Method and medical system for controlling an X-ray device

Abstract

The invention relates to a method for controlling an X-ray device during robot-assisted navigation of at least two objects (O1, O2) introduced into the body of a patient (15), in particular a hollow organ (H), by means of at least one robot system, the method comprising the following steps: providing a first selection criterion for selecting one of the objects, providing a second selection criterion for selecting one of the objects, selecting one of the at least two objects based on the two selection criteria, automatically setting recording parameters of the X-ray device in such a way that the selected object is highlighted in the X-ray image to be recorded, in particular relative to at least one other object, in particular with respect to image quality, image impression, positioning on the X-ray image and / or collimator setting of a collimator of the X-ray device, and recording the X-ray image with the recording parameters set in this way.

Description

Technical Field

[0001] The invention relates to a method for controlling an x-ray device during robot-assisted navigation of at least two objects introduced into a patient's body by means of at least one robot system, and to a medical system for carrying out such a method. Background Art

[0002] In the vascular system of the patient's body or on the vascular system, the interventional medical procedure requires that a medical object (equipment or apparatus) is introduced into the vascular system and guided to the target area to be treated by a percutaneous vascular access. As a further development of the manual navigation of the object in the vascular system, a robot system is advantageously connected between the operator's hand and the patient so that the operator no longer needs to directly stand on the support platform for the patient, but can remotely perform the maneuvering (rotational motion, forward motion and backward motion) of the object. This robot system is known in principle, for example, by EP 3406291 B1, and can realize the (semi) automatic motion of an object, for example a catheter and / or a guide wire, by means of the robot system in the patient's hollow organ, by robot-assisted ground. For this reason, the operator can use the corresponding user interface for the motion of remote control.

[0003] For assistance, imaging devices, such as X-ray devices, are usually used, which allow the operator to monitor and understand the progress of the operation, such as the position of the object, in real time based on the image data. For this purpose, for example, a series of two-dimensional fluoroscopic X-ray images can be generated. In order to give the operator the best possible visual overall image impression, the image data are captured using appropriate recording parameters. In the case of X-ray devices, the recording parameters can be formed, for example, by X-ray voltage, X-ray dose, X-ray current, baffle settings, filter settings, duration or intensity of the X-ray window. The selection of the recording parameters can be performed statically (one-time adjustment without further adaptive adjustment) or dynamically (repeated adaptive adjustment) and usually affects the overall image impression.

[0004] However, during an invasive procedure, it may be important for the operator to achieve a specific adaptation or adjustment, for example, of the image impression or image parts, for example, focusing on a specific medical object. The operator can make adjustments by automatic general adjustment (or setting) of the acquisition parameters or by manual specific adjustment. However, this is often not specific enough for the object of interest (or concern) or is too complex if manual adjustment is required for each small change.

[0005] An example of this is the adjustment of an X-ray baffle. In terms of radiation hygiene, it is advantageous to limit the X-ray beam of an X-ray emitter as well as possible. It has proven to be advantageous to make this limitation of the X-ray beam semi-transparent by covering image regions (ROI – Region of Interest) that are not in the field of view of the operator. The patient is thus ideally irradiated with the full dose only in the field of view of the examiner. When using multiple objects, for example, it is necessary to manually decide where the ROI should be positioned. Summary of the invention

[0006] The technical problem to be solved by the present invention is to provide a method for medical imaging, which enables an operator to focus on important image areas, especially during interventional surgery when there are multiple objects introduced into the patient's body; the technical problem actually solved by the present invention is also to provide a suitable medical system for performing the method.

[0007] This object is achieved according to the invention by a method and a medical system for controlling an x-ray device during robot-assisted navigation of at least two objects introduced into a body of a patient by means of at least one robot system.

