Apparatus, system and method for determining the position of a stent in an image of a vasculature structure

Abstract

The invention relates to a device (10) for determining the position of a stent (34, 36) in an image of a vascular system structure, the device (10) comprising: an input unit (12); a processing unit (14); and an output unit (16); wherein the input unit (12) is configured to receive a sequence of images (24) of a vascular system structure (38) comprising at least one vessel branch (44, 46); wherein the processing unit (14) is configured to: detect the positions of at least two markers (26, 28, 30, 32) for identifying the position of the stent in at least one of the images (24); and, at least for the vessel region in which the positions of the markers (26, 28, 30, 32) are detected, detect in at least one of the images (24) of the vascular system structure (38) a position of the stent (50, 52). at least one path indicator (64, 66, 74, 76) of at least one vessel branch (44, 46); associating the at least two markers (26, 28, 30, 32) with the at least one path indicator (64, 66, 74, 76) based on the detected position of the markers (26, 28, 30, 32) and the position of the at least one path indicator (64, 66, 74, 76); assigning the markers (26, 28, 30, 32) associated with the same path indicator (64, 66, 74, 76) to a marker group to indicate the position (50, 52) of at least one stent (34, 36) in the vascular system structure (38); and wherein the output unit (16) is configured to provide output data indicating the position of the markers (26, 28, 30, 32) of the marker group. The present invention provides an apparatus and method for improving the determination of the position of a stent in complex situations.

Description

Technical Field

[0001] The present invention relates to an apparatus, system and method for determining the position of a stent in an image of a vascular system structure. Background Art

[0002] In percutaneous coronary intervention, it is important that the coronary stent is fully expanded and in full contact with the coronary vessel wall after placement in a coronary stenotic lesion. In addition, correct positioning of the stent relative to the side branches of the vessel is critical, especially when the stent is placed in a coronary bifurcation. The stent is not always clearly visible under fluoroscopy or during an exposure run. Therefore, improvements in stent visibility during X-ray exposure facilitate interventional cardiologists to correctly place the stent and judge the clinical success of the intervention.

[0003] There are some complex cases where stents in different vessels of a bifurcated vessel structure overlap. In these cases, since the stents cannot be correctly detected, the improvement of the visibility of the stent cannot be performed.

[0004] US 8473030 B2 describes a prosthesis deployment device using a real-time monitoring method for monitoring the position of a blood vessel branching from another blood vessel. First, a multidimensional dataset of a portion of the blood vessel is acquired. Then, at least one marker is fixed to the blood vessel near the bifurcation. The position of the marker is determined in real time. Then, the position of the portion of the multidimensional dataset is updated based on the position of the marker. The method determines the position and / or orientation of the blood vessel or blood vessel branch before or during prosthesis deployment. However, it may not be possible to perform the determination of the position of several stents using this method. Summary of the invention

[0005] Therefore, it may be desirable to provide an apparatus and method that improves the determination of the position of a stent in complex situations.

[0006] The objects of the invention are solved by the subject-matter of the independent claims; further embodiments are incorporated in the dependent claims. It should be noted that the following described aspects of the invention also apply to the system, the method, the computer program element and the computer readable medium.

[0007] According to the present invention, a device for determining the position of a stent in an image of a vascular system structure is provided. The device comprises: an input unit; a processing unit; and an output unit; wherein the input unit is configured to receive a sequence of images of a vascular system structure including at least one vascular branch; wherein the processing unit is configured to: detect the positions of at least two markers for identifying the position of the stent in at least one of the images; at least for the vascular region where the positions of the markers are detected, detect at least one path indicator for the at least one vascular branch in at least one of the images of the vascular system structure; associate the at least two markers with the at least one path indicator based on the detected positions of the markers and the position of the at least one path indicator; assign the markers associated with the same path indicator to a marker group to indicate the position of at least one stent in the vascular system structure; and wherein the output unit is configured to provide output data indicating the positions of the markers of the marker group.

[0008] The image of the vasculature structure includes at least one blood vessel branch where the stent may be positioned. The stent may be detected using at least two markers positioned at the location of the stent. The locations of the at least two markers may be detected in the image of the vasculature structure by the processing unit.

