Ultrasound-ct registration method for pain intervention

Abstract

An ultrasound-CT registration method for interventional pain management, belonging to the field of ultrasound diagnostic and therapeutic technology, mainly includes: acquiring ultrasound image data; labeling the pleura and lamina in the ultrasound images; reconstructing CT data; manually aligning the spatial data reconstructed by ultrasound with the data reconstructed by CT in a 3D point cloud visualization processing software based on the labeled feature points; and outputting a formatted file containing the positional relationship between the 3D reconstructed data of the pleura and lamina in ultrasound and the CT reconstructed data after manual registration. This method utilizes the high echogenicity of the pleura and lamina in ultrasound images to perform multimodal image fusion of ultrasound and CT, solving both the problem of poor real-time performance of CT images and the problem of ultrasound images not being able to observe the dorsal root ganglia, greatly improving the accuracy, safety, and ease of operation of interventional pain management procedures.

Description

Technical Field

[0001] This invention relates to the field of ultrasound diagnostic and therapeutic technology, and in particular to an ultrasound-CT registration method for interventional pain management. Background Technology

[0002] Ultrasound-based interventional pain management is one of the most widely recognized and effective methods in clinical treatment. For example, pulsed radiofrequency ablation of the dorsal root ganglion is an effective neuromodulation therapy for postherpetic neuralgia. It can modulate the spinal nerves involved in transmitting pain signals, reduce the transmission of pain signals, and promote the release of analgesic substances to achieve pain control.

[0003] Currently, ultrasound-guided localization of dorsal root ganglia is commonly used in clinical practice. This is because real-time ultrasound-guided puncture not only has the advantage of no radiation contamination, but also allows for real-time dynamic observation of the needle tip and needle body's entry path and guidance for adjusting the puncture direction. This avoids exposure of both doctors and patients to radiation contamination and significantly improves the safety of the puncture process, making it a popular new method among clinicians.

[0004] However, because the thoracic dorsal root ganglion is located within the intervertebral foramen and on the ventral surface of the lamina, the ultrasound beam is blocked by the lamina bone when the ultrasound probe scans from the patient's dorsal side, making it impossible to accurately locate the dorsal root ganglion. Preoperative CT or MRI scans can show the relationship between the dorsal root ganglion and the surrounding vertebral structures. Measurements taken by preoperative CT or MRI can help locate the thoracic dorsal root ganglion and pre-plan the ultrasound puncture path, thereby shortening the ultrasound-guided dorsal root ganglion puncture time and improving puncture accuracy. (See attached image) Figure 1 As shown.

[0005] However, there are some problems with preoperative CT or MRI scan-assisted localization: if there is a distance between the specific location of the ultrasound image section and the location of the CT or MRI measurement section during puncture, the localization of the dorsal root ganglion based on the CT or MRI measurement results will be deviated, causing the preset puncture path and distance to fail to reach the dorsal root ganglion. Summary of the Invention

[0006] This disclosure provides an ultrasound-CT registration method based on the pleura and lamina, which can be used to achieve precise auxiliary localization of the dorsal root ganglion by preoperative CT or MRI for real-time ultrasound scanning during interventional pain treatment.

[0007] This method extracts the pleura and lamina from ultrasound images as feature points and matches and aligns them with the lamina and pleural structures in CT data. This allows the two different modalities of image data to be spatially matched through the two feature points. Then, by overlaying 2D images, the dorsal root ganglion in the CT image is projected onto the ultrasound image in real time to assist the operator in performing interventional pain treatment of the dorsal root ganglion under ultrasound guidance.

[0008] The method specifically includes the following steps:

[0009] S1, Image Acquisition: Ultrasound image data is acquired using an ultrasound device equipped with a spatial positioning system;

[0010] S2, Annotation of ultrasound images: Annotate two feature points, the pleura and the lamina, in the acquired ultrasound images;

[0011] S3, CT data reconstruction: Three-dimensional reconstruction of CT data, including bones and lungs;

[0012] S4. Based on the feature points marked in step S2, the spatial data reconstructed by ultrasound and the data reconstructed by CT are manually aligned in the 3D point cloud visualization software. The vertebral lamina in ultrasound coincides with the vertebral lamina in CT, and the ultrasound pleura coincides with the edge of the lung.

[0013] S5. After manual registration is completed, the 3D point cloud visualization software outputs a formatted file containing the relative positional relationship between the two registration matrices, that is, the positional relationship between the 3D reconstruction data of the pleura and lamina in ultrasound and the CT reconstruction data.

[0014] Furthermore, in step S1, the spatial positioning system uses a robotic arm with a position sensor at its end, which records the relative coordinates of the end in real time during movement; the ultrasonic probe is fixed at the end of the robotic arm, and the spatial coordinates corresponding to the instant of ultrasonic imaging are acquired at the same time. The image and the spatial coordinates generate a pair of matching data for subsequent three-dimensional spatial reconstruction and registration.