[0008] The method according to the invention for controlling an imaging device, in particular an X-ray device, during robot-assisted navigation of at least two objects introduced into a patient's body, in particular a hollow organ, by means of at least one robot system comprises the following steps: providing a first selection criterion for selecting one of the objects, providing a second selection criterion for selecting one of the objects, selecting one of the at least two objects based on the at least two selection criteria, automatically setting recording parameters of the imaging device, in particular an X-ray device, such that the selected object is highlighted in the image to be captured, in particular an X-ray image, in particular relative to at least one other object, in particular with respect to image quality, image impression, positioning on the X-ray image and / or collimator setting of a collimator of the imaging device, in particular an X-ray device, and capturing an image, in particular an X-ray image, with the recording parameters set (or adjusted) in this way.

[0009] The method according to the invention enables the operator to achieve automatic focusing on currently relevant objects during an interventional procedure without complex manual selection. In this way, for example, the image impression or image section is optimized for the selected object and the operator obtains all the important information and can concentrate on the operation. This reduces the time consumption for the operator and the patient and thus reduces the X-ray dose output to the patient, and improves the quality of the diagnostic state and possible treatment.

[0010] The selection criteria used for this purpose can be, for example, a combination of previously or currently generated, The measurement is obtained.

[0011] According to a design of the invention, the first selection criterion is formed based on an analysis of at least one previously or real-time image, in particular an X-ray image, with respect to the structure of interest, or based on an analysis of an eye tracking system with respect to the object of interest. The one or more previously generated images, in particular X-ray images, can be generated, for example, within the scope of a series of fluoroscopic X-ray images, but can also be at least one three-dimensional volume image. The one or more X-ray images can then be analyzed with respect to the structure of interest, for example, with respect to the position of the object, and for a plurality of X-ray images, for example, the movement of one of the objects can be analyzed. The selection criterion is then generated on this basis. In the presence of an eye tracking system, the measurement data generated by this system can be analyzed, for example, with respect to the frequency with which the operator of the eye tracker observes the object. On this basis, for example, the following selection criteria can also be generated, which are based, for example, on which object is observed most frequently. Eye tracking systems are known in principle.

[0012] According to another embodiment of the present invention, the second selection criterion is formed based on information about which object is currently being controlled or moved by at least one robot system. Thus, for example, a selection criterion about which object is currently being moved or last moved can be selected.

[0013] According to another embodiment of the invention, one of the selection criteria is weighted more heavily than the other selection criteria. This is particularly reasonable within the scope of an even number of selection criteria. It can be preset which selection criterion is decisive.

[0014] According to another embodiment of the present invention, a third selection criterion is provided and the object is selected according to the three selection criteria. The third selection criterion can be formed in particular based on an analysis of the eye tracker with respect to the object of interest or based on an analysis of at least one previously recorded X-ray image with respect to the structure of interest. Objects that meet at least two of the three selection criteria can then be selected. More than three, for example a plurality of, selection criteria can also be provided and used.

[0015] According to another embodiment of the present invention, the recording parameters are formed by the X-ray voltage and / or the X-ray dose or the X-ray current or the baffle setting (Blendeneinstellung) and / or the filter setting and / or the duration and / or the intensity of the X-ray window and / or the positioning with respect to the central beam. Thus, for example, the baffle setting of the baffle of the collimator can be performed in such a way that the selected object is in the center of the X-ray image to be recorded, the so-called region of interest, and is irradiated with the set full X-ray dose. For this purpose, the baffle of the collimator is controlled. In addition or as an alternative, the area surrounding the central object, i.e. the unselected second object, can also be irradiated with a smaller X-ray dose by means of a translucent baffle.

[0016] According to another embodiment of the present invention, the object is continuously or at regular time intervals updated using at least one selection criterion, and the recording parameters of the imaging device, in particular the X-ray device, are set so that the updated selected object is highlighted in the X-ray image to be recorded relative to at least one other object, in particular in terms of image quality, image impression, positioning on the X-ray image, and / or the baffle setting or collimator setting of the collimator of the X-ray device, and further recording of the X-ray image is performed by the recording parameters set in this way. In this way, changes can be taken into account at any time during the interventional procedure and included in the method. It can be ensured that the automatic focus on the currently important object can be maintained even when other objects different from the previous ones become important. If, for example, the object is changed and it is no longer the first object but the second object that is controlled and moved by the robot system, the second object is now selected and the recording parameters (for example ROI) are set for the second object as described above.

