of the vertebra and the rib (i.e., the origin of the rib), thus a portion of the first circle can be used to represent the first rib segment, where the intersection of the vertebra and the rib corresponds to the origin of the rib. The second circle passes through point C, the end of the costal cartilage, thus a portion of the second circle can be used to represent the second rib segment, where the end of the costal cartilage C corresponds to the end of the rib. The first rib segment corresponds to the line segment from the rib origin A to point B, the intersection of the first and second circles; the second rib segment corresponds to the line segment from the rib end C to point B, the intersection of the first and second circles.

[0114] like Figure 10 As shown, the first circle can also bypass the starting point of the rib, and optionally, the second circle can also bypass the ending point of the rib. This is because there are two considerations when using circles to fit the rib contour: firstly, the circles should fit the rib image as closely as possible to accurately simulate the rib contour; secondly, the first circle should pass through the starting point of the rib as much as possible, and the second circle should pass through the ending point of the rib as much as possible, so that the corresponding rib contour representation is the simplest and requires the least amount of computation.

[0115] In different situations, the priority of the two requirements mentioned above varies: if a more accurate simulation of the rib contour is desired, it is essential to ensure that the circles fit the rib image precisely. In this case, the first circle may not pass through the rib's origin, and the second circle may not pass through the rib's endpoint. However, when rotating the simulated rib contour, the rotation can still be centered on the rib's origin A and endpoint C, thus obtaining the predicted result for thoracic surgery. This approach ensures that the predicted surgical result is achievable; that is, the actual rotation of the rib is around the rib's origin and endpoint, rather than around a specific point on the simulated first or second circle.

[0116] In other situations, such as when faster calculation speed is required, it is important to ensure that at least one of the first or second circles passes through the start and end points of the ribs.

[0117] Since the cutting point is not close to the start and end points of the rib when it is selected, the fact that the two ends of the rib are not on the circle will not affect the calculation.

[0118] The first and second circles can be drawn completely independently, or they can be drawn with some correlation. For example, at least one of the diameters and positions of the first and second circles may be related.

[0119] like Figure 11 As shown, in one specific implementation, in step 2, the outline of the first circle passes through the center of the second circle. This arrangement reduces the number of parameters used, simplifies complexity, and lowers the computational load when representing the first and second circles using functions.

[0120] like Figure 14 As shown, as an optional implementation, the diameter of the first circle is the same as the radius of the second circle. The size of the first and second circles can be represented by the same parameter, which can reduce the number of parameters used, simplify complexity, and reduce computational load. In Figure 13, the two circles represent the first and second circles, and the line segment connecting points A, B, and C represents the simulated rib outline.

[0121] As an optional implementation, the first circle is tangent to the second circle, meaning their outlines have a unique point of intersection (see reference). Figure 9 , 10 By using this setup, when representing the first and second circles using functions, the number of parameters used can be reduced, simplifying the complexity and lowering the computational load.

[0122] Optionally, the first circle is tangent to the second circle, and the diameter of the first circle is equal to the radius of the second circle (see reference). Figure 9 , 10This setting can further reduce the number of parameters used and the amount of computation.

[0123] Step 3, as follows Figure 11 As shown, the part of the first circle that conforms to the shape of the rib is called the first arc segment AB, and the part of the second circle that conforms to the shape of the rib is called the second arc segment BC; the first arc segment AB and the second arc segment BC are tangent to each other and intersect at the point of tangency B; the first arc segment AB and the second arc segment BC together form the first contour line AC that simulates the outline of the rib.

[0124] Step 4, as follows Figure 11 As shown, the first contour line AC is divided into a first line segment AM and a second line segment MC based on the dividing point M on the first contour line AC.

[0125] Step 5, as follows Figure 12-1 As shown, the first line segment AM and the second line segment MC rotate around their ends furthest from the dividing point M, i.e., AM rotates α° around point A and MC rotates β° around point C. The first line segment AM and the second line segment MC intersect to form an intersection point D. The endpoint A of the first line segment AM furthest from the dividing point to the intersection point D, and the endpoint D of the second line segment MC furthest from the dividing point M to the intersection point C, together constitute the second contour line. That is, the second contour line is formed by the addition of line segment AD and line segment DC. Figure 13-2 As shown, based on the first contour line before rotation, the position of intersection point D on the first line segment AM is point E, and the position of intersection point D on the second line segment MC is point F;

[0126] Step 6, as follows Figure 13-2 As shown, the postoperative effect prediction results are calculated based on the second contour line as the postoperative rib contour. The position of the intersection point D on the first line segment AM and the second line segment MC is used as the two cutting points for rib cutting in the thoracic surgery, namely point E and point F. That is, the area between line segment EF is the area to be surgically removed. The rotation angle of the first line segment AM and the second line segment MC is used as the angle that the two rib segments need to be rotated in the thoracic surgery.