[0009] The processing unit may also detect at least one path indicator in at least one of the images of the sequence of images of the vascular system structure. The path indicator indicates a path along at least one vessel branch in the region where the marker has been detected. Based on the path indicator, the processing unit determines the location of the vessel branch in the image of the vascular system structure. In an example, the path indicator may be determined before receiving the image of the vascular system structure showing the stent and the marker. In this example, the processing unit will detect the path indicator for the entire vessel branch and then extract the vessel region in which the marker is found.

[0010] After detecting the path indicators and thus the positions of the vessel branches, the processing unit compares the positions of the markers with the positions and extensions of one or more vessel branches. If the comparison confirms that the positions of two or more markers correspond to the same vessel branch, the respective markers are then associated with the respective path indicators.

[0011] The processing unit thus groups all markers into marker groups associated with the same path, i.e., marker groups arranged in a vessel branch. The marker groups or pairs can determine the position of the stent in the image of the vascular system structure. Since the markers of the marker group are all arranged on the same path, the marker group determines the position of a single stent in the image of the vascular system structure.

[0012] Thus, according to the invention, a marker can be associated with the correct stent so that the stent position can be consistently determined. In addition, the consistency of the existing determined stent position can be checked. This provides an improved determination of the stent in complex situations.

[0013] In an example, the processing unit may select at least one preliminary marking set before detecting the path indicator. This means that the processing unit will check the consistency of the selection according to the above description.

[0014] In an example, the device is used during a percutaneous coronary intervention (PCI).

[0015] In the example, the tag group includes two tags.

[0016] The term "marking for identifying the position of a stent" relates to a marking indicating a possible position of the stent. The marking may also be referred to as a "stent marking". However, it must be noted that the marking may be provided on the stent itself, or may also not be provided on the stent itself, but rather on a separate stent element, such as on a balloon or another device used for stent positioning.

[0017] In an example, vessel branches are detected from angiograms (ie, contrast-enhanced images) because contrast-filled vessels obscure lines in angiograms, and lines are detected from non-contrast-enhanced images. In an example, marker locations are detected from non-contrast-enhanced images.

[0018] In an example, a sequence of images including both contrast-enhanced images and non-contrast-enhanced images is provided.

[0019] According to an example, the input unit is configured to receive a sequence of images of a vascular system structure including at least two vascular branches; wherein the processing unit is configured to: detect positions of at least three markers for identifying a stent position; and at least for a vascular region where the positions of the markers are detected, detect a path indicator for the at least two vascular branches in at least one image of the images of the vascular system structure; associate the at least three markers with the path indicator based on the detected positions of the markers and the position of the path indicator; and assign markers associated with the same path indicator to a marker group to indicate the positions of at least two stents in the vascular system.

[0020] In this example, the image of the vascular system structure includes at least two vessel branches in which stents are positioned. One stent is arranged in one vessel branch and another stent is arranged in another vessel branch. At least two stents may overlap near a bifurcation of the vessel branch.

[0021] At least two markers may be used to locate each stent, i.e., for two stents in the image, there are at least four markers. In the image of the vasculature structure, two markers may overlap, which are located on different stents, because close to the bifurcation, the stents may be arranged at the same position in the image of the vasculature structure. Therefore, in an image with four markers, at least three markers are visible in the image. The positions of the at least three markers may be detected in the image by the processing unit.

[0022] The processing unit may also detect at least two path indicators in the image of the vasculature structure. Each path indicator indicates a path along one of the at least two vessel branches. Based on the path indicators, the processing unit determines the vessel branch. In an example, the path indicators may be defined in a separate image of the vasculature structure prior to receiving the image of the vasculature structure showing the stent and the marker.

[0023] After detecting a path indicator and thus a vessel branch, the processing unit compares the position of the marker with the extension of the vessel branch. If the comparison results in that the position of the marker and the path are located in the same vessel branch, the corresponding marker is associated with the corresponding path indicator. A marker can be associated with several path indicators, for example, when the vessels cross each other and the marker is located at the intersection.

[0024] The processing unit groups all the markers into marker groups associated with the same path, i.e., marker groups arranged in the same blood vessel branch. The marker group determines the position of the stent in the image. Since the markers of the marker group are all arranged on the same path, the marker group determines the position of the stent in the image.

