Computed tomography (CT)-guided thermal ablation is an emerging treatment method for lung tumors. Ablation needle path planning in preoperative diagnosis is of critical importance. In this work, we proposed an automatic needle path-planning method for thermal lung tumor ablation. First, based on the improved cube mapping algorithm, binary classification was performed on the surface of the bounding box of the patient’s CT image to obtain a feasible puncture area that satisfied all hard constraints. Then, for different clinical soft constraint conditions, corresponding grayscale constraint maps were generated, respectively, and the multi-objective optimization problem was solved by combining Pareto optimization and weighted product algorithms. Finally, several optimal puncture paths were planned within the feasible puncture area obtained for the clinicians to choose. The proposed method was evaluated with 18 tumors of varying sizes (482.79 mm³ to 9313.81 mm³) and the automatically planned paths were compared and evaluated with manually planned puncture paths by two clinicians. The results showed that over 82% of the paths (74 of 90) were considered reasonable, with clinician A finding the automated planning path superior in 7 of 18 cases, and clinician B in 9 cases. Additionally, the time efficiency of the algorithm (35 s) was much higher than that of manual planning. The proposed method is expected to aid clinicians in preoperative path planning for thermal ablation of lung tumors. By providing a valuable reference for the puncture path during preoperative diagnosis, it may reduce the clinicians’ workload and enhance the objectivity and rationality of the planning process, which in turn improves the effectiveness of treatment.

It is rare to use the one-stage model without segmentation for the automatic detection of coronary lesions. This study sequentially enrolled 200 patients with significant stenoses and occlusions of the right coronary and categorized their angiography images into two angle views: The CRA (cranial) view of 98 patients with 2453 images and the LAO (left anterior oblique) view of 176 patients with 3338 images. Randomization was performed at the patient level to the training set and test set using a 7:3 ratio. YOLOv5 was adopted as the key model for direct detection. Four types of lesions were studied: Local Stenosis (LS), Diffuse Stenosis (DS), Bifurcation Stenosis (BS), and Chronic Total Occlusion (CTO). At the image level, the precision, recall, mAP@0.1, and mAP@0.5 predicted by the model were 0.64, 0.68, 0.66, and 0.49 in the CRA view and 0.68, 0.73, 0.70, and 0.56 in the LAO view, respectively. At the patient level, the precision, recall, and F₁scores predicted by the model were 0.52, 0.91, and 0.65 in the CRA view and 0.50, 0.94, and 0.64 in the LAO view, respectively. YOLOv5 performed the best for lesions of CTO and LS at both the image level and the patient level. In conclusion, the one-stage model without segmentation as YOLOv5 is feasible to be used in automatic coronary lesion detection, with the most suitable types of lesions as LS and CTO.

Accurate segmentation of the liver and liver tumors is crucial for clinical diagnosis and treatment. However, the task poses significant challenges due to the complex morphology of tumors, indistinct features of small targets, and the similarity in grayscale values between the liver and surrounding organs. To address these issues, this paper proposes an enhanced 3D UNet architecture, named ELANRes-MSCA-UNet. By incorporating a structural re-parameterized residual module (ELANRes) and a multi-scale convolutional attention module (MSCA), the network significantly improves feature extraction and boundary optimization, particularly excelling in segmenting small targets. Additionally, a two-stage strategy is employed, where the liver region is segmented first, followed by the fine-grained segmentation of tumors, effectively reducing false positive rates. Experiments conducted on the LiTS2017 dataset demonstrate that the ELANRes-MSCA-UNet achieved Dice scores of 97.2% and 72.9% for liver and tumor segmentation tasks, respectively, significantly outperforming other state-of-the-art methods. These results validate the accuracy and robustness of the proposed method in medical image segmentation and highlight its potential for clinical applications.

Objective: Aiming at the shortcomings of artificial surgical path planning for the thermal ablation of liver tumors, such as the time-consuming and labor-consuming process, and relying heavily on doctors’ puncture experience, an automatic path-planning system for thermal ablation of liver tumors based on CT images is designed and implemented. Methods: The system mainly includes three modules: image segmentation and three-dimensional reconstruction, automatic surgical path planning, and image information management. Through organ segmentation and three- dimensional reconstruction based on CT images, the personalized abdominal spatial anatomical structure of patients is obtained, which is convenient for surgical path planning. The weighted summation method based on clinical constraints and the concept of Pareto optimality are used to solve the multi-objective optimization problem, screen the optimal needle entry path, and realize the automatic planning of the thermal ablation path. The image information database was established to store the information related to the surgical path. Results: In the discussion with clinicians, more than 78% of the paths generated by the planning system were considered to be effective, and the efficiency of system path planning is higher than doctors’ planning efficiency. Conclusion: After improvement, the system can be used for the planning of the thermal ablation path of a liver tumor and has certain clinical application value.

Accurate segmentation of the liver and liver tumors is crucial for clinical diagnosis and treatment. However, the task poses significant challenges due to the complex morphology of tumors, indistinct features of small targets, and the similarity in grayscale values between the liver and surrounding organs. To address these issues, this paper proposes an enhanced 3D U-Net architecture, named ELANRes-MSCA- UNet. By incorporating a structural re-parameterized residual module (ELANRes) and a multi-scale convolutional attention module (MSCA), the network significantly improves feature extraction and boundary optimization, particularly excelling in segmenting small targets. Additionally, a two-stage strategy is employed, where the liver region is segmented first, followed by the fine-grained segmentation of tumors, effectively reducing false positive rates. Experiments conducted on the LiTS2017 dataset demonstrate that ELANRes-MSCA-UNet achieves Dice scores of 97.2% and 72.9% for liver and tumor segmentation tasks, respectively, significantly outperforming other state-of-the-art methods. These results validate the accuracy and robustness of the proposed method in medical image segmentation and highlight its potential for clinical applications.

This paper evaluates the advantages of overlapping microwave ablation (OMWA) for the personalized treatment of large tumors, providing quantitative and technical references for conformal tumor eradication. A three-dimensional numerical model coupled with electromagnetic fields and Pennes’ biological heat transfer equation was constructed, comprehensively considering the nonlinear behavior of tissue electrical and thermal parameters with temperature changes. A simulation model was developed to predict temperature distribution and the formation of the coagulation zone under single-needle multiple-point and multiple-needle multiple-point OMWA strategies. The LiTS2017 public dataset of liver tumor cases and real clinical cases was selected for verification. The results showed that OMWA could achieve faster thermal accumulation, higher central temperature, and more conformal tumor coverage. Compared with the single-needle strategy, OMWA significantly reduces thermal damage to surrounding healthy tissues while achieving complete tumor coverage. Therefore, OMWA is more efficient and safer than the single-needle strategy in the personalized treatment of large tumors and can provide important references for clinical preoperative planning and parameter optimization.