Method for operating an X-ray device, X-ray device, computing device, computer program and electronically readable data carrier

Abstract

The invention relates to a method for operating an X-ray device (1), comprising the following steps: recording at least one 2D X-ray image (4, 12, 17) of an examination object (5) by an X-ray device (2) of the X-ray device (1); 2D / 3D registration of the at least one 2D X-ray image (4, 12, 17) to a 3D model (9) by a computing device (3) of the X-ray device (1), wherein corresponding 3D image elements (10) located at respective 3D image element positions in the 3D model (9) are assigned to 2D image elements (13) of the at least one 2D X-ray image (4, 12, 17); determining a volume of interest (14) within the 3D model (9);Post-processing the at least one 2D X-ray image (4, 12, 17), wherein at least some of the 2D image elements (13) are processed depending on a relative position of the 3D image element position of the 3D image elements (10) corresponding to the respective 2D image elements (13) with respect to the volume of interest (14); and providing output data comprising the at least one 2D X-ray image (4, 12, 17).

Description

[0001] The invention relates to a method for operating an X-ray device, an X-ray device, a computing device, a computer program and an electronically readable data carrier.

[0002] In certain minimally invasive surgical procedures, X-ray images are taken to guide an instrument into the area of ​​the patient to be treated. In vertebroplasty, kyphoplasty, or broader procedures in which the instrument is guided into / onto a bone or other high-contrast anatomical structure, certain bone structures detected in the X-ray images can adversely affect image quality in a region of interest because they make it difficult to visually identify important landmarks of a bone relevant to the treatment, particularly a vertebral body. These other interfering bone structures lie in front of and / or behind the region of interest important for performing the procedure in one projection direction of the X-ray images.

[0003] Typical X-ray images taken during a vertebroplasty show a multitude of anatomical and sometimes artificial structures from various depths, simultaneously superimposed on one another. These superimposed structures often lie precisely in the area of ​​interest where an instrument tip and its position in relation to relevant anatomy are to be identified using the X-ray images.

[0004] 2D bone removal procedures are known from the state of the art, in which bones are detected in X-ray images and completely removed from the X-ray images. This would not be helpful in the treatment procedures in question, as relevant bone landmarks should remain in the X-ray images.

[0005] To highlight areas at a certain depth in images compared to areas at other depths, smartphone cameras use virtual bokeh or virtual depth-of-focus techniques. However, these techniques do not overlap in the image. Furthermore, depth information is typically obtained using multi-view geometry with multiple sensors. Therefore, these techniques cannot be applied to enhancing X-ray images.

[0006] The following procedures are known for improving X-ray images.

[0007] US 11 195 309 B2 discloses a method and system for generating X-ray images of an object. According to this invention, a shift-and-add method is used to generate a stack of linear tomography planes, each associated with a different region inside the object. A set of shift values ​​is defined based on the consideration that the stack of linear tomography planes fills the tomographic volume with a spatial density appropriate for the application. If the application requires it, some focal planes can be selectively edited to reduce sharpness in some areas and control the depth of field. A focus stacking method is used to synthesize a single 2D X-ray image from the tomographic image stack. A depth map of the focused regions from the linear tomography stack can be used to create a 3D object model.

[0008] US 2017 / 0281110 A1 discloses a method for identifying a tomographic image from a plurality of tomographic images. The method comprises receiving information indicating a region of interest in at least one of a plurality of projection images or in at least one of a plurality of tomographic images reconstructed from the plurality of projection images. The method comprises identifying a tomographic image from the plurality of tomographic images, wherein the identified tomographic image is more focused in a region corresponding to the region of interest than others of the plurality of tomographic images.

[0009] It is an object of the invention to improve a representation of structures of an area of ​​interest in X-ray images.

[0010] This object is achieved by the respective subject matter of the independent claims. Advantageous further developments and preferred embodiments are the subject matter of the dependent claims.

[0011] A first aspect of the invention relates to a method for operating an X-ray device. The X-ray device comprises an X-ray device and a computing device.