[0025] Thus, according to the present invention, a marker can be associated with the correct stent so that the stent position can be consistently determined. In addition, the consistency of the existing determined stent position can be checked. This provides an improved determination of the stent in complex situations.

[0026] According to an example, the device also includes an image enhancement module for further image processing; wherein the output data is provided to the image enhancement module; and wherein the image enhancement module is configured to provide stent enhancement for at least one stent in at least a portion of the sequence of images to provide a stent enhanced image.

[0027] Stent enhancement is also called stent lifting. Stent enhancement images are also called stent lifting images.

[0028] For example, WO 2003 / 043516 describes image enhancement with respect to a stent shown in the image. The image enhancement is called StentBoost (trademark of Koninklijke Philips NV).

[0029] According to an example, the device further comprises: a display; wherein the display is configured to display the enhanced bracket image.

[0030] In an example, enhancement may refer to a change in contrast, demarcation of the support, and / or a change in color.

[0031] According to an example, for detecting the at least one path indicator the processing unit is configured to detect at least one line and / or a guidewire connecting the markers in at least one of the images of the vasculature structure as the at least one path indicator.

[0032] For detecting the two path indicators, the processing unit is configured to detect at least two lines and / or guidewires in the image of the vasculature structure connecting the position markers as path indicators.

[0033] According to an example, in order to detect at least one path indicator, the processing unit is configured to: detect at least one separate vessel branch in at least one image of the image of the vascular system structure as at least one path indicator; and / or detect at least one segmented vessel feature of at least one separate vessel branch in at least one image of the image of the vascular system structure as at least one path indicator.

[0034] In an example, the bifurcated vasculature is a priori angiographically contrasted before introducing a stent into the vasculature, ie before receiving an image of the bifurcated vasculature with at least two stents in two different vessel branches.

[0035] In an example, the segmented vessel features are vessel centerlines as determined from angiograms.

[0036] According to an example, the processing unit is further configured to detect at least two stent elements in the image of the bifurcated vasculature as path indicators, the at least two stent elements extending in different vessel branches and connecting positions of two markers of the at least two markers.

[0037] According to an example, the stent element is a balloon.

[0038] According to the present invention, a system for enhancing a stent image in an image of a vascular system structure is also provided, the system comprising: an image acquisition device; and a device for determining a position of a stent in an image of a vascular system structure according to the aforementioned description; wherein the image acquisition device is configured to acquire and provide a sequence of images of the vascular system structure.

[0039] In an example, the processing unit is configured to indicate the marking group in real time during PCI.

[0040] According to an example, the image acquisition device is: an ultrasound device; or an X-ray image acquisition device, preferably an angiography device.

[0041] According to the present invention, a method for determining the position of a stent in an image of a vascular system structure is also provided, the method comprising the following steps: a) detecting the positions of at least two markers for identifying the position of the stent in at least one of the images; b) detecting at least one path indicator for at least one vascular branch in at least one of the images of the vascular system structure for the vascular region where the positions of the markers are detected; c) associating the at least two markers with the at least one path indicator based on the detected positions of the markers and the position of the at least one path indicator; d) assigning markers associated with the same path indicator to a marker group to indicate the position of at least one stent in the vascular system; and e) providing output data indicating the positions of the markers of the marker group.

[0042] In an example, in order to detect the at least one path indicator, provided are: d1) detecting at least one line and / or guidewire connecting markers in an image of the vascular system structure as at least one path indicator; and / or d2) detecting at least one separate vessel branch in an image of the vascular system structure as at least one path indicator; and / or d3) detecting at least one segmented vessel feature of at least one separate vessel branch in an image of the vascular system structure as at least one path indicator.

[0043] According to the invention, there is also provided a computer program element for controlling an apparatus according to the above description or a system according to the above description, said computer program element being adapted to perform the method steps according to the above description when run by a processing unit.

[0044] According to the present invention, there is also provided a computer readable medium storing a program element according to the above description.

