Guiding support for guiding medical instrument

Abstract

The invention relates to a guide support for guiding a medical device (7), in which image data representing the medical device (7) inside a hollow organ (8) is received, the medical device (7) extending along a portion (9) of the hollow organ (8). Depending on the image data, a diameter (D) and / or a curvature of the hollow organ (8) at a target location or in a target region (10) of the medical instrument (7) is determined. Guide support information for guiding at least the medical device (7) to the target position or the target area (10) is generated as a function of the diameter (D) and / or curvature and as a function of at least one geometric property of the medical device (7).

Description

Technical Field

[0001] This invention relates to a computer-implemented method for guiding a medical device, wherein image data representing a medical device inside a hollow organ, wherein the medical device extends along a portion of the hollow organ, is received. The invention also relates to a corresponding data processing system for performing the computer-implemented method, a medical imaging system including the data processing system, and a corresponding computer program product. Background Technology

[0002] Endovascular procedures, such as catheter-based shunt stent placement, also known as a shunt, to treat cerebral aneurysms, are typically based on pre-interventional imaging using methods such as computed tomography (CT), cone-beam computed tomography (CBCT), or magnetic resonance imaging (MRI), and / or intraoperative (real-time) imaging using methods such as CBCT, fluoroscopy, digital subtraction angiography (DSA), etc. The quality of the outcome depends on the intuition, experience, and skill of the interventional specialist.

[0003] To date, image information has only been interpreted by interventional specialists and then incorporated into consideration to guide subsequent clinical decisions and surgical procedures. Therefore, difficulties or complications may arise if it is found that the endovascular medical device used, or a portion thereof, is unsuitable for guidance to or through a location or area of ​​the vascular structure.

[0004] Furthermore, pre-interventional imaging data may not always be sufficient to optimally select medical devices, as endovascular interventions themselves can alter the geometry of vascular structures. Therefore, similar difficulties or complications may arise when using robotic endovascular devices to guide medical devices.

[0005] Similar or identical situations may occur in the context of other endovascular procedures, i.e., in the application to hollow organs that are not vascular structures, such as in bronchoscopy. Summary of the Invention

[0006] One object of the present invention is to provide an improved concept for image-based guidance support for guiding medical devices inside hollow organs, which at least partially overcomes the aforementioned disadvantages.

[0007] This objective is achieved through the subject matter of the independent claims. Further embodiments and preferred embodiments are the subject matter of the dependent claims.

[0008] The present invention is based on the idea of ​​generating guidance support information for guiding a medical device based on the diameter and / or curvature of a hollow organ at a target location or target region and based on at least one geometric property of the medical device.

[0009] According to one aspect of the invention, a computer-implemented method for guidance support of a medical device is provided. The method involves receiving image data representing a medical device inside a hollow organ, wherein the medical device extends along a portion of the hollow organ, particularly only along that portion of the hollow organ. Based on the image data, the diameter of the hollow organ at a target location or in a target region of the medical device and / or the curvature of the hollow organ at the target location or in the target region are determined. Based on the diameter and / or curvature of the hollow organ and based on at least one geometric property of the medical device, guidance support information for guiding the medical device at least to the target location or the target region is generated.

[0010] Unless otherwise stated, all steps of the computer-implemented method can be performed by a data processing system including at least one data processing device. Specifically, the at least one data processing device is configured or adapted to perform the steps of the computer-implemented method. For this purpose, the at least one data processing device may, for example, store a computer program comprising instructions that, when executed by the at least one data processing device, cause the at least one data processing device to perform the computer-implemented method. The terms "data processing system" and "at least one data processing device" are used interchangeably herein and hereinafter. This also applies to corresponding expressions derived therefrom.

[0011] If the at least one data processing device comprises two or more data processing devices, then certain steps performed by the at least one data processing device can also be understood as different data processing devices performing different steps or different parts of a step. In particular, it is not required that each data processing device fully perform these steps. In other words, the execution of these steps can be distributed among two or more data processing devices.

[0012] From each embodiment of this computer-implemented method, by including a corresponding step in generating the image data, particularly by means of a medical imaging device, a corresponding embodiment of a guidance support method for guiding medical devices that is not purely computer-implemented is obtained.

[0013] It should be noted that the computer implementation method according to the invention does not include any method steps for guiding or moving a medical device inside a hollow organ or inserting a medical device into a hollow organ or another part of a patient's body.

