Interventional imaging system

Abstract

Interventional imaging system comprising an imaging device (3) for recording interventional data of a body, at least two position markers (12, 13) recordable with the imaging device (3) for marking an interventional instrument (11), a display device (8) for displaying recorded interventional data and position markers (12, 13), a navigation device (6) connected to the display device (8) for loading pre-interventional data of the body, including an intervention site (14) of the body, and for mutually registering the pre-interventional data with the interventional data, wherein the navigation device (6) is configured to display the registered pre-interventional data, including the intervention site (14), together with the position markers (12, 13) on the display device. wherein the position markers (12, 13) are designed and can be arranged on an elongated intervention instrument (11) guided by a robot arm (10) such that they mark positions along the longitudinal axis of the intervention instrument (11) such that when the position markers (12, 13) on the display device (8) are aligned with each other and with the intervention site (14), the longitudinal axis of the intervention instrument (11) is aligned with the intervention site (14), characterized by that the navigation device (6) automatically controls the robot arm (10) until the position markers (12, 13) are aligned with each other and with the intervention site (14).

Description

[0001] The invention relates to an interventional medical diagnostic and / or therapeutic system.

[0002] Interventional procedures, such as those used in radiology, already play an important role in the diagnosis and treatment of many diseases. For example, certain instruments, such as needles, are used to access a specific location in the body or within an organ from the outside, through the skin (percutaneously). This includes procedures such as punctures, biopsies, ablations, and brachytherapy. Alternatively, fixation devices, such as screws, may be used.

[0003] Due to technological advancements in imaging systems, the so-called modalities, such as computed tomography, magnetic resonance imaging, or angiography, inflammatory or tumorous changes can be detected at increasingly earlier stages. To minimize the burden on patients, minimally invasive procedures are being performed more and more frequently at a very early stage, when the changes are still relatively small. Furthermore, increasingly finer instruments are being developed for punctures, catheterization, and probing of organ systems. Because ever smaller target areas in the body are being addressed with increasingly finer instruments, increasingly precise and accurate navigation methods are also required.

[0004] Since the physician cannot directly see the instrument inside the patient's body, they rely on imaging techniques. Ideally, the physician has access to a 3D dataset from a modality (e.g., magnetic resonance imaging, computed tomography, angiography) before the intervention, allowing them to identify the target region and, based on physiology, plan the ideal path to it and thus the entry point of the instrument. In a simpler approach, the target region is identified during the intervention, for example, using a C-arm X-ray machine capable of producing CT images, and further planning is carried out using the combined information from the 2D and 3D data of the X-ray machine. This planning determines the entry point on the body and the orientation of the interventional instrument, such as a needle.

[0005] Generally, the entry channel of the instrument is planned by a physician using a planning system, i.e. virtually with the help of suitable software, and then manually transferred to the interventional instrument, which may be robot-assisted.

[0006] The intervention plan can then be transmitted to a navigation system registered with the 3D dataset. The navigation system can control or assist the instrument's orientation using various manual or automatic methods. The instrument's advancement can be monitored fluoroscopically, i.e., in real time under X-ray fluoroscopy or ultrasound. Alternatively, the pre-interventional 3D dataset can be co-registered with the C-arm dataset, and the information can then be used for navigation.

[0007] Problems arise, for example, with obese or overweight patients. Due to the technical limitations of the C-arm X-ray machine, only a limited body volume can be reconstructed. Therefore, it can happen that the body surface is not included in the 3D dataset. In this case, during virtual planning, the physician cannot see where the puncture point is located or whether the planned access route is unsuitable for the intervention due to the superimposition of bones or ribs. Currently, for example, fine-needle aspiration or thermal ablation of a liver lesion is usually performed percutaneously under CT guidance. For access planning, the physician uses a combination of the CT scan image, markers placed externally on the patient's skin, and a laser crosshair mounted on the CT gantry.

[0008] In this procedure, the actual puncture and the advancement of the instrument are essentially performed manually by the physician. Depending on their experience level, multiple punctures may be necessary. Besides the discomfort for the patient, this approach also carries an increased risk of complications such as bleeding, organ damage, or hematomas. Furthermore, the accuracy of the puncture is limited with this method, especially in very small target areas.

