A lung biopsy path planning algorithm based on the double spherical constraint Pareto and indicators’ importance-correlation degree

Lung cancer has the highest mortality rate among cancers. The commonly used clinical method for diagnosing lung cancer is the CT-guided percutaneous transthoracic lung biopsy (CT-PTLB), but this method requires a high level of clinical experience from doctors. In this work, an automatic path planning method for CT-PTLB is proposed to provide doctors with auxiliary advice on puncture paths. The proposed method comprises three steps: preprocessing, initial path selection, and path evaluation. During preprocessing, the chest organs required for subsequent path planning are segmented. During the initial path selection, a target point selection method for selecting biopsy samples according to biopsy sampling requirements is proposed, which includes a down-sampling algorithm suitable for different nodule shapes. Entry points are selected according to the selected target points and clinical constraints. During the path evaluation, the clinical needs of lung biopsy surgery are first quantified as path evaluation indicators and then divided according to their evaluation perspective into risk and execution indicators. Then, considering the impact of the correlation between indicators, a path scoring system based on the double spherical constraint Pareto and the importance-correlation degree of the indicators is proposed to evaluate the comprehensive performance of the planned paths. The proposed method is retrospectively tested on 6 CT images and prospectively tested on 25 CT images. The experimental results indicate that the method proposed in this work can be used to plan feasible puncture paths for different cases and can serve as an auxiliary tool for lung biopsy surgery.