[0014] However, from each embodiment of the computer-implemented method, a corresponding method is obtained, which includes all the method steps of the corresponding embodiment of the computer-implemented method as well as the step of manually, automatically or semi-automatically guiding the medical device to the target location or the target area.

[0015] A hollow organ can be understood, for example, as an organ whose lumen is surrounded by biological tissue. Hollow organs should be distinguished in particular from solid organs. For example, blood vessels, especially vascular vessels, bronchi, pancreatic ducts, etc., are considered hollow organs. The medical imaging device can be any device used for insertion into a patient's hollow organ. The medical device can consist of a single component or may include two or more components. Components of the medical device may be designed to be deployed within the hollow organ, or in other words, remain inside the hollow organ. This may be the case, for example, with vascular prostheses, vascular implants, shunts, and stents. However, a component of the medical device can also be a tool for deploying another component of the medical device. This may be the case, for example, with guidewires or deployment catheters. A component of the medical device can also be another instrument designed to be removed from the hollow organ after use. This may be the case, for example, with catheters, such as balloon catheters.

[0016] Depending on the implementation of the medical imaging device and / or the method used to generate the image data, the image data can be of different types. For example, it can be an X-ray-based imaging method, such as a single-plane, biplane, or multiplane X-ray imaging method, a CBCT method, or another suitable method for fluoroscopy or angiography. In the case of an X-ray-based imaging method, the image data includes one or more two-dimensional X-ray images, particularly projection images, and / or three-dimensional reconstructions and / or one or more slice images obtained from the three-dimensional reconstructions, etc. This image data is particularly intraoperative image data.

[0017] The image data represents the medical device, specifically its current location or that of a designated portion thereof. Based on predetermined intervention plan data or the user's intent, the medical device or its designated portion should be guided from its current location to or beyond the target location or area, or in other words, to at least reach the target location or area. The designated portion of the medical device may be, for example, the tip of the medical device. The designated portion of the medical device may also be a designated component of the medical device.

[0018] The target location or the target area is not located within a portion of such a hollow organ, and the medical device extends within that portion of the hollow organ based on the image data.

[0019] Therefore, at least one geometric property of a medical device may include at least one geometric property of the entire medical device and / or at least one geometric property of a designated portion of the medical device.

[0020] The target location or target area can be obtained by a data processing system, for example, from intervention plan data, from user input, or from a combination of both.

[0021] At least one geometric property of a medical device may be determined, for example, based on image data, or may be a predetermined or specified attribute of the medical device.

[0022] The diameter and / or curvature of a hollow organ can be determined, for example, by applying a known segmentation algorithm to image data to obtain a segmentation representation or image of the hollow organ. The diameter and / or curvature of the hollow organ can then be determined from this segmentation representation.

[0023] The diameter of the hollow organ in the target region can, for example, correspond to the minimum or average diameter in the target region. The curvature of the hollow organ in the target region can, for example, correspond to the maximum or average curvature in the target region.

[0024] Image data, or data derived from image data, can be displayed, for example, on a display device to assist the user. This may be part of a computer implementation method according to the invention; however, it is not necessarily the case.

[0025] Guidance support information, or a portion thereof, may be provided to the user, for example, by display on a display device and / or through auditory output. The user can then use the guidance support information to at least guide the medical device to the target location or area. The user may also decide to terminate the procedure based on the guidance support information.

[0026] Guidance support information, or a portion thereof, may also be provided to an intravascular robotic device configured to automatically control the navigation of a medical device in a hollow organ based on the guidance support information.

[0027] In both cases, providing guidance and support information as real-time or near-real-time information based on the actual conditions of the hollow organ can improve the outcome of endovascular surgery in terms of quality or reduce operative time. The risk of damage to the hollow organ by the medical device is reduced.

[0028] According to several embodiments, guidance support information or a portion thereof is output to the user of the medical device and / or guidance support information or a portion thereof is provided to a control system for automatically controlling the navigation of the medical device, particularly in hollow organs.

[0029] The control system can be, for example, a control system for controlling an intravascular robotic device based on guidance support information.

[0030] According to several embodiments, at least one geometric property of the medical device is determined at least in part based on image data. In other words, at least one geometric property of the medical device is determined solely or in part based on image data.