[0009] To achieve more precise instrument guidance, various other navigation aids can be used, such as optical or electromagnetic tracking systems, or the use of a stereotactic frame whose position in space is known and which incorporates a device for instrument guidance. However, this approach is complex. Furthermore, the distal end of the instrument, furthest from the patient, can be monitored by tracking systems. However, this does not account for potential instrument deformations, such as a needle tip, caused by resistance within the body, which may lead to deviations from the puncture path.

[0010] German patent application DE 10 2007 045 075 A1 discloses an interventional navigation system that includes a multi-axis robotic arm for guiding an attached instrument. The robotic arm features compliance control, allowing it to yield in a controlled manner to external forces, such as manual ones. This enables the user to manually position the instrument while the navigation system automatically maintains it in the desired orientation and position, or along the desired path. This requires the mutual registration of 3D data from the patient, the robotic arm, and the intraoperative imaging device.

[0011] The prior art described in DE 10 2007 045 075 A1 allows, for example, the physician to manually pre-position a robotic needle guide during a biopsy, and the robot then takes over the final placement and alignment of the needle. A number of methods for position detection are mentioned, all of which are based on external positioning techniques (optical, electromagnetic navigation) or a fixed mechanical registration. With mechanical registration, the robot should be fixedly mounted relative to the C-arm system.

[0012] However, several limitations can arise when using such a system in a surgical setting. For example, in spinal fixation procedures, numerous screws are inserted into various vertebrae. With a fixed mechanical registration of the instrument holder, regular and complex calibration is necessary to ensure precise screw placement. This calibration is susceptible to interference, as accidental mechanical impacts on the instrument holder during surgery cannot be ruled out. Because accurate calibration is essential for precise screw placement, it must be repeated frequently. This is time-consuming and impractical in an operating room.

[0013] If an additional external positioning technology (optical, electromagnetic navigation) is used instead, the patient must first be registered with the surgical plan (e.g., planned screw position). Then, the patient and instrument holder must be registered with the positioning technology. Most of the registration steps are time-consuming. Furthermore, one would prefer to avoid additional positioning systems, as their hardware is often obstructive and also prone to malfunctions.

[0014] A method for determining the spatial orientation of a catheter is known from publication WO 2010 / 092 512 A1. For this purpose, the catheter is marked with asymmetrical markings. The asymmetry of these markings allows the orientation in space to be determined using a single 2D projection.

[0015] From publication US 2011 / 0060214A1, a catheter is known that has sensors for determining the spatial position of the catheter. The sensors do not individually provide any orientation information and are not individually represented in a multidimensional manner.

[0016] The object of the invention is to provide an interventional imaging system and method that supports and enables the control of an intervention to be carried out according to an intervention plan by means of continuous imaging, in particular fluoroscopy, while keeping the effort for calibration and registration low and doing without an additional locating system.

[0017] The invention solves this problem through an imaging system and a method with the features of the independent patent claims.

[0018] A basic concept of the invention comprises an interventional imaging system comprising an imaging device for recording intervention data of a body, at least two position markers recordable with the imaging device for marking an intervention instrument, a display device for reproducing recorded intervention data and position markers, a navigation device connected to the display device for loading pre-intervention data of the body, in which an intervention site of the body is included, and for mutually registering the pre-intervention data with the intervention data, wherein the navigation device is configured to reproduce the registered pre-intervention data including the intervention site together with the position markers on the display device, wherein the position markers are designed in such a way and can be arranged on an elongated intervention instrument,that they mark positions, particularly coaxial positions, along the longitudinal axis of the interventional instrument, such that when the position markers on the display device are aligned with each other and with the intervention site, the actual longitudinal axis of the interventional instrument is also aligned with the actual intervention site. By continuously recording and displaying only the easily detectable position markers, dose can be saved during acquisition; in the case of acquisition with an X-ray imaging system, this means a reduction in X-ray dose. The relevant spatial information regarding the target or intervention site is obtained from the recorded pre-intervention data. In addition to the position markers, the intervention data can also be continuously recorded and displayed.