[0015] Furthermore, the specific method of step S1 includes:

[0016] The ultrasound images were acquired using a plain scan method. The convex array probe held by the robotic arm was placed on the side of the volunteer's spine at T2. Then, a plain ultrasound scan was performed along the direction of the human body from head to toe, stopping in the T10 to T12 interval.

[0017] The ultrasound image truncated by the scan is acquired, and the image is split into frames to generate several image files for subsequent annotation operations.

[0018] Furthermore, in step S4, the two feature points marked in the ultrasound image are treated as a whole and registered with the CT data.

[0019] Furthermore, the method also includes the following steps:

[0020] S6. After the registration operation is completed, import the registration matrix data and the ultrasound and CT image information data into the medical image processing software. You can then see the superimposed image of ultrasound and CT images after registration according to the registration matrix, which completes the registration of CT and ultrasound images of the dorsal root ganglion.

[0021] Compared with the prior art, the beneficial effects of this disclosure are:

[0022] ① This method utilizes the high echogenicity of the pleura and lamina in ultrasound images to achieve multimodal image fusion of ultrasound and CT. It can project the dorsal root ganglion from the preoperative CT image onto the real-time ultrasound image, which solves both the problem of poor real-time performance of CT images and the problem of the inability to observe the dorsal root ganglion in ultrasound images, greatly improving the accuracy, safety and ease of operation of interventional pain treatment surgery.

[0023] ② Improve the observability of the dorsal root ganglion in ultrasound images, shorten the time required to locate the puncture target, improve procedure efficiency, and effectively improve the therapeutic effect of dorsal root ganglion puncture in interventional pain management.

[0024] ③ The method is simple, easy to implement, and highly accurate. Attached Figure Description

[0025] The above and other objects, features and advantages of this disclosure will become more apparent from the more detailed description of exemplary embodiments of this disclosure taken in conjunction with the accompanying drawings, in which the same reference numerals generally represent the same components.

[0026] Figure 1 The diagram shows the anatomical structure under ultrasound, where 1-1 is the original ultrasound image and 1-2 is a schematic diagram of the anatomical structure.

[0027] Figure 2 A flowchart illustrating an exemplary embodiment of this disclosure;

[0028] Figure 3 The annotation results and requirements for ultrasound images are as follows: pleura (left) and lamina (right); where 3-1 is the original image and 3-2 is the annotated image.

[0029] Figure 4 This is a schematic diagram of the spatial relationship between the lamina and pleura after continuous scanning and annotation of ultrasound images. From left to right, they are: oblique 45-degree view (pleura right lamina left), top view (pleura subpleura lamina), and frontal view (pleura right lamina left).

[0030] Figure 5 Bone and lung reconstruction under CT scan;

[0031] Figure 6This is a diagram showing the registration relationship between ultrasound reconstruction results and CT reconstruction results in three-dimensional space.

[0032] Figure 7 The images are, in order: fused image, actual ultrasound image (without CT overlay), and CT and ultrasound images overlaid (the lamina / pleura can be observed to overlap). Detailed Implementation

[0033] Preferred embodiments of the present disclosure will now be described in more detail with reference to the accompanying drawings. While preferred embodiments of the present disclosure are shown in the drawings, it should be understood that the present disclosure may be implemented in various forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that the present disclosure will be thorough and complete, and will fully convey the scope of the present disclosure to those skilled in the art.

[0034] This disclosure provides an ultrasound-CT registration method based on the pleura and lamina, which can be used to achieve precise auxiliary localization of the dorsal root ganglion by CT or MRI for real-time ultrasound scanning before interventional pain treatment.

[0035] In one exemplary implementation, the flowchart is attached. Figure 2 As shown, the main steps include:

[0036] 1. Image acquisition: First, ultrasound equipment with a spatial positioning system is needed to acquire ultrasound image data on the volunteer.

[0037] The spatial positioning system employs a robotic arm equipped with a position sensor at its end, which records the relative coordinates of the end in real time during movement. By fixing the ultrasonic probe to the end of the robotic arm, the spatial coordinates corresponding to the instant of ultrasonic imaging can be acquired simultaneously. The image and spatial coordinates can be used to generate a matching pair for subsequent 3D spatial reconstruction and registration.

[0038] Ultrasound images were acquired using a plain scan method, with the convex array probe held by the robotic arm positioned laterally on the volunteer's spine at the T2 level to ensure the ultrasound image was displayed as expected. Figure 1-1 Then, perform a flat ultrasound scan along the body from head to toe, stopping within the T10 to T12 interval;

[0039] The ultrasound image truncated by the scan is acquired, and the image is split into frames to generate several image files for subsequent annotation operations.

[0040] 2. Ultrasound image annotation: The ultrasound images obtained in step 1 are annotated by professional clinicians, referring to... Figure 3-2The annotation methods and standards used in this study are applied to annotate two feature points: the pleura and the lamina. Both of these feature points exhibit high echogenicity in ultrasound images and are clearly visible for most of the scanning process. The annotated feature point information is then matched with the spatial coordinate information obtained in step 1 to generate... Figure 4-1 The spatial relationship images in 4-2 and 4-3 are used for subsequent registration work.

