應用於肝腫瘤治療之超音波影像輔助機械臂HIFU燒灼實驗系統;An Ultrasound-imaging Guided Robotic HIFU Ablation Experimental System for Liver Tumor Treatment

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题名:	應用於肝腫瘤治療之超音波影像輔助機械臂HIFU燒灼實驗系統;An Ultrasound-imaging Guided Robotic HIFU Ablation Experimental System for Liver Tumor Treatment
作者:	安治宇;An, Chih-Yu
贡献者:	機械工程學系
关键词:	高強度聚焦超音波;超音波影像輔助導航系統;機械手臂;呼吸同步追蹤;High-intensity focused ultrasound;Ultrasound;Image-guided surgery;Robotic arm;Real-time tracking
日期:	2019-07-23
上传时间:	2019-09-03 16:34:29 (UTC+8)
出版者:	國立中央大學
摘要:	肝臟腫瘤是國人常見的疾病，隨著微創手術科技的進步，對病患傷害最小的微創或無創手術頗受到醫療界重視。近年來快速發展的高強度聚焦超音波(High Intensity Focused Ultrasound, HIFU)以高溫方式破壞細胞，通常應用於非侵入性腫瘤治療，例如治療子宮肌瘤或前列腺腫瘤，此一非侵入式的熱治療方式極具發展潛力。但對於會受到呼吸影響而移動的臟器，如肝臟，呼吸可能導致定位錯誤或對腫瘤的熱效應不足而影響治療準確度，甚至造成正常組織傷害。若能夠經由呼吸的訊號推算肝腫瘤的位置，便可進行同步治療以減少定位誤差進行精準的治療。本研究的目的是開發一種超音波影像輔助機械臂HIFU燒灼系統，並具有呼吸和腫瘤位移補償機制。在手術導引部分，透過超音波影像技術，由超音波影像計算腫瘤尺寸與方位資訊，再由電腦控制機械臂移動HIFU 探頭，使HIFU聚焦點能完整地掃過腫瘤區，進行燒灼治療。而呼吸追蹤的部分則使用雷射位移計量測呼吸狀態，並在不同的呼吸狀態下使用超音波探頭掃描腫瘤，經過資料處理之後將兩組資料以多項式函數擬合出位移軌跡並計算需要補償的時間，最後以機械手臂帶動HIFU探頭進行腫瘤位移同步治療。實驗結果首先是系統定位精度，超音波影像導引機械手臂定位精度為1.01±0.34mm，而加入HIFU系統之後其單點燒灼精度為1.32±0.58mm，且目標點產生白色凝固，代表溫度到達60°C以上。接著呼吸同步追蹤燒灼實驗則設計一個運動機構來模擬呼吸狀態下肝腫瘤位移與胸口起伏關係，實驗分為單點及三維切面追蹤，單點追蹤實驗平均誤差為1.72±1.26 mm，且溫度皆可達到80°C以上，能夠將細胞破壞。三維切面追蹤實驗平均誤差為3.04±1.24 mm，且規劃之路徑皆產生白色凝固，代表目標區域已成功完成燒灼。 ;In recent years, high-intensity focused ultrasound (HIFU) has commonly been applied in non-invasive tumor therapy, such as to treat uterine fibroids or prostate tumors. However, respiration may cause tumor displacement such as liver tumor, which may lead to error in localization or inadequate thermal effects on the tumor. The goal of this research is to develop an ultrasound-imaging guided robotic HIFU ablation system for tumor treatment with a respiration and displacement compensatory mechanism. The system integrates the technologies of ultrasound image assisted guidance, robotic positioning control, and HIFU treatment planning. With the assistance of ultrasound image guidance technology, the tumor size and location can be determined from ultrasound images as well as the robotic arm can be controlled to position the HIFU transducer to focus on the target tumor. According to the correlation between the measured displacements of the heaving chest and the target tumor, a respiration simulation device was designed, which used a phantom and a cam-driving mechanism to simulate displacements of the tumor and of the heaving chest. Then, a polynomial function of tumor position relative to the position of the heaving chest was generated. After the coordinate frames of the robotic arm, optic tracker and tumor phantom had been registered, the robotic arm was able to guide the HIFU probe to track and ablate the target tumor automatically and synchronously by inputting the displacement values of the heaving chest. After the development of the system, several experiments were conducted to measure the positioning accuracy of this system and the results shows either without respiration simulation device or with respiration simulation device. The experiment results show that the average positioning error in the positioning accuracy of the robotic arm is 1.01±0.34mm, and the average positioning error in positioning accuracy of the ultrasound-imaging guided robotic HIFU system with ablating a phantom is 1.32±0.58mm, and the target point becomes white coagulation lesions, which means this system is confirmed its possibility and accuracy. With the respiration device, the average positioning error in the single-point tracking experiment was 1.72 ± 1.26 mm, while the ablation temperature was stabilized at 80°C, which was enough to kill tumor cells. Furthermore, the average positioning error in the cross-section ablation experiment was 3.04 ± 1.24 mm, and the white coagulated lesion in the area of the planning route was obvious, which means the target area successfully ablated.
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