[0012] The method comprises capturing at least one 2D X-ray image of an examination subject using the X-ray device of the X-ray apparatus. The X-ray device may, for example, have a surface detector configured to detect X-ray radiation emitted by an X-ray source and passing through the examination subject arranged between the X-ray source and the surface detector.

[0013] A subsequent step of the method comprises a 2D / 3D registration of the at least one 2D X-ray image to a 3D model by the computing device of the X-ray device. In other words, the 2D / 3D registration is performed by the computing device, whereby the 2D X-ray image is assigned to the 3D model. The 3D model can, for example, be created from 2D X-ray images of a previous recording of the examination object and depict the examination object three-dimensionally. The 3D model can alternatively represent a generic object. In the 2D / 3D registration, 2D image elements of the at least one 2D X-ray image are assigned respective corresponding 3D image elements of the 3D model. The 3D image elements are located at respective 3D image element positions in the 3D model. In other words, the at least one 2D X-ray image comprises the 2D image elements. The 2D image elements represent the 3D image elements of the 3D model.

[0014] The image elements can be, for example, anatomical features, such as bones, organs, or blood vessels. The image elements can also be, for example, medical instruments, such as guidewires, catheters, endoscopes, or surgical tools. The image elements can also be, for example, implants, such as screws, spinal fusions, or artificial joints. The image elements can be represented, for example, as image areas with high image values, i.e., pixel values ​​or voxel values, as edges, or as contours.

[0015] The 3D image elements can be located at different 3D image element positions in the 3D model. Because the 2D X-ray image is a projection of the object under examination, the 2D image element positions of the respective 2D image elements in the respective 2D X-ray image depend on the 3D image element positions of the respective corresponding 3D image elements if the 3D model depicts the object under examination in three dimensions. If the 3D model represents a generic object, the 2D image element positions correspond to the corresponding 3D image element positions. If two of the 3D image elements are located one behind the other with respect to a projection direction of the respective 2D X-ray image, the two 3D image elements are located at different depths. If the two 3D pixels are not offset from each other along a direction perpendicular to the projection direction, the corresponding 2D pixels are imaged onto each other at an identical 2D pixel position.

[0016] In other words, the 2D image elements in the 2D X-ray image can overlap, at least in some areas. For example, the 2D X-ray image may represent the 2D image elements associated with 3D image elements arranged one behind the other along the projection path. The corresponding 3D image elements can thus jointly contribute to the value of a pixel of the 2D X-ray image.

[0017] In a further step of the method, a volume of interest is determined within the 3D model. In other words, a corresponding volume of the 3D model is imaged using at least one 2D X-ray image. The intention is that a specific volume of interest within the volume of the 3D model should be highlighted compared to the rest of the volume. The relevant volume of interest is determined for the 3D model.

[0018] A further step of the method comprises post-processing the at least one x-ray image. During post-processing, one or more of the 2D image elements are processed depending on a relative position of the 3D image element position of the 3D image elements corresponding to the respective 2D image element(s) in relation to the volume of interest. In other words, the at least one 2D x-ray image maps the 2D image elements that represent the 3D image elements of the 3D model. Some of the 3D image elements are arranged within the volume of interest of the 3D model, and others of the 3D image elements are arranged outside the volume of interest. Image elements are processed by editing the image values ​​associated with the respective image element, i.e. the pixel values. The pixel values ​​of image elements can, for example, be raised or decreased, or edges or contours can be enhanced by raising or lowering them.Reduction of contrasts can be emphasized more or less strongly. The processing of the individual 2D image elements depends on whether their associated 3D image element lies within or outside the volume of interest. For example, it can be provided that a different processing method is used for the 2D image elements whose corresponding 3D image element lies within the volume of interest than for the 2D image elements whose associated 3D image element lies outside the volume of interest. In particular, it can be provided that 2D image elements whose 3D image elements lie within the volume of interest are highlighted by the processing in the at least one 2D X-ray image and 2D image elements whose corresponding 3D image element lies outside the volume of interest are attenuated or filtered out in the 2D X-ray image.