[0031] Therefore, modifications or changes to at least one geometric property of the medical device caused by its insertion into a hollow organ are inherently taken into account when determining at least one geometric property. Thus, at least one geometric property is determined with improved accuracy.

[0032] According to several embodiments, the image data includes at least two projected images, such as X-ray projection images, representing a medical device inside a hollow organ according to at least two corresponding projection directions.

[0033] In particular, each of the at least two projection images represents a medical device inside a hollow organ from a different perspective.

[0034] Therefore, the diameter and / or curvature of the hollow organ, and in embodiments where at least one geometric property of the medical device is determined at least in part based on image data, can be determined with improved accuracy.

[0035] According to several embodiments, the image data includes multiple projected images, such as X-ray projection images, representing a medical device inside a hollow organ according to a corresponding projection direction. A three-dimensional reconstruction representing the medical device inside the hollow organ is generated based on the multiple projected images. The diameter and / or curvature of the hollow organ is determined based on the three-dimensional reconstruction.

[0036] In particular, each of the at least two projection images represents a medical device inside a hollow organ from a different perspective.

[0037] Reconstruction can be performed, for example, by applying known reconstruction techniques, such as those used in CT or CBCT or tomographic synthesis.

[0038] Therefore, the diameter and / or curvature of a hollow organ can be determined with improved accuracy.

[0039] According to several embodiments, at least one geometric property of the medical device is determined based on three-dimensional reconstruction.

[0040] Therefore, determining at least one geometric property of a medical device, at least in part, based on image data, can be done with improved accuracy.

[0041] According to several embodiments, at least one geometric property of the medical device includes a diameter, such as the maximum diameter of the medical device or a portion thereof and / or the curvature of the medical device or a portion thereof and / or the length of the medical device or a portion thereof.

[0042] A part of a medical device can be the tip or shaft of the medical device, or a component of the medical device as described above.

[0043] Therefore, attributes that are particularly relevant to guiding medical devices to or beyond a target location or target area are considered for generating guidance support information.

[0044] Therefore, the risk of damage to hollow organs by medical devices or distal vascular occlusion due to embolism is reduced and / or the guidance of medical devices can be simplified or can be performed more accurately.

[0045] According to several embodiments, guidance support information is generated based on at least one mechanical property of the medical device.

[0046] At least one mechanical property can be predetermined, for example, based on the specifications of the medical device or a simulation or model of the medical device.

[0047] Therefore, when a medical device is guided to or beyond a target location or area, the expected behavior of the medical device, such as deformation or friction, can be evaluated to generate guidance support information.

[0048] Therefore, the risk of damage to hollow organs by medical devices is reduced and / or unnecessary termination of surgery can be avoided.

[0049] At least one mechanical property may include, for example, the stiffness of the medical device or a part of the medical device and / or the elasticity of the medical device or a part of the medical device and / or the surface lubricity of the medical device or a part of the medical device.

[0050] At least one mechanical property can be determined, for example, before performing the computer-implemented method according to the invention. In some embodiments, determining at least one mechanical property, particularly by measuring a medical device, may also be part of the computer-implemented method according to the invention.

[0051] Stiffness can be, for example, tensile stiffness, shear stiffness, bending stiffness, or torsional stiffness. Surface lubricity, particularly the lubricity of the outer surfaces of medical devices, is also considered. Lubricity is given, for example, by the coefficient of inverse friction.

[0052] According to several embodiments, the medical device includes catheters and / or vascular prostheses and / or vascular implants and / or shunts and / or stents and / or guidewires.

[0053] According to several embodiments, the guidance support information includes risk information regarding the risk of damage to hollow organs when the medical device is moved to or beyond a target location or area. This risk information may, for example, be provided to the user.

[0054] Risk information may, for example, indicate whether there is a significant risk of damage to a hollow organ. Risk information may also include a risk value or probability indicating the risk of damage to a hollow organ.

[0055] Therefore, it reduces the risk of damage to hollow organs by medical devices.

[0056] According to several embodiments, the guidance support information includes recommendations or specifications for navigation operations used to move a medical device to a target location or target area or to move it beyond a target location or target area.

[0057] Recommendations or specifications for navigation operations can be provided, for example, to the user or the intravascular robotic device. The user or the intravascular robotic device can then perform navigation operations according to the recommendations or specifications.