[0019] An advantageous further development of the basic idea is that the intervention data are 2D data.

[0020] A further advantageous development of the basic idea is that the pre-intervention data are 3D data.

[0021] A further advantageous development of the basic idea is that the pre-intervention data were also recorded during the intervention, only before the respective current sub-intervention, and are 3D data (e.g. 3D DynaCT).

[0022] A further advantageous development of the basic idea is that the imaging device is an X-ray machine.

[0023] A further advantageous development of the basic idea is that the imaging system is a C-arm X-ray system which can acquire 3D data, thus advantageously providing an intrinsic registration between the 2D and 3D data.

[0024] A further advantageous development of the basic idea is that the intervention instrument can be an instrument, instrument holder, or instrument guide.

[0025] Another basic idea of ​​the invention consists of a method for interventional imaging comprising the steps - Recording of intervention data, - Arranging at least two position markers on an elongated intervention instrument, wherein the position markers are designed and arranged on the intervention instrument in such a way that they mark positions, in particular coaxial positions, along the longitudinal axis of the intervention instrument, such that when the position markers on the display device are aligned with each other and with the intervention site, the actual longitudinal axis of the intervention instrument is also aligned with the actual intervention site. - Recording the position markers, - Loading pre-intervention data that includes an intervention site on the body, - mutual registration of intervention data and pre-intervention data, - Displaying the recorded pre-intervention data, including the intervention location and position markers, on a display device.

[0026] By continuously recording and displaying only the easily detectable position markers, the radiation dose can be reduced during acquisition; in the case of an X-ray imaging system, this means a reduction in X-ray dose. The relevant location information regarding the target or intervention site is obtained from the recorded pre-intervention data. In addition to the position markers, the intervention data can also be continuously recorded and displayed.

[0027] One beneficial aspect of further training is that the intervention data are 2D data.

[0028] Another beneficial aspect of this further training is that the pre-intervention data are 3D data.

[0029] Another advantageous development is that the imaging device is an X-ray machine.

[0030] A further advantageous development of the basic idea is that - the current position and orientation of the intervention instrument is automatically recognized based on the position markers, - based on the pre-intervention data and the intervention location, a deviation of the current position and orientation from a target position and orientation of the intervention instrument is automatically detected, and - the deviation or a resulting movement suggestion for the movement of the intervention instrument is displayed on the display device.

[0031] As explained above, a fundamental aspect of the invention is the use of continuous interventional imaging (fluoroscopy) for the final and precise positioning of the instrument holder or guide of an interventional instrument according to a predetermined plan. Preferably, an X-ray system, such as a C-arm X-ray system, is used as the imaging system. This describes a system and method that allows for simple manual pre-positioning, can be easily moved to and from the patient table, requires no prior calibration, registration, or tracking system, and achieves extremely high flexibility.

[0032] For this purpose, the instrument guide is equipped with at least one, preferably two, radiopaque markers as position indicators, whose shape and relative position are known. These markers can be designed similarly to a sighting device. In an interventional image, they are detected using image processing and recognition techniques, thus displaying their position and orientation relative to the interventional image. If the position and orientation of the markers or the interventional instrument are to be calculated, parameters such as their size in the interventional image, their relative displacement, and / or their symmetry / tilt can be used. The result of such a calculation allows the current position and orientation of the interventional instrument to be compared with the position and orientation at the intervention site.The comparison result can then be displayed to the operator, or a movement suggestion for the interventional instrument towards the intervention site can be determined and displayed, or such a movement suggestion can be transmitted to a controller for automatic movement of the interventional instrument.

[0033] If a 2D imaging system, as is common in fluoroscopy, is used, information about the height of the guide or interventional instrument relative to the imaging system or the intervention site is initially lacking. However, this lack of information is not significant if the image detector is aligned so that the detector normal coincides with the planned intervention path. In this case, the height or distance of the interventional instrument to the patient can be monitored and, if necessary, manually adjusted by the surgeon.

