Bracket positioning

Abstract

The present invention relates to positioning of a stent or other medical interventional device. In order to provide improved marker detection suitable for smaller markers, a device (10) for supporting positioning of a medical interventional device is provided. The device comprises a data input interface (12), a data processing unit (14) and a data output interface (16). The data input interface is configured to provide at least one image of a region of interest of an object. In the at least one image, at least part of a guiding device for the medical interventional device is arranged in the region of interest, the part of the guiding device comprising at least one device position marker visible in the at least one image. In addition, in the at least one image, the medical interventional device is at least partly arranged in the region of interest, the medical interventional device comprising a device position marker, the device position marker being less visible in the image than the at least one device position marker. The data processing unit is configured to: detect the at least one device position marker in the at least one image, define a proximity region in the at least one image based on the at least one device position marker, select the proximity region, detect the device position marker in the proximity region, and enhance the device position marker in the at least one image to support positioning of the medical interventional device. The data output interface is configured to provide the at least one image with enhanced device location markers.

Description

Technical Field

[0001] The present invention relates to the positioning of a stent or other medical interventional device, and in particular to a device for positioning a medical interventional device, a medical imaging system and a method for positioning a medical interventional device (e.g., a stent), as well as a computer program unit for controlling the device and a computer-readable medium storing the program unit. Background Art

[0002] In minimally invasive surgery, it is known that medical intervention devices such as stents or other forms or prostheses are inserted into a lumen, for example, into the vascular system or tissue structure of an object via a guide device such as a guide wire. In order to correctly place the medical intervention device, the relative position of the medical intervention device must be determined. To this end, the current position of the device is determined and related to the object. An example of current position determination is the use of X-ray radiation to determine the relative position in an image of a region of interest. Other position determination methods can use electromagnetic waves to locate position markers inside the object and align these positions with the image data of the data. In order to indicate the current position of a medical intervention device that is difficult to see or even invisible in the X-ray image itself, a device marker visible in the X-ray can be used. However, it has been shown that even device marker detection may be troublesome, for example because of the need for a small-sized structure of the device, which also requires smaller markers. For example, examples of such smaller markers are provided on bioresorbable stents. Summary of the invention

[0003] Therefore, there may be a need for improved marker detection suitable for smaller and less X-ray visible markers.

[0004] 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 aspects of the invention described below also apply to a device for positioning a medical intervention device, a medical imaging system and a method for positioning a medical intervention device.

[0005] According to the present invention, a device for positioning a medical intervention device is provided. The device comprises a data input interface, a data processing unit and a data output interface. The data input interface is configured to provide at least one image of a region of interest of an object. In the at least one image, at least part of a guiding device for the medical intervention device is arranged in the region of interest, and the part of the guiding device comprises at least one device position marker visible in the at least one image. In addition, in the at least one image, the medical intervention device is at least partly arranged in the region of interest, and the medical intervention device comprises a device position marker, and the device position marker is less visible in the image than the at least one device position marker. The data processing unit is configured to: detect the at least one device position marker in the at least one image, and define a proximity region in the at least one image based on the at least one device position marker. The data processing unit is further configured to select the proximity region, detect the device position marker in the proximity region, and enhance the device position marker in the at least one image to support positioning of the medical intervention device. The data output interface is configured to provide the at least one image with the enhanced device position marker.

[0006] The medical intervention device can be, for example, a stent to be inserted into the vascular system or an organ or a tissue structure. As a further example, the medical intervention device can also be a prosthesis, for example, an artificial heart valve.

[0007] Advantageously, detection of device location markers is provided only for a selected portion of the image of the region of interest. The selected portion can then be searched in more detail, thereby increasing accuracy and reducing the risk of detecting false positives. Thus, the selection of a portion of the image also allows for searching for smaller markers. By defining a selected portion of the image for device location markers, the workload of device detection can also be reduced.

[0008] The term "proximity area" relates to an area around a detected object, i.e. an area in the vicinity of the object. The proximity area can also be referred to as a neighboring area or a surrounding area. The size or extension of the proximity area can be determined, selected or chosen depending on the range of positions of (smaller) device position markers to be found. The proximity area is determined such that only a smaller part of the entire image is selected, resulting in less than half of the image, for example a third or a quarter or a fifth of the image. In an example, the proximity area is less than one tenth of the image. In another example, the proximity area is less than 5% of the image, for example less than 1% of the image.