[0058] Recommendations or guidelines for navigation operations may include, for example, moving a medical device in a certain way and / or changing the orientation or state of a medical device in a certain way when guiding it to or beyond a target location or target area.

[0059] Therefore, the risk of damage to hollow organs by medical devices is reduced and / or the guidance of medical devices can be simplified or can be performed more accurately.

[0060] According to several embodiments, the guidance support information includes recommendations not to move the medical device to or beyond the target location or area.

[0061] Recommendations or guidelines can be provided, for example, to the user or the endovascular robotic device. The user can then decide whether to terminate the procedure or replace the medical device or its components with a more suitable alternative based on the recommendations. The endovascular robotic device can decide whether to terminate the procedure based on the recommendations. This reduces the risk of damage to hollow organs by the medical device.

[0062] According to several embodiments, the guidance support information includes the diameter of the hollow organ and / or the curvature of the hollow organ.

[0063] The diameter and / or curvature of the hollow organ can then be output to the user, for example. This reduces the risk of injury to the hollow organ from the medical device and / or simplifies or allows for more accurate guidance of the medical device.

[0064] Risk information, recommendations or guidelines for navigation operations, and / or recommendations for non-moving medical devices can be generated, for example, based on a comparison of the diameter and / or curvature of a hollow organ with at least one geometric property of the medical device, such as the diameter or maximum diameter of the medical device or a portion thereof, the curvature of the medical device or a portion thereof, and / or the length of the medical device or a portion thereof. They can, alternatively or additionally, be generated based on at least one mechanical property of the medical device.

[0065] According to several embodiments, blood flow in a hollow organ is inferred based on image data. Guidance support information includes the inferred blood flow.

[0066] Blood flow can be inferred, for example, from the analysis of image data regarding regions of higher or lower blood flow across the lumen of a hollow organ and / or luminal obstruction structures such as calcifications or other blockages.

[0067] According to another aspect of the present invention, a data processing system configured to perform a computer-implemented method according to the present invention is provided.

[0068] In this disclosure, the terms "data processing system" and "at least one data processing device" are used interchangeably. Specifically, a data processing device can be understood as a data processing device containing processing circuitry. Therefore, a data processing device is particularly capable of processing data to perform computational operations. This may also include operations for performing index accesses on data structures such as lookup tables (LUTs), as well as data processing methods implemented in hardware.

[0069] Data processing devices may include, in particular, one or more computers, one or more microcontrollers and / or one or more integrated circuits, such as one or more application-specific integrated circuits (ASICs), one or more field-programmable gate arrays (FPGAs), and / or one or more system-on-a-chip (SoCs). Data processing devices may also include one or more processors, such as one or more microprocessors, one or more central processing units (CPUs), one or more graphics processing units (GPUs), and / or one or more signal processors, particularly one or more digital signal processors (DSPs). Data processing devices may also include physical or virtual computer networks or other units mentioned above.

[0070] In various embodiments, the data processing device includes one or more hardware and / or software interfaces and / or one or more storage units.

[0071] The storage cell can be a volatile data memory, such as dynamic random access memory (DRAM) or static random access memory (SRAM), or a non-volatile data memory, such as read-only memory (ROM), programmable read-only memory (PROM), erasable programmable read-only memory (EPROM), electrically erasable programmable read-only memory (EEPROM), flash memory or flash EEPROM, ferroelectric random access memory (FRAM), magnetoresistive random access memory (MRAM), or phase-change random access memory (PCRAM).

[0072] According to another aspect of the present invention, a medical imaging system is provided. The medical imaging system includes a data processing system and a medical imaging device according to the present invention, the medical imaging device being configured to generate image data.

[0073] According to several embodiments, the medical imaging device is implemented as an X-ray-based imaging device, such as a fluorescence fluoroscopy device and / or a C-arm X-ray device or a biplane or multiplane X-ray device.

[0074] According to several embodiments, a medical imaging system includes an intravascular robotic device configured to automatically control the navigation of a medical device based on guidance support information, particularly in hollow organs.