[0019] In a further step, output data is provided by the computing device, wherein the output data comprise the at least one processed 2D X-ray image.

[0020] The invention provides the advantage that an X-ray image can be provided in which 2D image elements that correspond to 3D image elements within a volume of interest are particularly highlighted.

[0021] A further development of the invention provides that the post-processing of the at least one 2D X-ray image comprises processing one or more of the 2D image elements whose corresponding 3D image element has a 3D image element position located within the volume of interest, according to a first processing specification. In other words, a first processing specification is specified for 2D image elements that are projections of corresponding 3D image elements within the volume of interest. The first processing specification can, for example, specify an adjustment of the contrasts of the relevant 2D image elements by the computing device. This allows the 2D image elements associated with the volume of interest to be highlighted.

[0022] A further development provides that the post-processing of the at least one 2D X-ray image comprises processing one or more of the 2D image elements whose corresponding 3D image element has a 3D image element position located outside the volume of interest, according to a second processing specification by the computing device. In other words, the second processing specification is specified to the computing device in order to process the 2D image elements that are projections of a 3D image element outside the volume of interest. For example, it can be provided that the second processing specification provides for filtering out, blurring, or contrast reduction of the corresponding 2D image elements. This allows 2D image elements that are associated with 3D image elements from other volumes to be attenuated.

[0023] A further development of the invention provides that the post-processing of the at least one 2D X-ray image involves processing one or more of the 2D image elements, whose corresponding 3D image element is identified as a predefined object, according to a third processing specification. In other words, the third processing specification can be assigned to the 2D image elements that are assigned to corresponding 3D image elements of a predefined object of the 3D model. The computing device processes 2D image elements assigned to the predefined object according to the third processing specification. For example, it can be provided that the predefined object describes an instrument or an anatomical anomaly. It can be provided that the 2D image elements assigned to the object are to be processed according to the third processing specification, regardless of whether the object is located inside or outside the volume of interest.This makes it possible to display or hide specific objects, regardless of whether they are located inside or outside the volume of interest. The specified object can be specified manually, for example, or identified by the computing devices.

[0024] A further development of the invention provides that the post-processing of the at least one 2D X-ray image comprises determining a pixel of the 2D X-ray image at which several of the 2D image elements overlap. In other words, a pixel can be located in a region of the 2D X-ray image at which 2D image elements overlap. The overlapping 2D image elements can correspond to 3D image elements that are arranged one behind the other along the projection direction and thus arranged at different depth levels.

[0025] The pixel can have a total value that represents the absorption of an X-ray beam along the projection direction. The X-ray beam in question can be absorbed by tissue or material of the respective objects assigned to the 3D image elements. The 2D image elements can, for example, show bones arranged one behind the other. The total value of the pixel is formed by the partial values ​​of the respective 2D image elements.

[0026] In other words, the total value is determined from the partial values ​​of the respective 2D image elements.

[0027] It is intended that the processing of the partial values ​​of the respective 2D image elements is carried out according to the respective processing specifications specified for the 2D image elements. For example, it may be the case that two 2D image elements overlap at the image point, each of which may be assigned different depth information.

[0028] Accordingly, it can be provided that one of the 2D image elements is to be processed according to the first processing specification and the other of the 2D image elements according to the second processing specification. Since the image point maps both of the 2D image elements, it may be necessary to process the corresponding partial values ​​separately. For example, it may be possible that one of the 2D image elements should not be changed according to the first processing specification. Accordingly, the partial value attributable to the 2D image element in question is not changed. It can be provided that the second 2D image element is to be filtered out according to the second processing specification. Accordingly, the partial value attributable to the 2D image element in question is removed. The total value of the image point thus corresponds after processing only to the partial value of one of the 2D image elements.The further development has the advantage of enabling the editing of each individual pixel.

