射频消融（RFA）是治疗肝肿瘤的有效方法。术前路径规划在RFA治疗中扮演着关键角色，需要医生具备丰富的经验和能力。具体而言，正确且高效的术前路径规划应确保穿刺过程的整体安全性、肿瘤完全消融以及对健康组织的最小损伤。本文提出了一种针对肝肿瘤的高安全性自动多点穿刺路径规划方法，研究了在综合临床约束下优化消融次数、穿刺次数、目标位置和穿刺点位置的问题。特别地，考虑了穿刺路径的安全性和消融椭球体的分布。详细讨论了每个约束对整个穿刺过程安全性的影响。在此基础上，通过简化计算数据和优化变量明显提高了规划方法的效率。此外，还对所提出的方法在大小肿瘤上的性能和适应性进行了比较和总结。本文在7例患者的10个具有不同几何特征的肝肿瘤上进行了评估。测试结果显示，平均路径规划时间为41.4秒，平均消融效率为60.19%。对于不同大小的肿瘤，所提出的方法得到的规划结果具有相似的健康组织覆盖率。经过医生的临床评估，规划结果满足RFA治疗肝肿瘤的需求。所提出的方法能够提供合理的RFA规划穿刺路径，有助于确保肝肿瘤消融的安全性和效率。版权所有 © 2023 Elsevier B.V. 发表。

Radiofrequency ablation (RFA) is an effective method for the treatment of liver tumors. Preoperative path planning, which plays a crucial role in RFA treatment, requires doctors to have significant experience and ability. Specifically, correct and highly active preoperative path planning should ensure the safety of the whole puncturing process, complete ablation of tumors and minimal damage to healthy tissues.In this paper, a high-security automatic multiple puncture path planning method for liver tumors is proposed, in which the optimization of the ablation number, puncture number, target positions and puncture point positions subject to comprehensive clinical constraints are studied. In particular, both the safety of the puncture path and the distribution of ablation ellipsoids are taken into consideration. The influence of each constraint on the safety of the whole puncturing process is discussed in detail. On this basis, the efficiency of the planning method is obviously improved by simplifying the computational data and optimized variables. In addition, the performance and adaptability of the proposed method to large and small tumors are compared and summarized.The proposed method is evaluated on 10 liver tumors of various geometric characteristics from 7 cases. The test results show that the average path planning time and average ablation efficiency are 41.4 s and 60.19%, respectively. For tumors of different sizes, the planning results obtained from the proposed method have similar healthy tissue coverage. Through the clinical evaluation of doctors, the planning results meet the needs of RFA for liver tumors.The proposed method can provide reasonable puncture paths in RFA planning, which is beneficial to ensure the safety and efficiency of liver tumor ablation.Copyright © 2023. Published by Elsevier B.V.