[0009] "Guiding device" can be understood as any device or device or part thereof that can be used to guide and / or carry a medical intervention device. For example, for a stent as a medical intervention device, the guiding device may include one or more of a guide wire, a stent balloon, or a balloon catheter.

[0010] According to an example, the data input interface is configured to provide the at least one image with a stent as the medical intervention device at least partially arranged in the region of interest.

[0011] According to an example, the data processing unit is configured to define the proximity zone as a zone around the at least one device location marker.

[0012] According to an example, the guiding device further comprises a guide wire, and the data processing unit is configured to define the approach region as an image area having a longitudinal extension direction along the guiding device.

[0013] According to the present invention, a medical imaging system is also provided. The system comprises: an imaging device having an X-ray source and an X-ray detector, and a device for positioning a medical intervention device according to one of the aforementioned examples. The imaging device is configured to generate at least one image of a region of interest of an object.

[0014] Optionally, the image is a fluoroscopic image.

[0015] Medical imaging systems can also be referred to as interventional imaging systems.

[0016] According to an example, the system further comprises a guiding device for a medical intervention device, the guiding device comprising the at least one device position marker. The system further comprises a medical intervention device, the medical intervention device comprising the device position marker.

[0017] In one option, the medical intervention device is a stent to be deployed, and the device position marker is a stent position marker. The guide device is a stent guide device, and the at least one device position marker is at least one guide device position marker.

[0018] According to an example, the stent guide device is a balloon device to which a stent to be deployed is attached. The at least one guide device position marker is a balloon marker. The data processing unit is configured to define the access area based on the at least one balloon marker.

[0019] According to the present invention, a method for positioning a medical intervention device is also provided. The method comprises the following steps:

[0020] a) providing at least one image of a region of interest of an object;

[0021] b1) detecting in the at least one image at least one device position marker for a guiding device of a medical interventional device at least partially arranged in the region of interest;

[0022] b2) defining a proximity area in said at least one image based on said at least one device location marker;

[0023] c1) selecting the proximity area;

[0024] c2) detecting in the approach region a device position marker of the medical intervention device at least partially arranged in the region of interest, the device position marker being less visible in the image than the at least one guiding device marker;

[0025] d) enhancing the device location marker in the at least one image to support positioning of the medical intervention device.

[0026] In an example, the method is applied to percutaneous coronary intervention (PCI), for example using a bioresorbable stent (BVS).

[0027] In another example, the present invention uses other proximity objects, such as other guide tools or support tools for medical interventional devices, thereby detecting other objects besides stent markers.

[0028] According to an example, the medical intervention device is a stent to be deployed, and the device position marker is a stent position marker. In addition, the guide device is a stent guide device, and the device position marker is a device position marker.

[0029] In one option, the stent guide device is a balloon device to which a stent to be deployed is attached, and the at least one guide device position marker is a balloon marker. The access region is defined based on the at least one balloon marker.

[0030] According to an example, the access area is defined as a zone around at least one device position marker. Additionally or alternatively, the guide device further comprises a guide wire, and the access area is defined as the image area having a longitudinal extension direction along the guide wire.

[0031] According to an example, a sequence of images is provided. Steps b1) to c2) are provided for each of the images. Additionally, prior to step d), the following steps are provided: temporally registering the images based on respective detected device location markers, thus providing temporal enhancement of the images. The images are centered relative to each other based on: i) the detected device location markers; or ii) the detected at least one device location marker.

[0032] According to one aspect, image data of a region of interest is provided in which a device, such as a stand, is assumed to be placed and precisely positioned. However, the device is difficult to detect in the image data of the region of interest. As a first detection method for locating the device, an indicator that is believed to be related to the portion of the image in which the device is arranged is detected. The indicator is selected as a structure or feature that is easier to detect in the image data of the region of interest than the device. Based on the indicator, a portion of the image is selected. As a second detection method, a selected portion of the image is then captured to detect the device itself. Therefore, the image of the region of interest is divided into a portion of more detailed interest for the location of the device and a portion that will not be used further for the location of the device. Detection of the device is provided only for the selected portion of the image of the region of interest.

[0033] 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

[0034] Exemplary embodiments of the present invention will be described below with reference to the following drawings:

[0035] Figure 1 Steps of an example of a method for positioning a medical intervention device are shown.

[0036] Figure 2 X-ray images of a stent as an example of a medical intervention device and a balloon as an example of a device for positioning the stent are shown.