[0045] These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter. BRIEF DESCRIPTION OF THE DRAWINGS

[0046] Exemplary embodiments of the present invention will be described below with reference to the following drawings:

[0047] Figure 1 A schematic diagram of the system is shown.

[0048] Figure 2a -e shows a schematic diagram of an image of a vasculature structure illustrating the stent detection process.

[0049] Figure 3 Schematic diagram showing separate representations of two stents in an image of vasculature structure.

[0050] Figure 4 Schematic diagram showing an image of the vasculature structure with a guidewire.

[0051] Figure 5 Schematic diagram showing an image of contrast-enhanced vasculature structure.

[0052] Figure 6 A schematic flow chart of the method is shown. DETAILED DESCRIPTION

[0053] Figure 1 A system 15 for enhancing an image of a stent in an image of a vasculature structure is shown. The system 15 comprises an image acquisition device 11 and a device 10 for determining a position of a stent 34, 36 in an image of a vasculature structure.

[0054] The image acquisition device 11 acquires a sequence of images 24 of the vascular system structure 38. In one exemplary embodiment, the image acquisition device 11 may be an ultrasound device. In another exemplary embodiment, the image acquisition device 11 is an X-ray image acquisition device, preferably an angiography device. Furthermore, the image acquisition device 11 may be any image acquisition device capable of acquiring images of the vascular system structure 38.

[0055] In one exemplary embodiment, the image 24 of the vasculature structure 38 includes at least one vessel branch 44, 46. In another exemplary embodiment, the image 24 of the vasculature structure 38 includes at least two vessel branches 44, 46.

[0056] The vessel branches 44, 46 may include stents 34, 36. However, the stents 34, 36 are barely visible in the image 24 of the vasculature structure 38.

[0057] The image acquisition device 11 provides the device 10 with a sequence of images 24 of the vascular system structure 38 for determining the position of the stents 34 , 36 in the images of the vascular system structure.

[0058] Markers 26, 28, 30, 32 visible in the image of the vasculature structure are arranged at or near the stent 34, 36. The markers 26, 28, 30, 32 may be arranged on the stent 34, 36 or on a stent element of the stent 34, 36, such as on a balloon connected to the stent 34, 36. In addition, the markers 26, 28, 30, 32 may be radiopaque.

[0059] The device 10 comprises an input unit 12 for receiving a provided sequence of images 24 of a vasculature structure 38. Furthermore, the device 10 may comprise a processing unit 14, an output unit 16, an image enhancement module 13 and a display 22.

[0060] The processing unit 14 searches the sequence of images 24 to detect the positions of at least two markers 26, 28, 30, 32 for identifying a stent position 50, 52 in at least one of the images 24. Figure 2a to Figure 2d The search process is shown in FIG. The results of the search process are shown in FIG. Figure 2e shown.

[0061] Figure 2a An image 24 of a vasculature structure 38 including two vessel branches 44, 46 is shown. The image 24 is provided by the image acquisition device 11. Each vessel branch 44, 46 includes a stent 34, 36. Markers 26, 28, 30, 32 are associated with the stents 34, 36. Markers 26 and 28 are located on the stent 34, and markers 30 and 32 are located on the stent 36.

[0062] In an exemplary embodiment, the processing unit 14 may preliminarily group the markers 26, 28, 30, 32 immediately after detection, wherein each group refers to a preliminary position of a stent 34, 36. In this embodiment, the processing unit 14 will then provide a consistency check of whether these preliminary positions are consistent with the vasculature structure 38, because there may be a situation where the markers 28 and 32 are preliminarily grouped such that it will be determined that there is no position of a stent between the markers 28 and 32. However, in another exemplary embodiment, the processing unit 14 will not determine the preliminary position of the stent 34, 36 from the markers 26, 28, 30, 32, but will directly start with the detection path indicators 64, 66, 74, 76.

[0063] The processing unit 14 is configured to detect at least one path indicator 64, 66, 74, 76 of at least one vessel branch 44, 46. The path indicator 64, 66, 74, 76 indicates a path along the vessel branch 44, 46. This means that the path indicator 64, 66, 74, 76 provides the location of the vessel branch 44, 46 in the image 24 of the vasculature structure 38. Examples of path indicators 64, 66, 74, 76 are shown in FIG. Figure 4 and Figure 5 and will be discussed in detail below.