[0029] A further development of the invention provides that the method comprises determining a reference object position of a predetermined reference object depicted in the at least one 2D X-ray image in the 3D model. In other words, a reference object is predetermined which is depicted in the 2D X-ray image. The reference object can be, for example, an instrument or an anatomical structure. The reference object can be selected in the 2D X-ray image depending on a user input. It can also be provided that the reference object is automatically identified by the computing device, or that the reference object position of the reference object is provided in the 3D model by an external tracking system. It can be provided, for example, that the reference object position of the reference object is determined by an optical navigation system and / or by a surgical navigation system and provided to the computing device.The computing device determines the reference object position of the depicted reference object in the 3D model.

[0030] A further step of the method comprises determining the volume of interest within the 3D model as a function of the reference object position of the reference object. In other words, the computing device determines the volume of interest within the 3D model as a function of the reference object position of the reference object. For example, it can be provided that the volume of interest is defined according to a specification around the reference object position of the reference object. For example, it can be provided that the reference object describes an instrument. The volume of interest can have predetermined dimensions and be arranged around a tip of the instrument as the center point. This has the advantage that the volume of interest can be selected automatically based on the reference object.When guiding the instrument through the object, it is therefore not necessary to manually adjust the position of the volume of interest because the position of the volume of interest is linked to the reference object position of the instrument.

[0031] A further development of the invention provides that the method comprises receiving a spatial path relative to the 3D model for guiding a reference object through the 3D model. In other words, the path of the reference object along which the reference object is guided through the 3D model is provided to the computing unit. The path can, for example, describe a trajectory along which a tip of an instrument is to be guided through the 3D model.

[0032] The method comprises determining the volume of interest within the 3D model depending on the spatial course of the spatial path through the 3D model. In other words, the volume of interest is selected by the computing devices depending on the course of the path through the 3D model. For example, the volume of interest can describe a volume around the path or a specific section of the path of the reference object through the 3D model. This provides the advantage that the area relevant for guiding the reference object can be highlighted.

[0033] A further development of the invention provides that the method comprises receiving a workflow relating to the 3D model by the computing device. In other words, the workflow relating to processing the 3D model is provided to the computing device.

[0034] The method involves determining the volume of interest within the 3D model based on the current state of the workflow. In other words, the computing unit defines the volume of interest within the 3D model based on the current state of the workflow.

[0035] For use cases or application situations that may arise during the method and which are not explicitly described here, it may be provided that, in accordance with the method, an error message and / or a request to enter user feedback is issued and / or a default setting and / or a predetermined initial state is set.

[0036] A second aspect of the invention relates to an X-ray device which has an X-ray device and a computing device.

[0037] The X-ray device is configured to acquire at least one 2D X-ray image of an examination subject. The computing device is configured to perform a 2D / 3D registration of the at least one 2D X-ray image to a 3D model, wherein 2D image elements of the at least one 2D X-ray image are assigned corresponding 3D image elements located at respective 3D image element positions in the 3D model. The computing device is configured to determine a volume of interest within the 3D model.

[0038] The computing device is configured to post-process the at least one 2D X-ray image, wherein at least some of the 2D image elements are processed depending on a relative position of the 3D image element position of the 3D image elements corresponding to the respective 2D image elements with respect to the volume of interest. The computing device is configured to provide output data comprising the at least one 2D X-ray image.

[0039] A third aspect of the invention relates to a computing device.

[0040] The computing device is configured to perform a 2D / 3D registration of at least one 2D X-ray image to a 3D model, wherein corresponding 3D image elements located at respective 3D image element positions in the 3D model are assigned to 2D image elements of the at least one 2D X-ray image. The computing device is configured to determine a volume of interest within the 3D model.

[0041] The computing device is configured to post-process the at least one 2D X-ray image, wherein at least some of the 2D image elements are processed depending on a relative position of the 3D image element position of the 3D image elements corresponding to the respective 2D image elements with respect to the volume of interest. The computing device is configured to provide output data comprising the at least one 2D X-ray image.