[0034] If necessary, the guide height can also be calculated from another fluoroscopy image if the orientation of the imaging system is changed. This may be required if the detector normal does not coincide with the planned intervention path (e.g., if the detector cannot reach this position due to collision issues). In this case, the location, size, and shape of the markers in the detector image can be calculated based on the planning and the corresponding recorded detector position, and serve as the basis for further positioning.

[0035] No registration is necessary, because after an initial movement of the instrument holder and thus the markers, the relative movement of the instrument holder to its final, planned orientation can be calculated from the change in position in the interventional image. Therefore, the instrument holder, for example a robot, can be mounted on a trolley and simply moved to the patient table as needed.

[0036] One advantage is that close integration of a robot or interventional instrument holder with the imaging system, such as a C-arm X-ray system, is not necessary. Once the image detector has been aligned along the planned interventional trajectory, the robot arm can determine the desired position of the interventional instrument holder solely based on the interventional images, such as fluoroscopy images. This means that the trajectory planned in the imaging system does not need to be transferred to the interventional instrument holder system itself, but is determined solely by the interventional images.

[0037] The imaging itself can be performed at a low, adjusted frame rate. Since the markers are optimally absorbable, i.e., radiopaque in the case of an X-ray system, the fluoroscopy dose per image can also be significantly reduced.

[0038] The image transmission / transmission of the intervention plan from the imaging system or navigation device to the intervention instrument control, for example, a robot controller, can also be wireless. This concept can generally also be applied to completely manual positioning. In this case, a mechanical, manually controlled holder is preferably used.

[0039] Further advantageous embodiments will become apparent from the dependent claims and from the following description of exemplary embodiments with reference to the figures. The figures show: Fig. 1 Interventional Imaging System, Fig. 2 non-aligned position markers, Fig. 3 aligned position markers, Fig. 4 position markers with suggested movement and Fig. 5 position markers before and after initial movement

[0040] In Fig. Figure 1 shows a schematic representation of an interventional imaging system. It comprises a C-arm X-ray system 3, a patient positioning system 2, and a cart 9 equipped for interventional purposes.

[0041] The C-arm X-ray system 3 comprises an X-ray source 4 arranged on a C-arm and an image detector 5. It is connected to a navigation device 6, which serves to support interventions performed with the aid of interventional image data acquired by the C-arm X-ray system 3. According to a simple embodiment, interventional data are acquired in 2D by the C-arm X-ray system 3. In a more complex embodiment, however, 3D data can also be acquired, for which the detector normal, which results from the position of the C-arm, must be rotated.

[0042] The navigation system 6 loads pre-intervention data from a corresponding data storage device 7 to perform an intervention. The pre-intervention data is typically 3D data acquired prior to an intervention for planning purposes on the patient's body. This data can be acquired using a variety of imaging techniques, such as CT, MRI, and PET. It can also be acquired directly with the C-arm X-ray system 3 intended for the intervention. Alternatively, fused datasets from different modalities can be used. The pre-intervention data includes a representation of at least a portion of the patient's body containing the actual intervention site. Based on this data, procedures at the intervention site can be planned with regard to its precise position and access.

[0043] The navigation unit 6 registers the pre-intervention data loaded from the data storage device 7 with the interventional data received from the C-arm X-ray system 3, which may include, for example, low-dose fluoroscopy data. This registration ensures that an intervention site contained in the pre-intervention data can be precisely located within the interventional data. Thus, the registration allows the intervention site to be precisely located within the interventional data and, consequently, within the actual patient's body, enabling the intervention to be performed exactly at the intervention site. The registered interventional and pre-interventional data are displayed by the navigation unit 6 on a display device 8, such as a flat screen.

[0044] The patient body 1, to be undergoing an intervention, is positioned on a patient support 2. It is X-rayed using the C-arm X-ray system 3 to acquire interventional data. Specifically, the C-arm, and thus the patient body 1, is positioned so that the intervention site is included in the interventional data. Consequently, previously acquired pre-interventional data are displayed on the display unit 8 together with interventional data acquired in real time.