[0064] exist Figure 2b In FIG. 1 , a first exemplary embodiment of the path indicators 64, 66, 74, 76 are shown as lines of guidewires, which are the path indicators 64 and 66. Those lines or guidewires are shown as intersecting lines along the vessel branches 44, 46. Figure 2b, the paths indicated by the path indicators 64, 66 are shown as single hatching patterns along the vessel branches 44, 46. In the region where the paths intersect or overlap, i.e., at the bifurcation of the vasculature structure 38, the two hatching patterns form a cross hatching. The processing unit 14 searches for the path indicators 64, 66, 74, 76 at least in this region, where the markers 26, 28, 30, 32 are detected.

[0065] After identifying the locations of the vessel branches 44 and 46 using the path indicators 64, 66, 74, 76, the processing unit 14 associates the markers 26, 28, 30, 32 with the vessel branches 44 and 46. Figure 2b , the markers 26 and 28 are associated with the paths, i.e., the path indicators 64, 66, 74, 76 indicating the paths in the vessel branch 44. The markers 30 and 32 are associated with the path indicators 64, 66, 74, 76 indicating the paths and the vessel branch 46. In addition, the marker 26 may also be associated with the path indicators 64, 66, 74, 76 indicating the paths and the vessel branch 46, because the marker 26 is in the overlapping area covered by the two paths of the vessel branches 44, 46.

[0066] according to Figure 2c The processing unit 14 groups the marks 26 and 28 associated with the same path indicators 64, 66, 74, 76 into a mark group. The mark group including the marks 26 and 28 indicates the support position 50 of the support 34.

[0067] In addition, according to Figure 2d , markers 30 and 32 are grouped into a marker group by processing unit 14 and indicate a stent position 52 of stent 36. In an exemplary embodiment, processing unit 14 may also be configured to exclude marker 26 indicating stent position 52 from the marker group because marker 26 is already part of the marker group indicating stent position 50. In addition, portions of each stent 34, 36 are arranged in a bifurcation of vascular system structure 38. This means that markers 26 and 30 are close to each other. In some exemplary cases, those markers 26 and 30 may overlap so that they appear as a single marker. In this exemplary case, processing unit 14 may associate a single marker in a bifurcation with more than one marker group.

[0068] The output unit 16 provides output data indicating the positions of the markings 26 , 28 , 30 , 32 of the marking set.

[0069] The image enhancement module 13 for further image processing receives the output data from the output unit 16. The image enhancement module 13 provides stent enhancement for at least part of the sequence of stents 34, 36 and images 24 to provide a stent enhanced image 25.

[0070] Figure 2e Stent enhancement image 25 is shown. Stent enhancement image 25 includes an elevated stent image 54 for stent 34, stent image 54 providing an elevated image of stent 34, and an elevated stent image 56 for stent 36, instead of stents 34 and 36. Furthermore, elevated stent image 56 provides an elevated image of stent 36.

[0071] For example, lifting may be performed by changing the contrast of the image of stents 34 , 36 , by demarcating stents 34 , 36 in image 24 of vasculature structure 38 , and / or by changing the color of stents 34 , 36 in image 24 .

[0072] Processing unit 14 and image enhancement module 13 may process images of vasculature structure 24 in real time (ie, on the fly) during PCI.

[0073] The display 22 may display the stent-enhanced image 25. The display 22 may then provide the stent-enhanced image 25, wherein the two stents 34, 36 are replaced by the lifted stent images 54, 56, respectively.

[0074] exist Figure 3 In another exemplary embodiment shown, the display 22 can be configured to show two images 58, 56, wherein in image 58 only the bracket 34 is replaced by the lifting bracket image 54, and the bracket 36 is not replaced, and wherein in image 60 only the bracket 36 is replaced by the lifting bracket image 56, and the bracket 34 is not replaced.