[0042] The above-mentioned object is also achieved according to the invention by a computer program which can be loaded directly into a memory of a computing device, with program means for carrying out the steps of the above-mentioned method according to the second aspect of the invention when the program is executed in the computing device.

[0043] Likewise, an electronically readable data carrier with electronically readable control information stored thereon may be present, which comprises at least one described computer program (product) and is designed such that, when the data carrier is used in a computing device, it carries out the described method according to the first aspect of the invention.

[0044] The advantages and further developments presented above in connection with the method according to the invention according to the first aspect also apply mutatis mutandis to the X-ray device according to the invention, the computing device according to the invention, the computer program according to the invention, and the electronically readable data carrier according to the invention. Accordingly, the method features presented are to be viewed as features of the X-ray device, the computing device, the computer program, and the electronically readable data carrier.

[0045] The storage medium may comprise a storage unit.

[0046] A computing unit can be understood, in particular, as a data processing device that contains a processing circuit. The computing unit can therefore, in particular, process data to perform computing operations. This may also include operations for performing indexed access to a data structure, for example, a look-up table (LUT).

[0047] The computing unit may, in particular, contain one or more computers, one or more microcontrollers, and / or one or more integrated circuits, for example one or more application-specific integrated circuits (ASICs), one or more field-programmable gate arrays (FPGAs), and / or one or more single-chip systems (SoCs). The computing unit may also contain one or more processors, for example 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, in particular one or more digital signal processors (DSPs). The computing unit may also include a physical or virtual network of computers or other of the aforementioned units.

[0048] In various embodiments, the computing unit includes one or more hardware and / or software interfaces and / or one or more memory units.

[0049] A memory unit can be a volatile data memory, for example a dynamic random access memory (DRAM) or a static random access memory (SRAM), or a non-volatile data memory, for example a read-only memory (ROM), a programmable read-only memory (PROM), an erasable programmable read-only memory (EPROM), an electrically erasable programmable read-only memory (EEPROM), a flash memory or flash EEPROM, a ferroelectric random access memory (FRAM), a magnetoresistive random access memory,MRAM (magnetoresistive random access memory) or phase-change random access memory (PCRAM).

[0050] Regardless of the grammatical gender of a particular term, persons with male, female or other gender identities are included.

[0051] Further features of the invention emerge from the claims, the figures and the description of the figures. The features and combinations of features mentioned above in the description as well as the features and combinations of features mentioned below in the description of the figures and / or shown in the figures can be encompassed by the invention not only in the respectively specified combination, but also in other combinations. In particular, the invention can also encompass embodiments and combinations of features that do not have all the features of an originally formulated claim. Furthermore, the invention can encompass embodiments and combinations of features that go beyond the combinations of features set out in the backreferences to the claims or deviate from them.

[0052] The invention is explained in more detail below using specific embodiments and associated schematic drawings. In the figures, identical or functionally equivalent elements may be provided with the same reference numerals. The description of identical or functionally equivalent elements may not necessarily be repeated for different figures.

[0053] The figures show: Fig. 1 a schematic representation of an X-ray device; Fig. 2 a schematic representation of a sequence of a method for operating an X-ray device; and Fig. 3 a schematic representation of a 3D model of an object under investigation.

[0054] Fig. 1 shows a schematic representation of an X-ray device.

[0055] The X-ray device 1 can have an X-ray unit 2 and a computing device 3. The X-ray device 1 can be provided to record X-ray images 4 of an examination subject 5. The X-ray device 2 can have an X-ray source 6, which can be configured to emit X-ray radiation along a projection direction 7. The projection direction 7 can be aligned with a surface detector 8 of the X-ray device 2. An examination subject 5 can be arranged between the X-ray source 6 and the surface detector 8. The examination subject 5 can have locally different absorption properties. The computing device 3 can be provided to read out raw data from the surface detector 8 and generate the X-ray images 4.

[0056] Fig. 2 shows a schematic representation of a sequence of a method for operating an X-ray device.