[0017] According to another embodiment of the invention, one or more recorded X-ray images are reprocessed graphically, wherein objects selected by means of selection criteria are highlighted in the image impression within the scope of the reprocessing. Thus, for example, reprocessing steps such as edge sharpening, noise correction, adjustment of image contrast can be applied specifically to the selected objects in order to optimize the display of the selected objects.

[0018] The invention furthermore comprises a medical system for carrying out the method according to the invention, comprising an X-ray device for recording X-ray images, the X-ray device comprising an X-ray source, an X-ray detector and a collimator, and a system control for controlling the X-ray device, the medical system comprising at least one robot system, the robot system comprising at least one robot-assisted drive system, the drive system being designed to move at least two medical objects in a hollow organ of a patient, the medical system comprising an analysis unit for analyzing previously recorded X-ray images with respect to structures of interest, the medical system comprising a communication connection between the system control and the at least one robot system for transmitting information from the at least one robot system about which object is currently being controlled or moved, and the medical system comprising a selection unit for selecting one of the at least two objects according to a selection criterion. The medical system can furthermore comprise an eye tracking system for tracking eye movements of an operator, and a communication connection between the system control and the eye tracking system for transmitting information about the object of interest. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] The present invention and other advantageous embodiments are explained in detail below based on the exemplary embodiments schematically shown in the drawings, without thereby limiting the present invention to these exemplary embodiments. In the drawings:

[0020] Figure 1 shows a sequence of steps according to the method of the present invention;

[0021] Figure 2 Shown in accordance with Figure 1 A sequence of steps of a method having other steps;

[0022] Figure 3 A view showing a medical system according to the present invention;

[0023] Figure 4 showing a view of a photographed area with an area of ​​interest;

[0024] Figure 5 Shown in accordance with Figure 1 A sequence of other steps of a method having other steps. DETAILED DESCRIPTION

[0025] exist Figure 1 and Figure 2The steps of a method for controlling an X-ray device during robot-assisted navigation of at least two objects introduced into a patient's body, in particular into a hollow organ, such as a blood vessel system, a blood vessel tree, a bronchial system, etc., by means of at least one robot system are shown. In principle, robot systems are known, for example, from EP 3406291 B1, by means of which objects can be automatically moved in a hollow organ of a patient in a robot-assisted manner.

[0026] exist Figure 3 1 shows a medical system 1 for performing this method. The medical system 1 has a robot system and an X-ray device 10. The robot system is designed to semi-automatically or automatically move medical objects O1, O2 in the hollow organ of the patient 2. Semi-automatic control is understood here, for example, as a control that can be transmitted to the robot control device 8 by an operator through an input unit (not shown; for example, a joystick, a touch pad, a rotary regulator, etc.). In this example, two objects, namely the first object O1 and the second object O2, are first taken as the starting point. However, there may also be three or more objects. The objects may be, for example, catheters, guide wires or instruments. Objects O1, O2 are connected to the drive system 7 of the robot system 7; 8 and can be navigated in the hollow organ of the patient 2 by means of the drive system 7. The movement is controlled by the robot control device 8. Alternatively, there may also be two drive systems or even two robot systems to control two objects.

[0027] In order to have an overview of the operation and the movement, an X-ray device 10 is provided. The X-ray device 10 has, for example, a C-arm 13, which holds an X-ray source 12 with a collimator 14 and an X-ray detector 11 and is connected to a system control device 15. The C-arm 13 is arranged movably relative to the patient 2, and in the case of a mobile X-ray device, the entire X-ray device is also movable. With the help of the X-ray device 10, an X-ray image of the imaging area that can be imaged is generated, which is processed by an imaging system 16 and displayed on a display unit. The robot control device 8 and the system control device 15 of the X-ray device can exchange data bidirectionally via a communication connection 9 and communicate with each other.