[0075] Figure 4 Exemplary embodiments of path indicating elements 64 , 66 , 74 , 76 are shown. Figure 4 The image of the vasculature structure 24 shown includes wires or guidewires 64, 66, which are depicted as crossing lines along the vessel branches 44, 46. The wire or guidewire 64, 66 extending along the vasculature in one wire or guidewire 64 extends along the vessel branch 44, while the other wire or guidewire 66 extends along the vessel branch 46. The wires or guidewires 64, 66 can be used as path indicating elements 64, 66, 74, 76 by the processing unit 14. The wires or guidewires 64, 66 connect the markers 26, 28, 30, 32 in the image of the vasculature structure 24. According to Figure 4 , a wire or guide wire 64 connects markers 26 and 28. A wire or guide wire 66 connects markers 30 and 32.

[0076] exist Figure 5 Further exemplary embodiments of path indicating elements 64 , 66 , 74 , 76 are shown in . Figure 5A contrast-enhanced image 62 of the vasculature structure is shown, which may be an angiogram. Prior to acquiring the contrast-enhanced image 62 of the vasculature structure, a contrast agent is introduced into the vessel branches 44, 46. As a result, the vessel branches 44, 46 are clearly visible, and the contrast-enhanced image 62 of the vasculature structure is clearly visible. The processing unit 14 may analyze the contrast-enhanced image 62 of the vasculature structure to detect the extension of the vessel branches 44, 46 as the center lines of the vessel branches 44, 46. Alternatively or additionally, the analysis of the contrast-enhanced image 62 of the vasculature structure provides segmented vessel features of the vessel branches 44, 46. The contrasted vessel branches 44, 46 then provide path indicators 74, 76, wherein the path indicator 74 refers to the location of the path in the vessel branch 44, and the path indicator 76 refers to the location of the path in the vessel branch 46.

[0077] Figure 6 A flow chart of a method 100 for determining the position of a stent 34 , 36 in an image of a vasculature structure 24 is shown.

[0078] The image acquisition device may provide 101 a series of images of a vascular system structure including at least one blood vessel branch. The device for determining the position of a stent in an image of a vascular system structure may receive the image of the vascular system structure. The image may be received using an input unit of the device. In step a), a processing unit of the device may detect 102 the position of at least two markers for identifying the position of the stent at at least one of the images.

[0079] According to step b), at least one path indicator can be detected 103 in at least one vessel branch in at least one of the images. The detection can be performed in a vessel region in which the position of the marker has been previously detected. Furthermore, the detection can be performed using a processing unit. The path indicator can be, for example, a line or a guidewire along a vessel branch according to step b1), for example a previously acquired position of an individual vessel branch in the vascular system according to step b2), or at least one segmented vessel feature of at least one individual vessel branch according to step b3). For the detection of the line or the guidewire along the vessel branch, an image of the vascular system structure can be used, wherein the image of the vascular system structure does not include contrast enhancement of the vessels. For the detection of the position of the vessel branch, a contrast-enhanced image of the vascular system structure can be analyzed.

[0080] According to step c), at least two markers are associated with at least one path indicator based on the detected positions of the markers and the position of at least one path indicator 104. This means that the positions of the two markers are mapped to the position of the path indicator. If the position of the marker matches the position of the path indicator, this means that the marker and the path indicator are in the same vessel branch. The association may be performed by a processing unit.

[0081] In step d), the markings associated with the same path indicator are assigned 105 to a marking group. The marking group indicates the position of at least one stent in the vascular system. The assignment may be performed by a processing unit.

[0082] The positions of the markings of the marking set may be provided 106 as output data. This means that the output data indicates the positions of the markings in the marking set. The output data may be provided by an output unit.

[0083] The output data may be used to perform 107 stent enhancement with at least one stent in at least part of the sequence of images. Standard enhancement provides stent enhanced images. Furthermore, stent enhancement may be performed using a stent enhancement module.

[0084] In addition, the stent enhancement image can be received by a display. The display can display 108 the stent enhancement image to the user. The display can display the stent enhancement image as a single image, wherein all stents are enhanced. Alternatively or additionally, the display can display several stent enhancement images, each stent enhancement image showing a single enhanced stent, wherein the remaining stents are not shown in an enhanced manner. The enhancement of the stent in the stent enhancement image can be provided by a change in contrast, a change in color, or by delimiting the stent.

[0085] The method 100 may be performed in real time (ie, on the fly) during PCI.