[0075] Further embodiments of the medical imaging system according to the invention derive directly from various embodiments of the computer-implemented method according to the invention, and vice versa. In particular, individual features, corresponding explanations, and advantages associated with various embodiments of the computer-implemented method according to the invention can be similarly transferred to corresponding embodiments of the medical imaging system according to the invention. Specifically, the medical imaging system according to the invention is designed or programmed to perform the computer-implemented method according to the invention. Specifically, the medical imaging system according to the invention performs the computer-implemented method according to the invention.

[0076] According to another aspect of the present invention, a computer program comprising instructions is provided. When executed by a data processing system, the instructions cause the data processing system to perform a computer-implemented method according to the present invention.

[0077] Instructions may be provided, for example, as program code. Program code may be provided, for example, as binary code or assembler and / or as source code of a programming language (e.g., C) and / or as a program script (e.g., Python).

[0078] According to another aspect of the invention, a computer-readable storage medium is provided, particularly a tangible and / or non-transient computer-readable storage medium, which stores a computer program according to the invention.

[0079] A computer program and a computer-readable storage medium are computer program products, each including the instructions.

[0080] Further features and combinations of features of the present invention are obtained from the accompanying drawings and their description, as well as the claims. In particular, further embodiments of the present invention do not necessarily include all the features of a single claim. Further embodiments of the present invention may include features or combinations of features not recited in the claims.

[0081] The invention will be explained in detail below with reference to specific exemplary embodiments and corresponding schematic diagrams. In the drawings, the same or functionally identical elements may be denoted by the same reference numerals. Descriptions of the same or functionally identical elements are not necessarily repeated in different drawings. Attached Figure Description

[0082] Figure 1An exemplary embodiment of the medical imaging system according to the present invention is shown schematically;

[0083] Figure 2 A schematic flowchart illustrating an exemplary embodiment of a computer-implemented method for guiding a medical device according to the present invention is shown; and

[0084] Figure 3 The diagram schematically shows a hollow organ and medical devices inside the hollow organ. Detailed Implementation

[0085] Figure 1 An exemplary embodiment of a medical imaging system 1 according to the present invention is schematically shown. The medical imaging system 1 includes a medical imaging device 3 configured to generate image data representing a medical device 7 inside a patient's hollow organ 8, wherein the medical device 7 extends along a portion 9 of the hollow organ 8, such as... Figure 3 As illustrated schematically. In this example, the hollow organ 8 is, for example, a blood vessel structure.

[0086] As an example, the imaging device 3 is shown as a C-arm X-ray device with an X-ray source 4 and an X-ray detector 5. Therefore, the imaging device 3 can be designed, for example, as a biplane or multiplane fluorescence fluoroscopy device. However, the following explanation can be similarly applied to other imaging devices 3. The patient can be placed on the patient table 2 of the medical imaging system 1.

[0087] The imaging system 1 includes a data processing system 6 according to the invention, which is configured to perform a computer-implemented method for guiding the medical device 7 based on the image data.

[0088] Figure 2 A schematic block diagram illustrating an exemplary embodiment of this computer implementation method according to the present invention is shown.

[0089] In step 200, the image data is received, and in step 220, the diameter D and / or curvature of the hollow organ 8 at the target location or target region 10 of the medical device 7 is determined based on the image data. The curvature of the hollow organ corresponds to the reciprocal of the corresponding radius of curvature R. In step 240, guidance support information for guiding the medical device 7 to at least the target location or target region 10 is generated based on the diameter D and / or the curvature 1 / R of the hollow organ and based on at least one geometric property of the medical device 7.

[0090] In optional step 260, guidance support information or a portion thereof is output to the user of the medical device 7 or provided to a control system for automatically controlling the navigation of the medical device 7, such as to the control system of an intravascular robotic device, which is configured to automatically control the navigation of the medical device 7 based on the guidance support information.

[0091] exist Figure 3 In the example, the medical device 7 includes two components 7a and 7b. The first component 7a may be, for example, a catheter or shunt, or a shunt encapsulated within a catheter, or another device to be deployed inside the hollow organ 8 or another organ of the patient. The second component 7b may be, for example, a guidewire for navigating the medical device 7 or for navigating the first component 7a.

[0092] By means of the present invention, the disadvantages of conventional methods can be overcome at least in part. Various further embodiments and extensions of the described examples are possible.

[0093] In some embodiments, quantitative data based on intraoperative image data, such as quantitative data based on intraoperative image data combined with preoperative image data, is generated and provided to interventional specialists or clinical decision support systems to guide subsequent workflow steps in endovascular surgery, improve accuracy and safety, and ultimately improve patient outcomes.