[0037] Figure 3 Another example of a method for positioning a medical intervention device is shown.

[0038] Figure 4 Further examples of methods for positioning a medical intervention device are shown.

[0039] Figure 5 An example of a device for positioning a medical intervention device is schematically illustrated.

[0040] Figure 6 An example of a medical imaging system is schematically illustrated.

[0041] Figure 7 A catheter with a balloon and a stent is schematically illustrated. DETAILED DESCRIPTION

[0042] exist Figure 1 , an example of a method 100 for positioning a medical intervention device is shown.

[0043] The method 100 comprises the following steps:

[0044] In a first step 102 (also referred to as step a)), at least one image of a region of interest of an object is provided. In the at least one image, at least part of a guiding device for a medical intervention device is arranged in the region of interest, the part of the guiding device comprising at least one device position marker visible in the at least one image. In addition, in the at least one image, the medical intervention device is at least partly arranged in the region of interest, the medical intervention device comprising a device position marker, which is less visible in the image than the at least one guiding device marker.

[0045] In a second step 104 (also referred to as step b1)), at least one device location marker is detected in at least one image.

[0046] In a third step 106 (also referred to as step b2)), a proximity area is defined in at least one image based on at least one device location marker.

[0047] In a fourth step 108 (also referred to as step c1)), a proximity area is selected.

[0048] In a fifth step 110 (also referred to as step c2)), a device position marker is detected in the proximity area.

[0049] In a sixth step 112 (also referred to as step d)), device position markers are enhanced in at least one of the images to support the positioning of the medical intervention device.

[0050] The second step b1) and the third step b2) can be considered as respective first and second sub-steps provided for completing the first detection step b) of the at least one image (indicated with the hashed first frame 114).

[0051] The fourth step c1) and the fifth step c2) can be considered as respective first and second sub-steps of a second detection step c) (indicated by the hashed second frame 116) provided for a selected area (ie a proximity area, called proxy area).

[0052] exist Figure 2, an X-ray image 118 of a stent as an example of a medical interventional device is shown. A guidewire 120 is shown as being used as a guide and insertion device. A balloon is provided as an example of a device for positioning the stent. The balloon is provided on the guidewire and indicated by two position markers 122 (also referred to as balloon markers). The stent is arranged on the balloon, and as the balloon expands, the stent can be expanded and brought in and placed in the appropriate position. The stent is indicated by two barely visible stent markers 124. The stent can be provided as a bioabsorbable stent. The X-ray image 128 can be a collimated fluoroscopic image of a region of interest acquired live during the inspection to support the positioning of the stent. Collimation can be provided, for example, in the form of an elliptical diaphragm.

[0053] In an example of the method not shown in further detail, the medical intervention device is a stent to be deployed and the device position marker is a stent position marker. The guiding device is a stent guiding device and the device position marker is a device position marker. As an option, the stent guiding device provided is a balloon device to which the stent to be deployed is attached. At least one device position marker is a balloon marker. The access area is defined based on the at least one balloon marker.

[0054] The device for positioning a medical intervention device can also be referred to as a device for positioning a stent.

[0055] If the medical intervention device is provided as one stent or as two or more stents, the device position marker is provided as a stent marker.

[0056] In the example, the stent is a bioabsorbable stent. Note that, for example, a bioabsorbable stent (BVS) may be beneficial for the long-term outcome of stenosis treatment. A bioabsorbable stent may be used when treating, for example, a long stenosis in a young subject. Treatment of a long area may imply the need to implant several bioabsorbable stents in succession. Marker detection based on proximity definition facilitates, for example, the placement of stents relative to each other. As an advantage, the stents can be positioned close enough to completely cover the artery while minimally overlapping so as not to airtightly cover portions of the vessel. Even if the bioabsorbable stent is transparent (or at least nearly transparent) to X-rays, minimal overlap of adjacent stents can be achieved by placing the distal markers of the stent next to the proximity markers of the adjacent stent, so that the overlap is less than, for example, 1 mm.

[0057] Although bioresorbable stent markers can be so small that detecting them directly in an image is nearly impossible, by first selecting a region of proximity, detection of the stent markers can be achieved.

[0058] In one aspect, in a first step, the (larger and more contrasty) balloon markers are detected, and then in a second step, the (smaller and darker) markers of the stent itself are looked for in the vicinity of the balloon markers.