[0086] In another exemplary embodiment of the present invention, there is provided Figure 1 The computer program or computer program element 18 shown is characterized by being adapted to execute the method steps of the method according to one of the above-described embodiments on a suitable system.

[0087] Therefore, the computer program element can be stored on a computer unit, which can also be part of an embodiment of the present invention. The computing unit can be suitable for executing the steps of the method described above or inducing the execution of the steps of the method described above. In addition, it can be suitable for operating the components of the device described above. The computing unit can be suitable for automatically operating and / or executing the user's commands. The computer program can be loaded into the working memory of a data processor. The data processor can thus be equipped to perform the method of the present invention.

[0088] This exemplary embodiment of the invention covers both a computer program that right from the beginning uses the invention and a computer program that, by means of an up-date, turns an existing program into a program that uses the invention.

[0089] Furthermore, the computer program element can provide all necessary steps for implementing the procedures of an exemplary embodiment of the method as described above.

[0090] According to another exemplary embodiment of the present invention, a method is proposed as follows Figure 1 The computer readable medium 20 shown is, for example, a CD-ROM, wherein the computer readable medium 20 has a computer program unit 18 stored on the computer readable medium, the computer program unit 18 being described in the previous section. The computer program may be stored / distributed on a suitable medium, such as an optical storage medium or a solid-state medium provided together with or as part of other hardware, but the computer program may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.

[0091] However, the computer program may also be present on a network such as the World Wide Web and can be downloaded from such a network into a working memory of a data processor. According to a further exemplary embodiment of the present invention, a medium for making a computer program element available for downloading is provided, wherein the computer program element is arranged to perform a method according to one of the previously described embodiments of the present invention.

[0092] It must be noted that embodiments of the present invention are described with reference to different subject matters. Specifically, some embodiments are described with reference to method type claims, while other embodiments are described with reference to device type claims. However, a person skilled in the art will appreciate from the above and following descriptions that, unless otherwise indicated, in addition to any combination of features belonging to one type of subject matter, any combination between features relating to different subject matters is also considered to be disclosed by the present application. However, all features can be combined to provide synergistic effects that exceed the simple sum of the features.

[0093] Although the present invention has been described and illustrated in detail in the drawings and the foregoing description, such illustration and description are to be considered illustrative or exemplary rather than restrictive. The present invention is not limited to the disclosed embodiments. Other variations of the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention by studying the drawings, the description, and the appended claims.

[0094] In the claims, the word "comprising" does not exclude other elements or steps, and the word "a" or "an" does not exclude a plurality. A single processor or other unit may fulfill the functions of several items recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. Any reference signs in the claims should not be construed as limiting the scope.

Claims

1. A device for determining the position of a stent in an image of a vascular system structure, the device (10) comprising: - Input unit (12); - Processing unit (14); as well as - Output unit (16); wherein the input unit (12) is configured to receive a sequence of images (24) of a vascular system structure (38) including at least one vessel branch (44, 46); Wherein, the processing unit (14) is configured to: - detecting the position of at least two markings (26, 28, 30, 32) for identifying the position of the stent (50, 52) in at least one of the images (24); - detecting, at least for the vessel region in which the position of the marking (26, 28, 30, 32) is detected, at least one path indicator (64, 66, 74, 76) for the at least one vessel branch (44, 46) in at least one of the images (24) of the vascular system structure (38), wherein the at least one path indicator (64, 66, 74, 76) is detected by: - detecting at least one individual vessel branch (44, 46) in at least one of the images (24) of the vasculature structure (38) as the at least one pathway indicator (64, 66, 74, 76); and / or - detecting at least one segmented vessel feature (74, 76) of the at least one individual vessel branch (44, 46) in the at least one of the images (24) of the vasculature structure (38) as the at least one path indicator (64, 66, 74, 76); - associating the at least two markers (26, 28, 30, 32) with the at least one path indicator (64, 66, 74, 76) based on the detected positions of the markers (26, 28, 30, 32) and the position of the at least one path indicator (64, 66, 74, 76); - assigning markings (26, 28, 30, 32) associated with the same path indicator (64, 66, 74, 76) to the marking group to indicate the position (50, 52) of at least one stent (34, 36) in the vasculature structure (38); and Wherein the output unit (16) is configured to provide output data indicating the positions of the markings (26, 28, 30, 32) of the marking set.