[0127] In a preferred embodiment, the indicators calculated based on the second contour line to represent the predicted postoperative outcome include: a lung volume improvement indicator and a thoracic protrusion improvement indicator. The two parallel lines in Figure 12 represent the changes in thoracic protrusion before and after surgery, and can be used as an indicator of thoracic protrusion improvement. The space enclosed by the second contour line can represent lung volume, and is used to represent the lung volume improvement indicator.

[0128] As a specific implementation, in step 5, a dataset of second contour lines for different rotation angles of the first line segment AM and the second line segment MC is constructed by rotating the first line segment AM and the second line segment MC; the dataset of the second contour lines formed for a specific segmentation point M includes at least surgical operation indicators {E, F, α, β}, where E and F indicate the actual cutting point position, and α and β indicate the rotation angle of the two rib segments during the operation.

[0129] By adjusting the segmentation point M, step 5 is repeated to form a dataset of second contour lines based on segmentation point M, cutting points E and F, the rotation angle α of the first line segment AM, and the rotation angle β of the second line segment MC. This forms a dataset of the second contour lines with all segmentation points M: {M, E, F, α, β}. Points E and F are determined by the intersection point D and the rotation angle α of the first line segment AM and the rotation angle β of the second line segment MC. Therefore, the dataset of the second contour lines can also be represented as {M, D, α, β}. Furthermore, since segmentation point M is only process data, the dataset of the second contour lines can be represented as {D, α, β} or {E, F, α, β}.

[0130] For each second contour line in the dataset, postoperative outcome prediction results are calculated to aid in surgical plan selection. This process determines the corresponding second contour line, and subsequently, the cutting point E, cutting point F, rotation angle α of the first line segment AM, and rotation angle β of the second line segment MC. In other words, the cutting point E, cutting point F, rotation angle α of the first line segment AM, and rotation angle β of the second line segment MC corresponding to the surgical plan are determined from the second contour line dataset {E, F, α, β}.

[0131] As a specific implementation method, the method for obtaining the second contour line in step 5 includes the following steps:

[0132] Step 5.1 After determining the rotation angle α of the first line segment AM, rotate the second line segment MC to form a dataset of second contour lines with a determined angle for the first line segment AM and different rotation angles for the second line segment MC.

[0133] Step 5.2 Adjust the rotation angle α of the first line segment AM, and repeat step 5.1 to obtain a dataset of second contour lines with different rotation angles for the first line segment AM and the second line segment MC.

[0134] As a specific implementation method, when rotating the second line segment MC, once the second line segment MC no longer intersects with the first line segment AM, the continued rotation of the second line segment MC is terminated, and the addition of data to the dataset of the second contour line of the second line segment MC at different rotation angles under the determined angle of the first line segment AM is stopped.

[0135] As a specific implementation, the first line segment AM and the second line segment MC are respectively set with initial rotation angle and maximum rotation angle; the rotation angle range of the first line segment AM and the second line segment MC is respectively set between their initial rotation angle and maximum rotation angle.

[0136] As a specific implementation method, when the first line segment AM and the second line segment MC are rotated, their preset rotation angle increments are set respectively; when rotating the first line segment AM and the second line segment MC, their preset rotation angle increments are increased each time.

[0137] As a specific implementation method, a candidate area for dividing points is pre-set on the first contour line; when traversing the dividing point M on the first contour line, a selection is made from the candidate area for dividing points.

[0138] When two circles are used to simulate the rib contour in step 1, the other steps can be implemented in any of the embodiments described in this patent specification.

[0139] It will be apparent to those skilled in the art that the present invention is not limited to the details of the exemplary embodiments described above, and that the invention can be implemented in other specific forms without departing from its spirit or essential characteristics. Therefore, the embodiments should be considered in all respects as exemplary and non-limiting, and the scope of the invention is defined by the appended claims rather than the foregoing description. Thus, all variations falling within the meaning and scope of equivalents of the claims are intended to be included within the present invention. No reference numerals in the claims should be construed as limiting the scope of the claims.

[0140] Furthermore, it should be understood that although this specification describes embodiments, not every embodiment contains only one independent technical solution. This narrative style is merely for clarity. Those skilled in the art should consider the specification as a whole, and the technical solutions in each embodiment can also be appropriately combined to form other embodiments that can be understood by those skilled in the art.

Claims

1. A method for predicting the outcome of thoracic surgery, characterized in that, Includes the following steps: Construct or simulate the rib contour to obtain the first contour line; Based on the dividing points on the first contour line, the first contour line is divided into a first line segment and a second line segment. The first line segment and the second line segment rotate around their ends away from the dividing point, and the first line segment and the second line segment intersect to form an intersection point. The end of the first line segment away from the dividing point to the intersection point and the intersection point to the end of the second line segment away from the dividing point together constitute the second contour line. Based on the second contour line as the postoperative rib contour, the postoperative effect prediction result is determined, wherein the position of the intersection point on the first line segment and the second line segment is used as the two cutting points for rib cutting in the thoracic surgery, and the rotation angle of the first line segment and the second line segment is used as the angle that the two rib segments need to be rotated in the thoracic surgery.