[0059] As a result, the user can be presented with a view that is superior to that using existing stent-augmented techniques alone. Thus, in an example, a blur-free image can be provided even while the balloon position is readjusted to achieve smooth and comfortable stent positioning, for example. This is particularly useful in situations where the stent cannot move with exactly the same motion as the balloon markers, which is more likely to be the case when the stent markers are far from the balloon markers.

[0060] The two-step detection process facilitates the use of smaller markers for stents. The two-step detection process also allows for the use of lower doses of X-ray radiation.

[0061] The two-step detection process can also center the target area and move the manipulated object relative to the target area, which is more intuitive.

[0062] Two-step detection also offers the advantage of indicating stent position even when the stent disappears completely and no structure moves in coherence with the balloon markers when the clinician repositions their balloon.

[0063] The clinician is provided with gestural support, wherein a solution focusing on, for example, stent markers continuously enhances the stent markers, for example by means of enhancement, highlighting and / or stabilization.

[0064] In the example, it is proposed to perform the detection of stent markers in dependence on proximity, i.e., in two steps: identifying easily detectable proximity objects close to structures of interest. For example, these easily detectable proximity objects may be (larger and more contrasting) balloon markers; and, looking for barely detectable structures of interest near the proximity objects, such as (small and faint) stent markers. Once the detection is done, the solution can be enhanced, for example, highlighting, enhancement or stabilization can be provided.

[0065] The device for positioning a support can also be referred to as a device for determining the position of a support or a device for supporting the positioning of a support.

[0066] The data input interface can also be referred to as an image data input interface, and the data output interface can also be referred to as an image data output interface.

[0067] In a further example of the method, which is not shown in further detail, the proximity zone is defined as a region around at least one device location marker.

[0068] In a further example of the method, not shown in further detail, additionally or alternatively, a guide device is provided, which further comprises a guide wire, and the access area is defined as an image area having a longitudinal extension direction along the guide wire.

[0069] exist Figure 3 , a further example of a method for positioning a medical interventional device is shown. In step a), a sequence of 128 images is provided. As indicated by dashed line 132, steps b1) to c2) are provided for each of the images. Prior to step d), the following step is provided: the images are temporally registered 130 based on the corresponding detected device position markers, which provides a temporal enhancement of the images. For example, the images are centered relative to each other based on i) the detected device position markers or ii) the detected at least one device position marker.

[0070] exist Figure 4 , yet another example of a method for positioning a medical intervention device is shown. A fluoroscopic image is provided 134 as input.

[0071] On the first frame one or several so-called proxy objects are detected 136, which allow to define regions in the corresponding image, i.e. to find compact areas with low visibility, e.g. faint markers. The term "proxy object" refers to an object that can be easily detected to provide a basis for defining a region within an image, which is then selected for a more detailed search to detect the actual marker of interest. The proxy object can be, for example, a marker of a catheter, a marker of a balloon or a guidewire present in the image. The defined region is also referred to as a BVS region. An example for an actual marker with low visibility is a marker of a bioresorbable stent (BVS marker).

[0072] A specific detector searches for (ie, detects 138) the location of the BVS marker in the region.

[0073] The detected BVS markers are then used to enhance 140 a bioresorbable scaffold (BVS).

[0074] Once the first image has been processed, a BVS region of interest (essentially, the BVS markers are expected to remain close to their last detected position) can be defined using temporal merging 142. This option is indicated with a dashed line. As indicated with a dashed frame 144, temporal merging can replace or supplement the proxy-based region.

[0075] In the agent-based definition of the BVS region, the detected objects are a good indicator of the expected location of the object of interest, and the detected objects are easier to detect. In the example, in the case of multi-stent branch stent placement, balloon markers are of particular interest because the balloon markers are expected to be close to the deployed (or to be deployed) BVS. The clinician can easily manipulate the balloon in the approximate deployment area because she / he knows in which vessel segment she / he has just placed the stent, i.e., which area has been entered with the catheter in which the stent is applied. However, final accurate positioning is required.

[0076] Detecting balloon markers, which are the object of many studies, is a key building block in applications that enhance stents (i.e., in so-called stent enhancement applications). By designing filters that enhance balloon markers and then developing intelligent tracking algorithms, balloon markers can be found. Alternatively, machine learning techniques can be used to train marker detectors.