2. The device according to claim 1, in, The input unit (12) is configured to receive a sequence of images (24) of a vasculature structure (38) comprising at least two vessel branches (44, 46); Wherein, the processing unit (14) is configured to: - detecting the positions of at least three markers (26, 28, 30, 32) for identifying the position of the stent (50, 52); and - detecting, at least for the vessel region in which the position of the marking (26, 28, 30, 32) is detected, path indicators (64, 66, 74, 76) for the at least two vessel branches (44, 46) in at least one of the images (24) of the vasculature structure (38); - associating the at least three markers (26, 28, 30, 32) with the path indicator (64, 66, 74, 76) based on the detected positions of the markers (26, 28, 30, 32) and the position of the path indicator (64, 66, 74, 76); and - assigning markings (26, 28, 30, 32) associated with the same path indicator (64, 66, 74, 76) to the marking group to indicate the position of at least two stents (34, 36) in the vasculature structure (38).

3. The device according to claim 1 or 2, further comprising: - an image enhancement module (13) for further image processing; wherein the output data is provided to the image enhancement module (13); and Wherein, the image enhancement module (13) is configured to provide stent enhancement for the at least one stent (34, 36) in at least part of the sequence of images (24) to provide a stent enhanced image (25).

4. The device according to claim 3, further comprising: - Display (22); Wherein, the display (22) is configured to display the stent-enhanced image (25).

5. The device according to one of claims 1 to 4, wherein: In order to detect the at least one path indicator (64, 66, 74, 76), the processing unit (14) is configured to: - detecting at least one line and / or guidewire (64, 66) connecting markers (26, 28, 30, 32) in at least one of the images (24) of the vasculature structure (38) as the at least one pathway indicator (64, 66, 74, 76).

6. The device according to one of claims 1 to 5, wherein: The processing unit (14) is further configured to detect at least two stent elements in the image (24) of the vascular system structure (38) as path indicators (64, 66, 74, 76), the at least two stent elements extending in different vessel branches (44, 46) and connecting the positions of two of the at least two markers (26, 28, 30, 32).

7. The device according to claim 6, wherein: The stent element is a balloon.

8. A system for enhancing a stent image in an image of a vascular system structure, comprising: - Image acquisition device (11); as well as - a device (10) for determining the position of a stent (34, 36) in an image of a vascular system structure according to one of the preceding claims; Therein, the image acquisition device (11) is configured to acquire and provide the sequence of images (24) of the vascular system structure (38).

9. The system according to claim 8, wherein: The image acquisition device (11) is: - Ultrasound equipment; or - X-ray image acquisition equipment, including angiography equipment.

10. A method for determining a position of a stent in an image of a vascular system structure, the method (100) comprising the following steps: a) detecting (102) the positions of at least two markers for identifying the position of the stent in at least one image; b) detecting (103) at least one path indicator for at least one vessel branch in the at least one image of the vascular system structure, at least for the vessel region in which the position of the marker is detected, wherein the at least one path indicator is detected by: - detecting at least one individual vessel branch in the at least one image of the vasculature structure as the at least one pathway indicator; and / or - detecting at least one segmented vessel feature of at least one individual vessel branch in the at least one image of the vasculature structure as the at least one pathway indicator; c) associating the at least two markers with the at least one path indicator based on the detected positions of the markers and the position of the at least one path indicator (104); d) assigning (105) a marker associated with the same path indicator to the marker group to indicate the position of at least one stent in the vasculature structure; and e) providing (106) output data indicative of the positions of the markers of the set of markers.

11. The method according to claim 10, wherein: In order to detect the at least one path indicator, it is provided that: b1) Detecting at least one line and / or a guidewire connecting markers in the image of the vasculature structure as the at least one pathway indicator.

12. A computer program product comprising computer program instructions adapted to perform the steps of the method according to claim 10 or 11 when executed by a processing unit.

13. A computer readable medium storing computer program instructions adapted to perform the steps of the method according to claim 10 or 11 when executed by a processing unit.

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