2. The method for predicting the outcome of thoracic surgery according to claim 1, characterized in that, One endpoint of the first contour line corresponds to the intersection of the rib and the vertebra, and is defined as the rib origin; the other endpoint corresponds to the end of the costal cartilage, and is defined as the rib end. A coordinate system is established with the direction perpendicular to the patient's sagittal plane as the x-direction and the direction perpendicular to the patient's coronal plane as the y-direction, wherein the y-axis passes through the origin of the rib.

3. The method for predicting the outcome of thoracic surgery according to claim 2, characterized in that, The segmentation points are determined by scanning or traversing within a range of 5% to 70% of the length of the first contour line.

4. The method for predicting the outcome of thoracic surgery according to claim 2, characterized in that, The indicators used to represent the predicted results of postoperative effects, calculated based on the second contour line, include one or more of the following: lung volume improvement indicators, chest wall protrusion improvement indicators, cutting point distance indicators, and surgical incision location indicators.

5. The method for predicting the outcome of thoracic surgery according to claim 4, characterized in that, Lung capacity is represented by the area of ​​the figure enclosed by the starting point, ending point, and contour lines of the ribs. The difference between the lung capacity corresponding to the second contour line and the lung capacity corresponding to the first contour line is calculated as a value of the lung capacity improvement index.

6. The method for predicting the outcome of thoracic surgery according to claim 4, characterized in that, Using the patient's coronal plane as the reference plane, the distance difference between the farthest points on the first and second contour lines from the reference plane is calculated and used as a numerical value for the improvement index of thoracic protrusion.

7. The method for predicting the outcome of thoracic surgery according to claim 4, characterized in that, The cutting point distance index is defined as the reciprocal of the length difference between the first contour line and the second contour line.

8. The method for predicting the outcome of thoracic surgery according to claim 4, characterized in that, The location indicators for the surgical incision include the back, side, and chest; Starting from the origin of the coordinate system, the first and fourth quadrants are divided into three regions, corresponding to the back region, the side region, and the chest region, respectively. Based on the region where the cutting point is located on the second line segment, the surgical incision location index is determined as the prediction result.

9. A method for predicting the outcome of thoracic surgery according to any one of claims 1 to 8, characterized in that, A dataset of the second contour lines for different rotation angles of the first and second line segments is constructed by rotating the first and second line segments. By adjusting the dividing points, the rotation operations of the first line segment and the second line segment are repeated to form a dataset of the second contour line based on the dividing points, the two cutting points, the rotation angle of the first line segment, and the rotation angle of the second line segment.

10. A method for predicting the outcome of thoracic surgery according to claim 9, characterized in that, For each second contour line in the dataset of the second contour lines, the postoperative effect prediction result is calculated for the selection of surgical plan. The corresponding second contour line is determined, and then the two cutting points, the rotation angle of the first line segment, and the rotation angle of the second line segment corresponding to the second contour line are determined.

11. The method for predicting the outcome of thoracic surgery according to claim 9, characterized in that, The method for obtaining the second contour line includes the following steps: After determining the rotation angle of the first line segment, the second line segment is rotated to form a dataset of second contour lines with a determined angle for the first line segment and different rotation angles for the second line segment. Adjust the rotation angle of the first line segment and repeat the above steps to obtain a dataset of the second contour lines for different rotation angles of the first and second line segments.

12. The method for predicting the outcome of thoracic surgery according to claim 11, characterized in that, When rotating the second line segment, once the second line segment no longer intersects with the first line segment, the rotation of the second line segment is terminated, and the addition of data to the dataset of the second contour line of the second line segment at different rotation angles under the determined angle of the first line segment is stopped.

13. The method for predicting the outcome of thoracic surgery according to claim 1, characterized in that, Set the initial rotation angle and the maximum rotation angle for the first line segment and the second line segment respectively; The rotation angle ranges of the first line segment and the second line segment are respectively set between their initial rotation angle and their maximum rotation angle.

14. The method for predicting the outcome of thoracic surgery according to claim 1, characterized in that, When the first line segment and the second line segment rotate, their preset rotation angle increments are set respectively; When rotating the first line segment and the second line segment, the preset rotation angle increment is increased each time.

15. A method for predicting the outcome of thoracic surgery according to claim 4, characterized in that, It also includes a step of configuring requirements, which includes setting weights for indicators of the prediction results and / or setting exclusion conditions.

16. The method for predicting the outcome of thoracic surgery according to claim 15, characterized in that, The exclusion criteria include the distance to the cutting point and / or the location of the surgical incision.

17. A method for predicting the outcome of thoracic surgery according to claim 15, characterized in that, The predicted score for surgical outcome is calculated based on the weights. The predicted score is the sum of the specific values ​​of the selected indicators and the weighting coefficients.

18. A method for predicting the outcome of thoracic surgery according to claim 15, characterized in that, Before calculating the postoperative outcome prediction results, the configuration requirements are set up.

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