[0077] The possible location of the BVS marker can be deduced from the proxy location. A rough region will be simply formed with a few circles centered on the balloon marker.

[0078] By using the balloon orientation the region can be made anisotropic, thus providing a good estimate of the orientation of the local vessel.The search region can then be formed by two ellipses centered on the two detected balloon markers and elongated in the directions defined by the markers.

[0079] It is also possible to detect the guidewire (near the balloon marker) and define the region of interest as being near the guidewire.

[0080] In BVS marker detection, it is possible to focus on a reduced area (ie, an area within the image but smaller than the entire image). Regardless of the detail of the selected area definition, the focus will be on the compact area where the BVS marker is expected to be.

[0081] The task of detecting these small faint markers, which is almost impossible when considering the entire image, becomes feasible. The detection object as a marker is then provided, which is a trade-off between accuracy and false alarms. Now, the search area has been reduced to a certain extent, for example between 100 times and 10,000 times (on the surface), which can provide a large false positive rate and thus reliably find BVS markers. For this purpose, manual features that highlight BVS markers need to be manually designed. In another option, a detector that learns by using machine learning methods such as deep learning is provided.

[0082] Furthermore, temporal merging 142 can be utilized. The shape, orientation and position of the markers can be gradually learned and the detection can be improved. After a few frames, the expected shape and position of the BVS markers learned by the BVS detector can be defined well enough to ensure robust detection itself, so for further steps the definition of the proximity region can be replaced. However, for initialization, a proxy detection is provided.

[0083] In the BVS highlighting, an enhanced image 146, also referred to as an enhanced image, is generated. To this end, once the BVS markers have been enhanced, a variety of visualization modes can be provided to assist the clinician in her / his manipulations (ie, gestures).

[0084] One example provides BVS-marker-enhancement. However, the enhancement process is centered on the BVS marker instead of the balloon marker. This will make the BVS marker spatially clear because the view will be centered on the BVS marker and the clarity of the BVS marker will not be affected by the sliding movement of the balloon marker. This allows for comfortable and smooth positioning of the balloon.

[0085] Alternatively, the view provided is centered on the balloon marker, but with temporal enhancement based on the BVS marker. In other words, the view is essentially the same as the previous view (same enhancement, same spatiotemporal BVS clarity), except that the balloon marker is centered in the end. This is a view made for clinicians who are accustomed to the "stent enhanced" view and prefer to continue using the same reference. In one option, the BVS marker is colored on the original or enhanced image.

[0086] exist Figure 5, an example of a device 10 for positioning a medical intervention device is schematically illustrated. The device 10 includes a data input interface 12, a data processing unit 14, and a data output interface 16. The data input interface 12 is configured to provide at least one image of a region of interest of an object. In at least one image, at least part of a guiding device for a medical intervention device is arranged in the region of interest, and the part of the guiding device includes at least one device position marker visible in at least one image. In addition, in at least one image, the medical intervention device is at least partially arranged in the region of interest, and the medical intervention device includes a device position marker, which is less visible in the image than the at least one device position marker. The data processing unit 14 is configured to detect at least one device position marker in at least one image. The data processing unit 14 is also configured to define a proximity region in at least one image based on the at least one device position marker. The data processing unit 14 is further configured to: select a proximity region, detect a device position marker in the proximity region, and enhance the device position marker in at least one image to support the positioning of the medical intervention device. The data output interface 16 is configured to provide at least one image with enhanced device location markers.

[0087] The supplied image data is indicated by a first dashed arrow 20 and the output data is indicated by a second dashed arrow 22 .

[0088] In an example not shown in further detail, the data input interface 12 is configured to provide at least one image with a stent as a medical intervention device at least partially arranged in the region of interest.

[0089] exist Figure 5 As an alternative example, a display unit 24 is provided, which is configured to present at least one image of the region of interest with enhanced device position markers.

[0090] In an example not shown in further detail, the data processing unit is configured to define the proximity zone as a zone around the at least one device location marker.

[0091] In an example not shown in further detail, the guiding device further comprises a guidewire, and the data processing unit 14 is configured to define the approach region as an image area having a longitudinal extension direction along the guidewire.

[0092] In an example not shown in further detail, the data input interface 12 is configured to provide a sequence of images. The data processing unit 14 is configured to detect at least one device location marker. The data processing unit 14 is configured to define a proximity zone based on the at least one device location marker, select the proximity zone, and detect the device location marker in the proximity zone for each of the images. The data processing unit 14 is also configured to temporally merge the images based on the respective detected device location markers, thus providing a temporal enhancement of the images. The data processing unit 14 is also configured to center the images relative to each other based on i) the detected device location markers, or based on ii) the detected at least one device location marker.