[0094] For example, it can provide real-time information.

[0095] In some embodiments, real-time information includes distances to predefined, such as user-specific landmarks, like the proximal and / or distal landing zones of a stent, or anatomical landmarks, such as vascular bifurcation, aneurysm neck, etc.

[0096] In some embodiments, these distances can be measured in 3D along the centerline of the corresponding blood vessel. For this purpose, the centerline can be determined in the current 3D angiography image. Furthermore, the instrument tip can be detected and / or the instrument tip can be back-projected into the 3D angiography image.

[0097] In some embodiments, real-time information includes an estimated vessel diameter at the instrument tip. This may be based, for example, on intraoperative 3D angiographic imaging or on an estimated vessel diameter derived from 2D angiographic images from at least one viewing direction. If a dual-plane angiography system is used, there are two available viewing directions. However, if more than two viewing directions should be used to improve the accuracy of the vessel diameter estimate, the angles of the planes / planes can be readjusted.

[0098] In some embodiments, the real-time information includes geometric measurements to estimate the degree of deformation of the patient's vascular system due to the insertion of the medical device compared to the pre-interventional patient's vascular system, which can be derived from pre-interventional angiographic images.

[0099] In some embodiments, the displacement of the centerline point can be continuously estimated, for example by estimating the distance between the corresponding centerline points in 3D. Changes in curvature can also be continuously estimated. These estimates can be derived from 2D images in approximately real-time, for example using a biplane angiography imaging system, such that there are two available viewing directions at each time point.

[0100] In some embodiments, continuous tomography, i.e., finite-angle 3D imaging, can be used to accurately depict the geometric deviation from a reference 3D dataset.

[0101] In some embodiments, tomography is used to continuously acquire 3D images and compare the results with reference 3D images to update real-time geometric parameters and indicators, such as the ratio of vessel diameter to instrument diameter, vessel movement, and instrument tip position.

[0102] In some embodiments, hydrodynamic analysis is performed to estimate, for example, the time it takes for the bolus to reach representative anatomical landmarks or the filling of downstream parenchymal tissue. The results can be compared with previously acquired reference data.

[0103] In some embodiments, changes in X-ray attenuation in parenchymal tissues such as lung parenchyma during the cardiac cycle can be analyzed. For example, recanalization (e.g., in the lungs) may result in changes in X-ray attenuation during a patient's cardiac cycle because blood volume varies during different phases of the heart cycle. This effect can be used to generate metrics for assessing the success of recanalization, such as estimates of X-ray attenuation based on real-time 2D images.

[0104] Intraoperative but non-real-time information can be provided as an alternative to real-time information or in addition to real-time information.

[0105] In some embodiments, the aneurysm coils protruding into the parent artery can be evaluated. This unfortunate situation can be assessed by analyzing real-time image data, provided that an appropriate viewing direction that allows for vertical observation of the parent artery and the aneurysm is selected. Based on 3D image information, such a viewing direction can be automatically selected.

[0106] In some embodiments, the coverage of the saccular aneurysm neck can be assessed when the first coil is placed into the aneurysm dome. For this purpose, high-resolution, particularly non-contrast-enhanced 3D angiographic images can be used, and an appropriate view of the aneurysm neck can be analyzed. The results can be provided to interventional specialists as a 3D rendering of the aneurysm neck using the vertical viewing direction.

[0107] In some embodiments, a visual display of the various parameters is provided. This can be done by displaying the corresponding numbers or by using more intuitive representations or visualizations, such as traffic lights, color bars, progress bars, etc.

[0108] In some embodiments, the medical device may output an audio signal when it approaches or moves away from a specific marker.

[0109] In some embodiments, the evaluation of the aforementioned real-time parameters, such as distance to the marker, diameter, displacement, and curvature changes, is performed periodically. Alternatively or additionally, the evaluation of the aforementioned real-time parameters may be adapted to specific conditions, such as the speed of the instrument tip (higher speed means more frequent parameter evaluation), or the distance to a specific marker (the closer the instrument is to the specific marker, the more frequent the parameter evaluation can be).

[0110] In some embodiments, intravascular imaging, such as optical coherence tomography (OCT) or intravascular ultrasound (IVUS), is additionally used to provide further real-time data to guide endovascular treatment.