[0028] The method according to the invention is advantageous in order to focus on a specific medical object selected from at least two objects by means of X-ray monitoring during an interventional procedure without requiring constant manual effort.

[0029] In a first step 20 of the method for controlling an X-ray device, a first selection criterion for selecting one of the objects is provided. The first selection criterion can be, for example, based on the presence of a structure of interest (see Figure 2The seventh step 25 in the example is an analysis of the aspect of the present invention. The analysis can be based on, for example, a calculation or estimation of a probability. The one or more X-ray images can be analyzed with respect to structures of interest, for example with respect to the position of the object, and for a series of X-ray images (for example, fluoroscopic images), for example, the movement of the object can be analyzed (independently of the patient's respiratory movement, cardiac movement or other movement). The analysis can be performed, for example, with the aid of an analysis unit 17. The information can be stored accordingly and provided for other analysis steps. The analysis can be performed in a conventional (module-based) manner or can also be performed by a trained function (machine learning). A first selection criterion can then be provided on this basis.

[0030] Alternatively, in the presence of an eye-tracking system 4, the measurement data generated by this system can be analyzed, for example, by means of a camera or glasses with a camera, for example with regard to the frequency with which an operator observes an object. On this basis, selection criteria can then also be generated, which are based, for example, on which object O1; O2 is observed most frequently. The eye-tracking system 4 has a communication connection 9 with a system control device 15, by means of which data can be exchanged bidirectionally. All communication connections 9 can be wireless or wired. Wireless communication connections can, for example, work in the new mobile radio standard 5G with very little latency.

[0031] In a second step 21 of the method for controlling an X-ray device, a second selection criterion is provided for selecting one of the objects. The second selection criterion is formed in particular based on information about which object is currently being controlled or moved by at least one robot system (see Figure 2 The eighth step 26 in the figure). Thus, for example, a selection criterion can be selected about which object is currently being moved or has been moved last. To this end, information or data can be exchanged and continuously updated via the communication connection 9 between the robot control device 8 and the system control device 15.

[0032] As in Figure 5 As shown in FIG. 2 , a third selection criterion may optionally also be provided in a third step 27. If the selection criterion is not already formed by the first selection criterion, the selection criterion may be based, for example, on which object O1; O2 is most frequently observed by the operator (see Figure 2 The information about the most frequent observations of the respective object is transmitted (or communicated) to the system control device 15 via the eye tracking system 4 .

[0033] By using two or more selection criteria, the subjects can be selected particularly well, so that irregularities in the measurement have only a small effect and disruption of the interventional procedure is minimized.

[0034] In a fourth step 22, one of the at least two objects is selected according to two selection criteria. In this connection, one of the selection criteria can be weighted more than the other selection criteria. This is particularly reasonable within the scope of an even number of selection criteria. It is possible to pre-set which selection criteria are weighted.

[0035] In a fifth step 23, at least one recording parameter of the X-ray device is automatically set in such a way that the selected object is highlighted or optimized in the X-ray image to be recorded relative to at least one other object and / or also relative to the rest of the surroundings, in particular with regard to image quality, image impression, positioning on the X-ray image and / or collimator settings of a collimator of the X-ray device. The one or more recording parameters can be, for example, an X-ray voltage, an X-ray dose, an X-ray current, a baffle setting, a filter setting, a duration or an intensity of an X-ray window. Thus, for example, the selected object, for example the first object O1, can be arranged in the center of the recording area 30, i.e. in the so-called region of interest ROI, see Figure 4 . The area outside the region of interest ROI but inside the acquisition area 30, where, for example, the second object O2 that has not been selected is located, is covered semi-transparently by the baffle of the collimator 14. This reduces the time consumption for the operator and the patient and thus reduces the X-ray dose output to the patient, and improves the quality of the diagnostic state and possible treatment. Filters can also or alternatively be used to reduce the X-ray dose or radiation contribution to the surrounding environment. It is also conceivable that the selected object is covered non-centrally and the remaining acquisition area is covered semi-transparently by the baffle of the collimator 14. It can also be provided that the X-ray dose or the X-ray voltage or the X-ray current is optimized for the selected object. It can also be provided that the remaining acquisition area is acquired with a lower resolution by means of a combined readout (Binning).