[0057] The process can be carried out, for example, by Fig. 1 shown X-ray device 1.

[0058] In a step S1, at least one 2D X-ray image 4 of an examination object 5 can be recorded by an X-ray device 2 of the X-ray apparatus 1.

[0059] In a step S2, a 2D / 3D registration of the at least one 2D X-ray image 12 to a 3D model 9 can be performed by a computing device of the X-ray device. In this step, corresponding 3D image elements 10 located at respective 3D image element positions in the 3D model 9 can be assigned to 2D image elements 13 of the at least one 2D X-ray image 12.

[0060] In a step S3, the computing device 2 can determine a volume of interest 14 within the 3D model 9. For example, determining the volume of interest 14 can include identifying a reference object 11 in the at least one 2D X-ray image 12 and subsequently determining a reference position of the reference object 11 within the 3D model 9. The reference object 11 can be an instrument, for example.

[0061] In a step S4, the computing device 2 can perform post-processing of the at least one 2D X-ray image 12. At least some of the 2D image elements 13 can be processed depending on a relative position of the 3D image element position of the 3D image elements 10 corresponding to the respective 2D image elements 13 with respect to the volume of interest 14. For example, it can be provided that at least some of the 2D image elements 13 whose corresponding 3D image elements 10 lie within the volume of interest 14 are processed by the computing device 2 according to a first processing specification. The first processing specification can, for example, comprise image processing steps that improve the recognizability of the 2D image elements 13 in the at least one 2D X-ray image 12. The first processing specification can, for example, provide for an increase in contrast, a sharpening and / or a marking of the relevant 2D image elements 13.At least some of the 2D image elements 13 whose corresponding 3D image elements 10 lie outside the volume of interest 14 can be processed by the computing device 2 according to a second processing specification. The second processing specification can be provided to attenuate the relevant 2D image elements 13 in the at least one 2D X-ray image 12. For example, it can be provided that the sharpness of the corresponding 2D image elements 13 is reduced and / or the contrast values ​​of the corresponding 2D image elements 13 are lowered. As a result, the 2D image elements 13 within the volume of interest 14 can be highlighted even more clearly compared to 2D image elements 13 outside the volume of interest 14.

[0062] It can be provided that 2D image elements 13 whose corresponding 3D image element 10 is identified as a predetermined object 15 are processed by the computing device 2 according to a third processing specification. This can occur independently of the 3D image element position of the object 15 in question. In other words, it is irrelevant whether the object 15 lies inside or outside the volume of interest 14. It can be provided, for example, that the 2D image element 13 in question is highlighted according to the third processing specification, even if it is located outside the volume of interest 14. This can be provided, for example, if the object 15 concerns defined anomalies identified by the computing device 2 or certain instruments. It can also be provided that certain 2D image elements 13 within the volume of interest 14 that depict the predetermined object 15 are filtered out.

[0063] In a fifth step S5, output data comprising the at least one processed 2D X-ray image 17 can be provided by the computing device 2.

[0064] Fig. 3 shows a schematic representation of a 3D model of an object under investigation.

[0065] The 3D model 9 of the examination object 5 can, for example, be generated from 2D X-ray images of the examination object 5 from a previous examination. The 3D model 9 can depict 3D image elements 10. The 3D image elements 10 can, for example, be anatomical structures, such as bones. The 3D image elements 10 can also include a reference object 11, wherein the reference object 11 can be an instrument. Fig.3 also shows an unprocessed 2D X-ray image 12, which may have been acquired of the examination subject 5 by the X-ray device 1. The unprocessed 2D X-ray image 12 may have been acquired along a projection direction shown relative to the 3D model 9. The unprocessed 2D X-ray image 12 may depict 2D image elements 13, which may correspond to 3D elements 10 of the 3D model 9. The 2D image elements 13 may overlap in the unprocessed 2D X-ray image 12.