[0041] 3. CT Data Reconstruction: Three-dimensional reconstruction was performed on the volunteers' CT data, focusing on the bones and lungs. See Figures 5-1, 5-2, and 5-3 for the reconstructed images.

[0042] 4. Finally, in CloudCompare software, manually align the spatial data reconstructed by ultrasound with the data reconstructed by CT. Ideally, the vertebral lamina in ultrasound should coincide with the vertebral lamina in CT. Simultaneously, the ultrasound pleura should align with the edge of the lung. Refer to the ideal registration diagram. Figure 6-1 ,6-2,6-3.

[0043] In the three-dimensional registration of ultrasound images and CT data, the relative positions of the lamina and pleura are fixed. The ultrasound reconstructed data is registered as a whole, rather than one element at a time. Therefore, during manual registration, two feature points in the ultrasound image have a fixed spatial relationship and are registered together with the CT data as a whole.

[0044] 5. After manual registration is complete, CloudCompare software will output a .bin file containing the relative positional relationship between the two registration matrices, i.e., the positional relationship between the 3D reconstruction data of the pleura and lamina in ultrasound and the CT reconstruction data. This file serves as the output result after manual registration.

[0045] 6. After the registration operation is completed, import the registration matrix data along with the ultrasound and CT image information data into MITK. You will then be able to view the ultrasound and CT images. Based on the registration matrix, complete the overlay image after registration, thus completing the registration of the CT and ultrasound images of the dorsal root ganglion. See the image after registration. Figure 7-1 , 7-3.

[0046] Figure 7 The image fusion result after registration is shown with a CT image as the background and a fan-shaped ultrasound image superimposed on the CT image. It can be observed that the pleura and lamina in the CT and ultrasound images are completely overlapped, indicating that the registration was successful.

[0047] The above technical solutions are merely exemplary embodiments of the present invention. For those skilled in the art, based on the application methods and principles disclosed in the present invention, it is easy to make various types of improvements or modifications, and not limited to the methods described in the specific embodiments of the present invention. Therefore, the methods described above are only preferred and not restrictive.

Claims

1. An ultrasound-CT registration method for interventional pain management, characterized in that, Includes the following steps: S1, Image Acquisition: Ultrasound image data is acquired using an ultrasound device equipped with a spatial positioning system; S2, Annotation of ultrasound images: Annotate two feature points, the pleura and the lamina, in the acquired ultrasound images; S3, CT data reconstruction: Three-dimensional reconstruction of CT data, including bones and lungs; S4. Based on the feature points marked in step S2, the spatial data reconstructed by ultrasound and the data reconstructed by CT are manually aligned in the 3D point cloud visualization software. The vertebral lamina in ultrasound coincides with the vertebral lamina in CT, and the ultrasound pleura coincides with the edge of the lung. S5. After manual registration is completed, the 3D point cloud visualization software outputs a formatted file containing the relative positional relationship between the two registration matrices, that is, the positional relationship between the 3D reconstruction data of the pleura and lamina in ultrasound and the CT reconstruction data.

2. The method according to claim 1, characterized in that, In step S1, the spatial positioning system uses a robotic arm with a position sensor at the end of the robotic arm to record the relative coordinates of the end in real time during movement. The ultrasonic probe is fixed at the end of the robotic arm, and the spatial coordinates corresponding to the instant of ultrasonic imaging are obtained at the same time. The image and the spatial coordinates generate a pair of matching data for subsequent three-dimensional spatial reconstruction and registration.

3. The method according to claim 2, characterized in that, The specific method of step S1 includes: The ultrasound images were acquired using a plain scan method. The convex array probe held by the robotic arm was placed on the side of the volunteer's spine at T2. Then, a plain ultrasound scan was performed along the direction of the human body from head to toe, stopping in the T10 to T12 interval. The ultrasound image truncated by the scan is acquired, and the image is split into frames to generate several image files for subsequent annotation operations.

4. The method according to claim 2 or 3, characterized in that, Step S2 specifically includes: Professional clinicians annotate the ultrasound images obtained in step S1, marking the two feature points: the pleura and the lamina. The labeled feature point information is matched with the spatial coordinate information obtained in step S1 to generate a spatial relationship image of the pleura and lamina, which is used for subsequent registration work.

5. The method according to claim 1, characterized in that, In step S4, the two feature points marked in the ultrasound image are treated as a whole and registered with the CT data.

6. The method according to claim 1, characterized in that, It also includes the following steps: S6. After the registration operation is completed, import the registration matrix data and the ultrasound and CT image information data into the medical image processing software. You can then see the superimposed image of ultrasound and CT images after registration according to the registration matrix, which completes the registration work of CT and ultrasound images.

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