[0093] exist Figure 6 , an example of a medical imaging system 30 is schematically illustrated. The medical imaging system 30 comprises an imaging device 32 having an X-ray source 36 and an X-ray detector 38. The medical imaging system 30 also comprises an example 34 of the device 10 for positioning a medical intervention device according to one of the aforementioned examples. The imaging device 32 is configured to generate at least one image of a region of interest of an object. As an option, the image is a fluoroscopic image.

[0094] The imaging device 32 may be provided as a C-arc X-ray system. The example shows a C-arc suspended from a ceiling, but floor-standing or even mobile X-ray imaging systems are also provided.

[0095] An object of interest, ie a subject, is schematically indicated by a circle 40. The subject may be arranged on a patient table 42.

[0096] As an option, the medical imaging system 30 is shown to further include a guiding device 44 for a medical intervention device, the guiding device 44 including at least one device position marker. The medical imaging system 30 further includes a medical intervention device including a device position marker.

[0097] As an option, the medical intervention device is a stent to be deployed, and the device position marker is a stent position marker. In addition, the guide device is a stent guide device, and the at least one device position marker is at least one guide device position marker.

[0098] In an example, the stent guide device is a balloon device to which the stent to be deployed is attached. The at least one guide device position marker is a balloon marker. The data processing unit is configured to define an access region based on the at least one balloon marker.

[0099] exist Figure 7, a catheter device is shown. The dotted line indicates a guidewire 46. A balloon 48 with a balloon marker 50 is provided. In addition, a stent 52 with a stent marker 54 is shown. A handle 56 or holding portion is schematically indicated. The stent marker 54 is less visible in the X-ray image than the balloon marker 50.

[0100] Detection of the less visible stent marker 54 is provided by limiting the detection to a region (ie, portion of the image). The limitation is based on detection of the more visible balloon marker 50, since the stent marker is assumed to be arranged near the balloon marker.

[0101] In a further exemplary embodiment of the present invention, a computer program or a computer program element is provided, characterized in that it is adapted to execute the method steps of the method according to one of the preceding exemplary embodiments on a suitable system.

[0102] Therefore, the computer program element can be stored in a computer unit, which can also be part of an embodiment of the present invention. The computing unit can be suitable for executing or causing the execution of the steps of the above-mentioned method. In addition, the computing unit can be suitable for operating the components of the above-mentioned device. The computing unit can be suitable for automatic operation and / or running the user's command. The computer program can be loaded into the working memory of a data processor. Therefore, a data processor can be equipped to perform the method of the present invention.

[0103] This exemplary embodiment of the invention covers both a computer program that right from the beginning uses the invention and a computer program that is converted by means of an update into a program that uses the invention.

[0104] Furthermore, the computer program element may be able to provide all necessary steps to fulfill the procedure of an exemplary embodiment of the method as described above.

[0105] According to a further exemplary embodiment of the present invention, a computer readable medium, such as a CD-ROM, is provided, wherein the computer readable medium has a computer program unit stored on the computer readable medium, the computer program unit being described by the previous section. The computer program can be stored and / or distributed on a suitable medium, such as an optical storage medium or a solid-state medium supplied together with or as part of other hardware, but can also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.

[0106] 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 download is provided, the computer program element being arranged to perform a method according to one of the previously described embodiments of the present invention.

[0107] It must be noted that embodiments of the present invention are described with reference to different subject matters. In particular, some embodiments are described with reference to method claims, while other embodiments are described with reference to apparatus claims. However, unless otherwise stated, a person skilled in the art will infer from the above and following descriptions that, in addition to any combination of features belonging to one type of subject matter, any combination of features relating to different subject matters is also considered to be disclosed in the present application. However, all features can be combined to provide synergistic effects that are more than the simple addition of the features.

[0108] Although the present invention has been illustrated and described in detail in the drawings and the foregoing description, such illustration and description should be considered illustrative or exemplary rather than restrictive. The present invention is not limited to the disclosed embodiments. Those skilled in the art will be able to understand and implement other variations to the disclosed embodiments in practicing the claimed invention by studying the drawings, the disclosure, and the claims.