[0045] To precisely target and locate the intervention site on the patient's body 1, as indicated in the recorded image data displayed on the display device 8, using an interventional instrument 11, the interventional instrument 11 is guided by a robotic arm 10. The robotic arm 10 can include a compliance control system, allowing the surgeon to manually guide the interventional instrument 11. It can also be operated remotely, enabling the surgeon to precisely control the interventional instrument 11 remotely. Furthermore, an automated embodiment is conceivable in which the robotic arm 10 is automatically controlled by the navigation system 6 based on the pre-interventional and interventional image data.

[0046] A data connection between the Cart 9 and the navigation unit 6 can be used to transfer planning and image data, or to transmit further commands. Alternatively, data can also be transferred to the Cart 9 before the intervention. A data connection between the Cart 9 and the navigation unit 6 can be established as described in the Fig. 1 indicated by a dashed line, must be wireless.

[0047] To ensure clear visibility in the interventional data, the interventional instrument 11 has position markers 12 and 13. These markers are designed to be easily detectable by the interventional imaging device. If the interventional imaging device is an X-ray system, the position markers 12 and 13 are therefore radiopaque. The position markers 12 and 13 are explained in more detail below.

[0048] In Fig. Figure 2 is a schematic representation of interventional and pre-interventional data, for example, on the display device 8. The intervention site 14 is identified and marked based on the pre-interventional data. The interventional data are recorded along with the pre-interventional data, so that the intervention site 14 is also represented in the interventional data at the correct position. The image detector is centrally and directly aligned with the intervention site 14.

[0049] While the interventional instrument itself is not identifiable in the interventional data, the position markers 12 and 13 are clearly visible. These markers are circular and arranged coaxially along the interventional instrument's longitudinal axis. Position marker 12 is located on the side of the interventional instrument facing the intervention site 14, and position marker 13 is located on the opposite, away side.

[0050] The longitudinal axis of the intervention instrument is therefore clearly recognizable, but not precisely aligned with the intervention site 14. An imaginary line passing through the respective centers of the position markers 12 and 13 corresponds to the longitudinal axis of the intervention instrument and obviously does not pass through the intervention site 14. Furthermore, the oval distortion of the image projection of the actually circular position markers 12 and 13 indicates that the intervention instrument is not oriented perpendicular to the image detector, i.e., in the detector normal, but is tilted.

[0051] In Fig. Figure 3 schematically depicts the previously described pre-intervention and intervention data, including position markers 12 and 13, with the intervention instrument repositioned. The intervention site 14 remains in the center of the projection. As before, the image detector is centrally aligned with the intervention site 14. The position markers 12 and 13 are also located in the center of the image. They are aligned so that the circular markers overlap each other. This clearly indicates that the longitudinal axis of the intervention instrument is also positioned exactly in the center and aligned with the intervention site 14. Since the intervention instrument is thus located in the center of the image and therefore automatically perpendicular to the image detector, the projections of the circular position markers 12 and 13 are also circular.

[0052] The angle at which the interventional instrument is tilted relative to the image detector normal can obviously be determined from the oval deformation of the respective projection of the projection markers 12, 13. If the actual distance between the position markers 12, 13 is known, the spatial position of the interventional instrument can also be deduced from the distance between the oval-deformed projections of the position markers 12, 13 when the interventional instrument is tilted relative to the detector normal.

[0053] The accuracy of such position determination can be increased by performing a precisely known, arbitrary movement of the intervention instrument and subsequently recording two further positions and deformations of the position markers 12, 13. In this way, with the aid of the position markers 12, 13, given their known geometry and arrangement on the intervention instrument, as well as, if applicable, their distance from each other, and, if applicable, known variation in the location and orientation of the intervention instrument between two recordings, position data of varying degrees of accuracy can be determined.