[0036] In a sixth step 24, an X-ray image is then recorded with the set recording parameters. This results in an X-ray image that particularly highlights the selected object or optimizes the selected object with particularly good image quality or particularly good image contrast. A series of X-ray images, for example a fluoroscopic X-ray image or one or more volume images, can also be generated.

[0037] In another embodiment of the present invention, the updating of the method can be performed in the tenth step 30, for example continuously or at regular time intervals, see Figure 2If a change occurs, for example if a further object is now moved by means of the robot system or the robot systems, an updated selection is carried out (fourth step 22) by means of at least one selection criterion (first step 20 and / or second step 21 and / or third step 27). The recording parameter or recording parameters are then automatically adapted to the currently selected object (fifth step 23) and at least one X-ray image is recorded (sixth step 24).

[0038] As in Figure 5 As shown in , after recording at least one X-ray image, a post-processing step 29 can be performed, which optimizes the selected objects in the X-ray image by using the selection. This can, for example, make adjustments in terms of image contrast or image noise or other image processing. It is also possible to perform colored, circled or otherwise marked highlights. The operator can also additionally manually perform other adjustments, such as marking or image processing.

[0039] Furthermore, various methods can be used as an aid in the automatic setting of the recording parameters optimized for the selected object. In particular, known methods for segmentation can be used. Information about the material composition of the object can also be used, for example, in order to obtain and adjust an optimal X-ray dose or to perform filtering. For example, a depth estimation for determining the image plane can be performed on a previously produced volume image (preoperative image) in order to optimize the depth sharpness. In this connection, the path moved in the (2D) X-ray image can also be calculated or estimated in order to be able to estimate the position of the object.

[0040] Of course, it is also possible to move a plurality of objects simultaneously, for example, if there is a first object, a second object and a third object, to move the second object and the third object. In this case, the corresponding other selection criteria (eye tracking system or image analysis) can be decisive. Alternatively, the recording parameters can also be set optimally for more than one object. Since the requirements for the view adjustment can be unclear in this case, it is possible to implement a compromise solution in this case, for example, by averaging the recording parameters.

[0041] It is also possible that the operator wants to continue or re-highlight an object at a later point in time, for example when a different current object is already being viewed, in particular within the scope of post-processing. For this purpose, the necessary information can be stored accordingly and made available again later. The visual display can include adjustments to existing, previously recorded X-ray images, superposition of different X-ray images or side-by-side display of a plurality of X-ray images. Furthermore, it can be provided that the operator switches directly (also without re-viewing) between the adjusted X-ray images for the respective object.

[0042] Furthermore, in another embodiment, it is also possible in all three variants to subsequently adjust the image impression locally, for example to highlight certain areas or structures or also to make them less noticeable in the view. This can be achieved by a model-based function or also by a trained function.

[0043] The selection of the recording parameters and the adaptation of the image during further processing can be carried out statically (one-time adaptation without further adaptation) or dynamically (repeated adaptation) and in this case usually influence the overall image impression.

[0044] The present invention can be briefly summarized as follows: In order to focus specifically on a certain medical object in a particularly simple and low-cost manner, a method for controlling an X-ray device during robot-assisted navigation of at least two objects introduced into a patient's body, in particular a hollow organ, by means of at least one robot system is provided, the method comprising the following steps: providing a first selection criterion for selecting one of the objects, providing a second selection criterion for selecting one of the objects, selecting one of the at least two objects based on the two selection criteria, automatically setting recording parameters of the X-ray device so that the selected object is highlighted in the X-ray image to be recorded, in particular with respect to at least one other object, in particular with respect to image quality, image impression, positioning on the X-ray image and / or collimator setting of a collimator of the X-ray device, and recording the X-ray image with the recording parameters set in this way.