[0066] It may be desired that certain of the 2D image elements 13 be highlighted compared to others of the 2D image elements 13. This can be made dependent on whether the associated 3D image elements 10 of the 2D image elements 13 are located inside or outside a volume of interest 14. The volume of interest 14 can define a volume that is to be highlighted in a processed 2D X-ray image 17. The volume of interest 14 can, for example, depend on a reference position of the reference object 11. For example, it can be provided that the volume of interest 14 describes an area around a tip of a reference object 11 embodied as an instrument.

[0067] A first processing specification can be stored in the computing device 3, which can specify how the 2D image elements 13 whose 3D image elements 10 are arranged within the volume of interest 14 are to be processed. The first processing specification can be provided for highlighting the corresponding 2D image elements 13. A second processing specification can be stored in the computing device 3, which relates to 2D image elements 13 whose 3D image elements 10 can be arranged outside the volume of interest 14. The second processing specification can be aimed at attenuating the corresponding 2D image elements 13. In addition, a third processing specification can be stored in the computing device 3, which can specify how 2D image elements 13 are assigned to the specified objects 15, such as the reference object 11 or an anomaly.In this case, it can be provided that the 2D image elements 13 of the corresponding objects 15 are highlighted according to the third processing specification, even if the corresponding objects 15 are arranged outside the volume of interest 14. Likewise, it can be provided that the 2D image elements 13 of the corresponding objects 15 are filtered out according to the third processing specification, even if they are arranged within the volume of interest 14. The third processing specification can thus be prioritized over the first and / or the second processing specification. Furthermore, the processed x-ray image 17 is shown, which can be generated by processing the unprocessed x-ray image 12 by the computing device 3.

[0068] The processed x-ray image 17 depicts one of the 2D image elements 13 whose associated 3D image element 10 is located within the volume of interest 14 and is therefore highlighted in the processed x-ray image 17 according to the first processing specification. The 2D image elements 13 whose associated 3D image elements 10 are located outside the volume of interest 14 can be displayed in a weakened manner according to the second processing specification. The corresponding 3D image elements 10 can, for example, lie in front of or behind the volume of interest 14 along the projection direction 7. Compared to the unprocessed 2D x-ray image 12, the 2D image element 13 within the volume of interest 14 is thus highlighted, so that a surgeon can be assisted in guiding the reference object 11 into the volume of interest 14. An anomaly detectable in the 3D model 9 can be identified by the computing device 3 and defined as one of the objects 15.The object 15 can, for example, describe a splinter. In the processed x-ray image 17, a 2D image element 16 associated with the splinter can be highlighted according to the third processing specification, even though it is located outside the volume of interest 14. This allows anomalies in the processed x-ray image 17 to be highlighted. QUOTES CONTAINED IN THE DESCRIPTION

[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited patent literature

[0000] US 11 195 309 B2

[0007] US 2017 / 0281110 A1

[0008]