[0054] In Fig. Figure 4 again shows interventional and pre-interventional data, including intervention site 14 and a respective projection of the position markers 12 and 13. As before, intervention site 14 is centered, and the image detector is precisely aligned with it. Position markers 12 and 13 are, as before, not centered, and their projection is oval-shaped. The interventional instrument is therefore tilted relative to the detector normal and is not aligned with intervention site 14. Arrows a and b indicate displacement vectors intended to achieve more precise alignment of the interventional instrument with intervention site 14. By manually or automatically controlling the interventional instrument according to the displacement vectors a and b, intervention site 14 could thus be gradually approached with the interventional instrument.

[0055] In Fig.Figure 5 shows the intervention site 14 and the position markers 12 and 13, as before. The position markers 12 and 13 are arranged in a different position compared to the previous image. This is due to a pre-defined, arbitrary change in the position of the intervention instrument relative to its previous position. Given the pre-defined arbitrary change in position and the known distance between the position markers 12 and 13 on the intervention instrument, relatively accurate position data of the intervention instrument can be obtained from the position data of the position markers 12 and 13 before and after the arbitrary movement. This includes, in particular, the z-axis, which is not included in the 2D data; that is, the distance of the intervention instrument from the intervention site 14 or from the image detector.

[0056] Using the data acquired from the interventional instrument, as well as the instantaneous position evident from the interventional and pre-interventional data, a suggested movement for the interventional instrument can be determined, allowing it to be aligned more precisely with intervention site 14. In particular, by considering any information about the position of the interventional instrument on the Z-axis, i.e., its distance from intervention site 14, the required distance to intervention site 14 or the patient's body can be maintained.

[0057] The described embodiments enable the following exemplary workflow A for the positioning of, for example, a screw with existing pre-interventional planning, using a drill sleeve as an example: 1. Manual positioning of the robot with the drill sleeve near the patient table 2. Manual rough positioning of the drill sleeve 3. Positioning the C-arm X-ray system so that the detector normal points towards the intervention site, or alternatively calculating the target position, size and shape of the markers on the fluoroscopic image. 4. Start of automatic positioning by the robot 5. Registration with the schedule a. Fluoroscopy and image recognition of markers in the interventional fluoroscopy image b. Calculation of the relative position (x,y,z*) and initial movement suggestion (delta_x, delta_y) c. Movement of the drill sleeve d. Fluoroscopy and image recognition of markers in the interventional fluoroscopy image e. Calculation of the relative position change (dx,dy,dz), initial registration 6. Positioning / alignment of the sleeve a. Calculation of a new motion proposal (dx,dy) b. Movement of the drill sleeve c. Fluoroscopy and image recognition of the markers in the fluoroscopy image d. Repeat steps 6a to 6d until the final position / alignment is reached. 7. Optional: Positioning the sleeve at the planned distance from the object

[0058] Regarding point 7): The positioning of the drill sleeve in the z-direction relative to the object is critical, as injuring the patient with the sleeve must be avoided. Therefore, an initial distance from the detector and, if interventional planning and 2D / 3D registration are available, an initial distance from the patient are determined (e.g., from the magnification of the markers in point 5b). This distance measurement is continuously refined during positioning using a wealth of data.

[0059] An alternative solution is to automate only the x,y positioning and alignment. Once this is complete, the physician approaches the object with the compliance-controlled robot arm, whereby the robot only allows movement along the detector normal.

[0060] A combination of both approaches is also conceivable. The doctor guides the robot or interventional instrument manually until he receives a signal to stop.

[0061] Several options are conceivable for implementing the overall system: 1. The robot arm is fully integrated with the C-arm system and is also controlled by it via a corresponding unit. 2. The robot arm has its own control unit (image recognition, image processing and motion planning and control) and receives the pre-interventional planning data and interventional fluoroscopy images from the C-arm system. 3. The robot arm control system includes complete intervention planning, detection, and control. 4. Both systems are completely separate. Planning takes place at the C-arm system. The C-arm aligns itself according to the plan (detector normal corresponds to the planned path). The robot arm controller only receives the interventional fluoroscopy data. Navigation is possible using the knowledge of the C-arm's orientation, without the need to transfer 3D or planning data.

