指導教授：陳永耀臺灣大學：電機工程學研究所張凱翔Chang, Kai-HsiangKai-HsiangChang2014-11-282018-07-062014-11-282018-07-062014http://ntur.lib.ntu.edu.tw//handle/246246/262906腫瘤的定位追蹤在肝腫瘤放射線治療以及熱治療中佔據極為重要的角色，由於肝腫瘤受到呼吸作用影響而在腹腔內產生移動，增加了治療的困難度，所以追蹤精度是影響治療的效率以及安全性的重要因素。本論文提出了兩種追蹤肝腫瘤的方式：(1)呼吸替代訊號追蹤法，以及(2)超音波與斷層掃描影像對位追蹤法。 第一個方法是利用呼吸替代訊號進行肝腫瘤追蹤，其主要概念是利用呼吸替代訊號與肝腫瘤運動之間存在的運動關聯性對肝腫瘤進行位置追蹤。不同於其他追蹤方法，本研究所採用的呼吸替代訊號是體表變化等生理訊號，因此具有非侵入性與即時量測之優點，再者此方法沒有X光暴露的疑慮，適合進行長時間的追蹤。本研究以動物實驗之方式確認體外呼吸替代訊號與肝腫瘤運動之關聯性，並且以仿體實驗進行端點定位方法的驗證，結果顯示提出之方法具有良好的準確度。 第二個方法是超音波與電腦斷層影像對位追蹤法，由於肝腫瘤在肝臟內且肝臟外型具有形狀的特殊性，因此提出的方法主要概念是先利用肝臟外型對肝臟位置進行定位，再由肝臟位置與肝腫瘤的相對位置推測出肝腫瘤的位置，以達到肝腫瘤追蹤的目的。本研究提出一種超音波與電腦斷層影像校正技術，提升影像對位速度，改善影像對位時間過長之困難，使其可對肝腫瘤進行即時追蹤。此方法具有其新穎性，並且以仿體實驗進行靜態與動態追蹤的驗證，其結果顯示此方法應用於即時肝腫瘤追蹤的可行性。 本論文提出的兩個肝腫瘤即時追蹤方法，經過實驗驗證皆能對在腹腔內移動的肝腫瘤進行即時的位置追蹤，並且未來可作為位置導引系統應用於肝腫瘤的治療，例如肝腫瘤放射線治療以及熱治療等。兩種方法具有自身的獨特性，可在不同的情況下選擇適合的追蹤方式，極具有臨床研究的潛力。Tumor tracking plays one of the most important roles in liver tumor treatment, like radiotherapy and thermotherapy. Due to the fact that liver tumors have respiration-induced movements, accurate tracking is the key issue in treatment. Two methods for liver tumor tracking are proposed in this dissertation: (1) surrogate-based tracking with end-points registration and (2) tracked ultrasound tracking with image registration. A surrogate-based tracking with end-points registration is presented in this dissertation. Abdominal wall displacement as external respiratory surrogate is used to track liver tumor movement, because liver movement has high correlation to surrogate signals. The end-points of tumor movement are determined by CT image registration to build correlation model. Unlike previous tumor tracking methods, the proposed method is non-invasive and real time. Moreover, it is radiation free so that patients are allowed undergoing long-term tracking. An animal experiment has validated the effectiveness of external respiratory surrogates for liver motion estimation, and a phantom experiment has been validated the performance of image registration. It shows a considerably good accuracy for real-time tracking. A novel tracked ultrasound tracking method involving image registration is proposed in this dissertation, too. In this method, the position of liver tumor is obtained based on liver’s position and the relative position between the tumor and the liver. The relative position between the tumor and the liver is obtained by CT scan, and the liver position is determined by tracked ultrasound and image registration with CT. An alignment method is proposed to reduce the run time of image registration for real-time liver tumor tracking. A phantom experiment is conducted, and the results show that the proposed approach has good tracking performance for real-time liver tumor tracking. The proposed methods have capability to track liver tumor in real time. They have potential to being guidance in radiotherapy or thermotherapy for liver tumor treatment.誌謝 i 摘要 ii Abstract iv Contents vi List of Figures ix List of Tables xvi Chapter 1 Introduction 1 1.1 Motivation and Problem Definition 1 1.2 Previous Work 4 1.3 Proposed Approach 5 1.4 Organization 8 Chapter 2 Tumor Tracking Methods 11 2.1 Invasive Tracking 12 2.2 Mini-Invasive Tracking 13 2.2.1 Biplane X-Ray 13 2.2.2 Computed Tomography 14 2.3 Non-Invasive Tracking 14 2.3.1 Magnetic Resonance Imaging 15 2.3.2 Tracked Ultrasound 15 2.3.3 Surrogate Signal 16 2.4 Discussions and Summary 20 Chapter 3 Surrogate-Based Tracking with End-Points Registration 23 3.1 Proposed Approach 23 3.2 End-points Registration 25 3.2.1 Image-To-Physical Registration Using External Markers 25 3.2.2 Experiment Design 30 3.2.3 Experiment Results and Discussions 32 3.3 Liver-Surrogate Movement Correlation Model 36 3.3.1 Liver Motion Estimation Procedure 36 3.3.2 Animal Experiment Design 39 3.3.3 Liver and Chest/Abdomen Movement Analysis 44 3.3.4 Estimation Results and Discussions 51 3.4 Summary 61 Chapter 4 Tracked Ultrasound with CT Image Registration 63 4.1 Proposed Approach 63 4.1.1 Computed Tomography 66 4.1.2 Tracked Ultrasound 68 4.1.3 Ultrasound-CT Image Registration 70 4.2 Experiment Design 74 4.3 Experiment Results 79 4.3.1 Static Localization 79 4.3.2 Real-Time Tracking 81 4.4 Discussions and Summary 84 Chapter 5 Conclusions and Future Work 87 References 894698911 bytesapplication/pdf論文公開時間：2019/08/21論文使用權限：同意無償授權肝腫瘤追蹤呼吸替代訊號醫學影像定位定位行超音波影像對位thesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/262906/1/ntu-103-D97921009-1.pdf