通过轮廓约束提升头颈手术标本配准精度,降低术后复发病灶定位误差。
Contour-Constrained Deformable Registration with Parameter Characterization for Head and Neck Surgical Guidance

- 基于弹性力学的可变形配准,融合表面点云、标志点与边界轮廓约束。
- 在舌部组织上误差降低至5.62±2.28毫米,较刚性配准减少49.41%。
- 边界约束权重对大侧向变形组织最关键,参数组合灵活适应性强。
全球每年新增约89万例头颈鳞状细胞癌,是复发率最高的实体恶性肿瘤之一。尽管冰冻切片分析是术中边缘评估的标准方法,但因切除标本与创面间对齐不准确,加之黏膜组织术后收缩,精准定位阳性边缘仍具挑战。本文提出一种基于生物力学的可变形配准框架,用于校正术后组织形变,提供术中导航支持。该方法采用正则化凯尔文基函数的可变形配准,将三维标本网格与术中创面点云进行匹配,同时考虑表面点云、标志点及边界轮廓约束,直接惩罚标本与创面边界间的垂直距离偏差。在来自皮肤、颊黏膜和舌部的九个标本上,刚性配准的平均目标配准误差为11.11±4.07毫米,使用无轮廓约束的可变形配准后降至8.20±2.68毫米(降低26.19%),而引入轮廓约束后进一步降至5.62±2.28毫米,较刚性配准减少49.41%。其中舌部组织的误差下降最为显著。我们还进行了两阶段系统性参数搜索,以表征表面匹配、标志点对应、轮廓约束和应变能正则化的相对重要性。结果表明,对于大侧向变形组织,轮廓权重主导配准精度,且算法在广泛参数组合下仍保持稳定性能。
原文摘要 · Abstract (English)
With 890,000 annual new cases globally, head and neck squamous cell carcinoma has one of the highest recurrence rates among solid malignancies. Although frozen section analysis is the standard of care for intraoperative margin assessment, accurately relocating detected positive margins on the resection bed remains challenging due to imprecise alignment between resected specimens and their resection bed, compounded by post-resection mucosal tissue shrinkage. We present a biomechanics-driven deformable registration framework that corrects post-resection tissue deformation to provide intraoperative guidance. Our approach registers 3D specimen meshes to intraoperative resection bed point clouds using a deformable registration approach based on regularized Kelvinlet basis functions. The registration matches surface point clouds, fiducial landmarks, and boundary contour constraints that directly penalize perpendicular distance-to-agreement between specimen and resection bed boundaries. Across nine specimens from skin, buccal mucosa, and tongue sites, the overall mean target registration error was $11.11 \pm 4.07$ mm using rigid registration, which decreased to $8.20 \pm 2.68$ mm (26.19\% reduction) using deformable registration without contour constraint. The proposed contour-constrained deformable registration further reduced the error to $5.62 \pm 2.28$ mm, a 49.41\% reduction relative to rigid registration. We observed the largest reduction in the most clinically challenging tongue specimens. We also performed a systematic two-stage parameter search to characterize the relative importance of surface alignment, fiducial correspondences, contour constraint, and strain energy regularization. This search revealed that contour weighting dominates registration accuracy for tissue types with large lateral deformation, while the algorithm operates over a broad range of parameter combinations.
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