Claims

1. A method for controlling an imaging device during robot-assisted navigation of at least two objects (O1, O2) introduced into a body of a patient by means of at least one robot system, the method comprising the following steps: providing a first selection criterion for selecting an object of the at least two objects, providing a second selection criterion for selecting the object or a further object of the at least two objects, selecting one of the at least two objects according to at least the first selection criterion and the second selection criterion, automatically setting the photographic parameters of the imaging device so that the selected object is highlighted in the image to be captured, and • An image is captured with the capturing parameters thus automatically set.

2. The method according to claim 1, wherein: The imaging device is an X-ray device and the body is a hollow organ (H).

3. The method according to claim 1, wherein: The photographing parameters of the imaging device are automatically set so that the selected object is highlighted relative to at least one other object of the at least two objects.

4. The method according to claim 3, wherein: Recording parameters of the imaging device are automatically set so that the selected object is highlighted relative to at least one other of the at least two objects with respect to image quality, image impression, positioning on the x-ray image and / or collimator setting of a collimator of the imaging device.

5. The method according to claim 1, wherein: One of the selection criteria is weighted more heavily than the other selection criterion.

6. The method according to claim 1, wherein: A third selection criterion is provided and objects are selected based on at least three selection criteria.

7. The method according to claim 6, wherein: The first selection criterion is formed based on an evaluation of at least one recorded image with respect to the structure of interest or based on an evaluation of the eye tracking system with respect to the object of interest.

8. The method according to claim 1, wherein: The second selection criterion is formed based on the information of the at least one robotic system about which object is currently being controlled or moved.

9. The method according to claim 1, wherein: The acquisition parameters are formed by the X-ray voltage and / or the X-ray dose or the X-ray current or the shutter setting and / or the filter setting and / or the duration and / or the intensity of the X-ray window and / or the positioning with respect to the central beam.

10. The method according to claim 7, wherein: The third selection criterion is formed on the basis of an evaluation of the eye tracker with respect to the object of interest or on the basis of an evaluation of at least one previously acquired x-ray image with respect to the structure of interest.

11. The method according to claim 6, wherein: The object is selected continuously or at regular time intervals in an updated manner using at least one of the first, second and third selection criteria, and the shooting parameters of the imaging device are set so that the updated selected object is highlighted in the image to be captured relative to at least one other object of the at least two objects, and the method further comprises performing a further capture of the image using the shooting parameters set in this manner.

12. The method according to claim 1, wherein: The recorded image or images are graphically reprocessed, wherein objects selected by means of the first selection criterion and the second selection criterion are highlighted in the image impression within the scope of the reprocessing.

13. A medical system (1) for carrying out the method according to one of claims 1 to 12, comprising: An X-ray device (10) for recording X-ray images, the X-ray device comprising an X-ray source (12), an X-ray detector (11) and a collimator (14), and a system control device (15) for controlling the X-ray device (10); at least one robotic system having at least one robot-assisted drive system (7) which is designed to move at least two medical objects (O1; O2) in a hollow organ of a patient (2); an analysis unit (17) which is designed to analyze previously recorded X-ray images with respect to the structure of interest; a communication connection (9) between a system control device (15) and at least one robot system, the communication connection being designed to transmit information from the at least one robot system about which of the at least two objects (O1; O2) is currently being controlled or moved, and A selection unit (18) is configured to select one of the at least two objects (O1; O2) according to a selection criterion.

14. The medical system according to claim 13, further comprising: An eye tracking system (4; 6) for tracking the operator's eye movements; as well as A communication connection (9) between the system control device (15) and the eye tracking system (4; 6) is configured to transmit information about the object of interest.

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