[0111] Further advantages of several embodiments include: more objective evaluation of endovascular treatment delivery; more precise deployment of endovascular devices, such as stents; and avoidance of vasospasm that may result from inserting large-diameter catheters into relatively narrow blood vessels.

[0112] Further advantages of several embodiments include: enabling the standardization of endovascular procedures and improving patient outcomes; preventing the use and / or deployment of inappropriate endovascular devices, such as stents that are too large for the target vessel diameter, stents that are too long for the target location in the target vessel, or guidewires or catheters that are too rigid for the patient's vascular system.

Claims

1. A computer-implemented method for guiding a medical device (7) with guidance support, characterized in that, - Receive image data representing a medical device (7) inside a hollow organ (8), wherein the medical device (7) extends along a portion (9) of the hollow organ (8); - Based on the image data, determine the diameter (D) and / or curvature of the hollow organ (8) at the target location or target region (10) of the medical device (7); and - Based on the diameter (D) and / or the curvature and based on at least one geometric property of the medical device (7), guide support information is generated for guiding the medical device (7) to at least the target location or the target region (10).

2. The computer implementation method according to claim 1, characterized in that, The at least one geometric property of the medical device (7) is determined at least in part based on the image data.

3. The computer implementation method according to any one of the preceding claims, characterized in that, The image data includes at least two projected images, which represent the medical device (7) inside the hollow organ (8) according to at least two corresponding projection directions.

4. The computer implementation method according to claim 1 or 2, characterized in that, - The image data includes multiple projected images, which represent the medical device (7) inside the hollow organ (8) according to the corresponding projection direction; - Generate a 3D reconstruction based on the multiple projected images; and - Determine the diameter (D) and / or the curvature based on the three-dimensional reconstruction.

5. The computer implementation method according to any one of the preceding claims, characterized in that, The at least one geometric property of the medical device (7) includes the diameter of the medical device (7) or a portion (7a, 7b) of the medical device (7) and / or the curvature of the portion (7a, 7b) of the medical device (7) and / or the length of the portion (7a, 7b) of the medical device (7) and / or the ratio of the inner diameter to the outer diameter of the portion (7a, 7b) of the medical device (7).

6. The computer implementation method according to any one of the preceding claims, characterized in that, The guidance support information is generated based on at least one mechanical property of the medical device (7).

7. The computer implementation method according to claim 6, characterized in that, The at least one mechanical property includes the stiffness of the medical device (7) or a portion (7a, 7b) of the medical device (7) and / or the elasticity of the medical device (7) or the portion (7a, 7b) of the medical device (7) and / or the surface lubricity of the medical device (7) or the portion (7a, 7b) of the medical device (7).

8. The computer implementation method according to any one of the preceding claims, characterized in that, The boot support information or a portion thereof is output to the user of the medical device (7).

9. The computer implementation method according to any one of the preceding claims, characterized in that, The guidance support information, or a portion thereof, is provided to a control system for automatically controlling the navigation of the medical device (7).

10. The computer implementation method according to any one of the preceding claims, characterized in that, The medical device (7) includes catheters and / or vascular prostheses and / or vascular implants and / or shunts and / or stents and / or guidewires.

11. The computer implementation method according to any one of the preceding claims, characterized in that, The guidance support information includes - Risk information regarding the risk of damage to the hollow organ (8) when the medical device (7) is moved to or beyond the target location or target area (10); and / or - Recommendations or specifications for navigation operations used to move the medical device (7) to or beyond the target location or target area (10); and / or - Recommendations for not moving the medical device (7) to or beyond the target location or target area (10).

12. A data processing system (6), characterized in that, The data processing system is configured to perform a computer-implemented method according to any one of the preceding claims.

13. A medical imaging system (1), characterized in that, The medical imaging system includes a data processing system (6) according to claim 12 and a medical imaging device (3), the medical imaging device being configured to generate the image data.

14. The medical imaging system (1) according to claim 13, characterized in that, It further includes an intravascular robotic device configured to automatically control the navigation of the medical device (7) based on the guidance support information.

15. A computer program product, including instructions, characterized in that, When the instruction is executed by the data processing system (6), the data processing system (6) performs the computer implementation method according to any one of claims 1 to 11.

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