Claims

[1] Method for operating an X-ray device (1), comprising the following steps: - recording at least one 2D X-ray image (4, 12, 17) of an examination object (5) by an X-ray device (2) of the X-ray apparatus (1); - 2D / 3D registration of the at least one 2D X-ray image (4, 12, 17) to a 3D model (9) by a computing device (3) of the X-ray device (1), wherein 2D image elements (13) of the at least one 2D X-ray image (4, 12, 17) are assigned corresponding 3D image elements (10) located at respective 3D image element positions in the 3D model (9); - Determination of a volume of interest (14) within the 3D model (9); - post-processing of the at least one 2D X-ray image (4, 12, 17), wherein at least one of the 2D image elements (13) is processed in dependence on a relative position of the 3D image element position of the 3D image element (10) corresponding to the at least one 2D image element (13) with respect to the volume of interest (14); and - Providing output data comprising the at least one 2D X-ray image (4, 12, 17). [2] Method according to claim 1, wherein the post-processing of the at least one 2D X-ray image (4, 12, 17) comprises: - processing at least one of the 2D image elements (13), whose corresponding 3D image element (10) has a 3D image element position which is located within the volume of interest (14), according to a first processing specification. [3] Method according to claim 1 or 2, wherein the post-processing of the at least one 2D X-ray image (4, 12, 17) comprises: - processing at least one of the 2D image elements (13), whose corresponding 3D image element (10) has a 3D image element position which is located outside the volume of interest (14), according to a second processing specification. [4] Method according to one of the preceding claims, wherein the post-processing of the at least one 2D X-ray image (4, 12, 17) comprises: - processing at least one of the 2D image elements (13), whose corresponding 3D image element (10) is identified as a predetermined object (15), according to a third processing specification. [5] Method according to one of the preceding claims, wherein the post-processing of the at least one 2D X-ray image (4, 12, 17) comprises: - determining an image point of the 2D X-ray image (4, 12, 17) at which several of the 2D image elements (13) overlap, wherein partial values of the respective 2D image elements (13) of the image point form a total value of the image point; - processing the partial values of the respective 2D image elements (13) according to the respective processing specifications specified for the 2D image elements (13) [6] A method according to any one of the preceding claims, wherein the method comprises the following steps: - Determining a reference object position of a predetermined reference object (15) depicted in the at least one 2D X-ray image (4, 12, 17) in the 3D model (9); - Determining the volume of interest (14) within the 3D model (9) as a function of the reference object position of the reference object (15) in the 3D model (9). [7] A method according to any one of the preceding claims, wherein the method comprises the following steps: - receiving a spatial path with respect to the 3D model (9) for guiding a reference object (15) through the 3D model (9); - Determination of the volume of interest (14) within the 3D model (9) as a function of a spatial course of the spatial path through the 3D model (9). [8] A method according to any one of the preceding claims, wherein the method comprises the following steps: - Receiving a workflow related to the 3D model (9); - Determination of the volume of interest (14) within the 3D model (9) depending on a current status of the workflow. [9] X-ray device (1), comprising an X-ray device (2) and a computing device (3), wherein the X-ray device (2) is designed to record at least one 2D X-ray image (4, 12, 17) of an examination object (5); the computing device (3) is designed to - to carry out a 2D / 3D registration of the at least one 2D X-ray image (4, 12, 17) to a 3D model (9), wherein corresponding 3D image elements (10) located at respective 3D image element positions in the 3D model (9) are assigned to 2D image elements (13) of the at least one 2D X-ray image (4, 12, 17); - to determine a volume of interest (14) within the 3D model (9); - to post-process the at least one 2D X-ray image (4, 12, 17), wherein at least one of the 2D image elements (13) is processed as a function of a relative position of the 3D image element position of the 3D image element (10) corresponding to the at least one 2D image element (13) with respect to the volume of interest (14); - to provide output data comprising the at least one 2D X-ray image (4, 12, 17). [10] Computing device (3), wherein the computing device (3) is designed to - to carry out a 2D / 3D registration of at least one 2D X-ray image (4, 12, 17) to a 3D model (9), wherein 2D image elements (13) of the at least one 2D X-ray image (4, 12, 17) are assigned corresponding 3D image elements (10) located at respective 3D image element positions in the 3D model (9); - to determine a volume of interest (14) within the 3D model (9); - to post-process the at least one 2D X-ray image (4, 12, 17), wherein at least one of the 2D image elements (13) is processed as a function of a relative position of the 3D image element position of the 3D image element (10) corresponding to the at least one 2D image element (13) with respect to the volume of interest (14); - to provide output data comprising the at least one 2D X-ray image (4, 12, 17). [11] Computer program which can be loaded directly into a memory of a computing device (3) according to claim 10, with program means for carrying out the steps of the method according to one of claims 1 to 8 when the program is executed in the computing device (3). [12] Electronically readable data carrier with electronically readable control information stored thereon, which comprises at least one computer program according to claim 11 and is designed such that, when the data carrier is used in a computing device (3) according to claim 10, it carries out a method according to one of claims 1 to 8.

Images