[0062] Overall, the workflow is as follows: 1. Creation of a pre-interventional 3D dataset of a patient using a medical imaging device (triggered by the physician) 2. Determination of a target region / intervention site for the patient to be treated using the 3D data set (manually by the doctor) 3. Planning the intervention, e.g. drilling into a vertebra of the patient (also manually by the doctor, possibly supported by a therapy planning system) 4. Transfer of the plan to the robot with the intervention instrument 5. Positioning of the intervention instrument, e.g. a drill sleeve, according to workflow A above) 6. Manual advancement of the interventional instrument / drill by the surgeon, - optional control during the advancement of the instrument (e.g. by means of interventional images created by fluoroscopy or another imaging procedure)

Claims

[1] Interventional imaging system comprising an imaging device (3) for recording interventional data of a body, at least two position markers (12, 13) recordable with the imaging device (3) for marking an interventional instrument (11), a display device (8) for displaying recorded interventional data and position markers (12, 13), a navigation device (6) connected to the display device (8) for loading pre-interventional data of the body, including an intervention site (14) of the body, and for mutually registering the pre-interventional data with the interventional data, wherein the navigation device (6) is configured to display the registered pre-interventional data, including the intervention site (14), together with the position markers (12, 13) on the display device, wherein the position markers (12, 13) are designed and can be arranged on an elongated intervention instrument (11) guided by a robot arm (10) such that they mark positions along the longitudinal axis of the intervention instrument (11) such that when the position markers (12, 13) on the display device (8) are aligned with each other and with the intervention site (14), the longitudinal axis of the intervention instrument (11) is aligned with the intervention site (14), characterized by , that the navigation device (6) automatically controls the robot arm (10) until the position markers (12, 13) are aligned with each other and with the intervention site (14). [2] Imaging system according to claim 1, wherein the navigation device (6) is configured to display the intervention data on the display device (8) in addition to the pre-intervention data including intervention location (14) and position markers (12, 13). [3] Imaging system according to any of the preceding claims, wherein the intervention data are 2D data. [4] Imaging system according to any of the preceding claims, wherein the pre-intervention data are 3D data. [5] Imaging system according to any of the preceding claims, wherein the imaging device (3) is an X-ray device. [6] Imaging system according to any of the preceding claims, wherein the intervention instrument (11) is an instrument, instrument holder or instrument guide. [7] Interventional imaging procedures include the steps - Recording of intervention data, - Arranging at least two position markers (12, 13) on an elongated intervention instrument (11) guided by a robot arm (10), wherein the position markers (12, 13) are designed and arranged on the intervention instrument (11) such that they mark positions along the longitudinal axis of the intervention instrument (11) such that when the position markers (12, 13) are aligned with each other and with an intervention site (14) on the display device (8), the longitudinal axis of the intervention instrument (11) is aligned with the intervention site (14). - Recording the position markers (12, 13), - Loading of pre-intervention data, which includes an intervention site (14) of the body, by a navigation device (6), - mutual registration of intervention data and pre-intervention data by the navigation device (6), - Displaying the recorded pre-intervention data including the intervention location (14) together with the position markers (12, 13) on a display device (8), - Control of the robot arm (10) by the navigation device (6), - re-establishing the position markers (12, 13), - Repeat the last two steps until the position markers ()12, 13) are aligned with each other and with the intervention site (14). [8] Method according to claim 7, wherein in addition to the position markers (12, 13) the intervention data are recorded and displayed together with the position markers (12, 13) and the pre-intervention data on the display device (8). [9] Method according to claim 7 or 8, wherein the intervention data are 2D data. [10] Method according to any one of claims 7 to 9, wherein the pre-intervention data are 3D data. [11] Method according to any one of claims 7 to 10, wherein the imaging device (3) is an X-ray device. [12] Method according to any one of claims 7 to 11, wherein - based on the position markers (12, 13) a current position and orientation of the intervention instrument (11) is automatically recognized, - based on the pre-intervention data and the intervention location (14), a deviation of the current position and orientation from a target position and target orientation of the intervention instrument (11) is automatically detected, and - the deviation or a movement suggestion formed therefrom for the movement of the intervention instrument (11) is displayed on the display device (8).

Images