[0109] 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. Although certain measures are recited in mutually different dependent claims, this 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 (10) for supporting positioning of a medical intervention device, comprising: Data input interface (12); Data processing unit (14); as well as Data output interface (16); wherein the data input interface is configured to provide at least one image of a region of interest of the object; Wherein, the data processing unit is configured as: i) detecting in the at least one image at least one device position marker for a guiding device of a medical interventional device at least partially arranged in the region of interest; ii) defining a proximity area in said at least one image based on said at least one device location marker; iii) detecting, in the proximity region of the at least one image, a device position marker of the medical intervention device at least partially arranged in the region of interest, and iv) enhancing the device location marker in the at least one image to support positioning of the medical intervention device; wherein the equipment location marker is less visible in the image than the at least one device location marker, and Wherein, the data output interface is configured to provide an enhanced device location marker to the at least one image.

2. The device according to claim 1, wherein The data input interface is configured to provide the at least one image with a stent as the medical intervention device at least partially arranged in the region of interest.

3. The device according to claim 1 or 2, wherein: A display unit (24) is provided, which is configured to present the at least one image of the region of interest with enhanced device location markers.

4. The device according to claim 1 or 2, wherein: The data processing unit is configured to define the proximity zone as a region around the at least one device location marker.

5. The device according to claim 1 or 2, wherein: The guiding device comprises at least one of a guide wire, a balloon and a catheter; and Therein, the data processing unit is configured to define the approach area as an image area having a longitudinal extension direction along the guiding device.

6. The device according to claim 1 or 2, wherein: The data input interface is configured to provide a sequence of images; The data processing unit is configured to: detect the at least one device location marker, define a proximity zone based on the at least one device location marker; select the proximity zone, and detect the device location marker in the proximity zone for each of the images; wherein the data processing unit is further configured to temporally merge the images based on corresponding detected device position markers, thereby providing temporal enhancement of the images; and Wherein the data processing unit is configured to center the images relative to each other based on i) the detected device location marker or ii) the detected at least one apparatus location marker.

7. A medical imaging system (30), comprising: an imaging device (32) having an X-ray source (36) and an X-ray detector (38); as well as The device (10) according to one of claims 1 to 6; Therein, the imaging device is configured to generate at least one image of a region of interest of the object.

8. The medical imaging system according to claim 7, wherein: The image is a fluoroscopic image.

9. The medical imaging system according to claim 7, wherein: The system further comprises a guide device (44) for a medical interventional device, the guide device comprising the at least one device position marker; and Wherein, the system further comprises a stent to be deployed as a medical intervention device, the stent comprising a stent position marker; and wherein the guiding device is a stent guiding device, and the at least one device position marker is at least one guiding device position marker.

10. The medical imaging system according to claim 9, wherein: The stent guide device is a balloon device to which the stent to be deployed is attached; wherein the at least one guide device position marker is a balloon marker; and Therein, the data processing unit is configured to define the access area based on the at least one balloon marker.

11. A method (100) for supporting positioning of a medical intervention device, comprising the following steps: a) providing (102) at least one image of a region of interest of an object; b1) detecting (104) in the at least one image at least one device position marker for a guiding device of a medical intervention device at least partially arranged in the region of interest; b2) defining (106) a proximity area in said at least one image based on said at least one device location marker; c1) selecting (108) the proximity area; c2) detecting (110) in the proximity region of the at least one image a device position marker of the medical intervention device at least partially arranged in the region of interest, the device position marker being less visible in the image than the at least one guiding device marker; d) enhancing (112) the device location marker in the at least one image to support positioning of the medical intervention device.

12. The method according to claim 11, wherein: providing a sequence of images (128); wherein steps b1) to c2) are provided for at least part of said images of said sequence; and Therein, before step d), the following step is provided: temporally registering (130) the images based on corresponding detected device position markers, which provides a temporal enhancement of the images.

13. The method according to claim 12, wherein: The images are centered relative to each other based on: i) the detected device location marker; or ii) said at least one device location marker detected.

14. Computer program product comprising a computer program for controlling an apparatus according to one of claims 1 to 10, said computer program being adapted to perform the steps of the method according to one of claims 11 to 13 when run by a processing unit.

15. A computer readable medium storing a computer program for controlling the apparatus according to one of claims 1 to 10, said computer program being adapted to perform the steps of the method according to one of claims 11 to 13 when run by a processing unit.

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