3D Interventional Imaging Navigation With Low-Dose 2D Updates

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Solution Overview

Problem

Current medical imaging techniques for guiding interventional materials in minimally invasive procedures, such as vascular surgery, face challenges including high radiation exposure, reliance on contrast agents, and loss of depth information, particularly when using 2D X-ray projections, which are inadequate for real-time 3D reconstruction due to mechanical limitations and motion artifacts.

Innovation Solution

A method utilizing a first 3D image, acquired preoperatively or intraoperatively, combined with real-time 2D update images to extract anatomical and non-anatomical structures, employing machine learning and image processing to reconstruct accurate 3D images of non-anatomical structures while minimizing radiation exposure by allowing asynchronous acquisition of 2D images.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If 2D X-ray fluoroscopy is used for visualizing interventional materials and anatomy, then the imaging process is simple and widely available, but depth information is lost and spatial characteristics are largely lost

Engineering Contradiction:
Improveimaging process simplicityVSAvoiddepth information and spatial characteristics
Core Design Contradiction:
Ease of operationVSLoss of information

Solution Approach 1:

The patent applies dimensionality change by transitioning from 2D fluoroscopic images to 3D reconstructions. The system acquires multiple 2D projection images from different angles and reconstructs them into a 3D volume, thereby recovering depth information and spatial characteristics that are lost in conventional 2D imaging while maintaining the simplicity of X-ray-based acquisition.

Inventive Principle:
Principle #17Another dimension (Dimensionality change)

2Reliability

If continuous sequential acquisition of 3D X-ray images is performed for 4D interventional guidance, then real-time 3D visualization is achieved, but radiation exposure becomes very high

Engineering Contradiction:
Improvereal-time 3D visualization accuracyVSAvoidradiation exposure
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent implements partial action by acquiring a limited number of 2D projection images at strategically selected angles rather than continuous sequential acquisition. The system reconstructs 3D volumes from these partial datasets and updates them selectively, achieving real-time guidance functionality while significantly reducing the total radiation dose compared to continuous 3D imaging.

Inventive Principle:
Principle #16Partial or excessive action

Solution Approach 2:

The system performs preliminary action by acquiring a complete set of 2D projections for 3D reconstruction before the interventional procedure begins or at the start of each phase. This pre-acquired 3D dataset is then used for guidance throughout the procedure, avoiding the need for continuous radiation exposure while maintaining accurate spatial reference.

Inventive Principle:
Principle #10Preliminary action

3Reliability

If contrast agents are administered repeatedly for subtraction-based 2D imaging when imaging geometry changes, then vascular system visibility is maintained, but kidney toxicity increases and contrast agent administration becomes contraindicated in renal insufficiency

Engineering Contradiction:
Improvevascular system visibilityVSAvoidkidney toxicity
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent applies preliminary action by performing a single contrast-enhanced 3D CT scan before the interventional procedure to create a detailed vascular roadmap. This pre-acquired 3D vascular information is then reused throughout the procedure for navigation and guidance, eliminating the need for repeated contrast agent administration that would be required in conventional 2D subtraction angiography when imaging geometry changes.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The system uses partial action by acquiring contrast-enhanced images only at specific critical moments (e.g., before the procedure or at major procedural milestones) rather than continuously. The 3D reconstruction technique allows extrapolation of vascular information between these limited contrast-enhanced acquisitions, reducing total contrast exposure while maintaining vascular visibility when needed.

Inventive Principle:
Principle #16Partial or excessive action

4Loss of information

If multiple C-arm X-ray units with different projection directions are used to obtain complete 3D information, then vascular system 3D visualization is improved, but time, radiation dose, and contrast agent requirements increase enormously

Engineering Contradiction:
Improve3D information completenessVSAvoidprocedure time and resource consumption
Core Design Contradiction:
Loss of informationVSLoss of time

Solution Approach 1:

The patent applies segmentation by dividing the 3D reconstruction task into two separate processing streams: one for anatomical structures and one for interventional materials. This allows independent optimization of each reconstruction, enabling accurate 3D visualization of both categories simultaneously from a single set of multi-angle projections, rather than requiring multiple C-arms or sequential scanning.

Inventive Principle:
Principle #1Segmentation

Solution Approach 2:

The system implements universality by using a single C-arm X-ray unit that performs multiple functions: acquiring projections for anatomical 3D reconstruction, acquiring projections for interventional material 3D reconstruction, and providing 2D fluoroscopic guidance. This multi-functional approach achieves complete 3D information from one device, eliminating the need for multiple specialized systems.

Inventive Principle:
Principle #6Universality (Multi-functionality)

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

Enables real-time 3D visualization of interventional materials with reduced radiation dose and contrast agent use, providing accurate 4D guidance for surgical navigation by integrating 3D reconstructions with minimal mechanical demands on the imaging system.

Implementation Method 1

2D X-ray fluoroscopy is particularly common, meaning that 2D images, especially 2D X-ray images, are acquired sequentially

Methodology Applied
Scientific EffectX-ray: X-Ray

Implementation Method 2

A 3D reconstruction is a 3D volume calculated from numerous individual measurements. In computed tomography, these individual measurements are 2D X-ray projections

Methodology Applied
Scientific EffectTomography: Tomography

Data Source

PatentEP4129189B1Method for operating a medical imaging device for the correct presentation of non-anatomical structures during an imaging examination and device therefor
Publication Date: 2026.04.22 ZIEHM IMAGING GMBH
  • EP4129189B1 patent drawingFigure 1
  • EP4129189B1 patent drawingFigure 2
  • EP4129189B1 patent drawingFigure 3

AI summary

The invention discloses a method for operating a medical imaging device for the positionally correct representation of non-anatomical structures during an imaging examination, comprising the following method steps: a.) providing a first 3D image (1) containing at least one anatomical structure (3); b.) extracting at least one anatomical model (5) from the at least one anatomical structure (3) of the first 3D image (1); c.) providing at least two 2D update images (2) by means of the medical imaging device, wherein at least two 2D update images (2) were acquired at different times; d.) extracting (6) non-anatomical structures (4) from a first subset (7) of the 2D update images (2); e.) extracting (13) anatomical structures (3) from a second subset (8) of the 2D update images (2); f.) Calculating a non-anatomical 3D image (10) from at least two partial reconstructions (9) from the first subset (7), wherein the at least two partial reconstructions (9) are calculated from the extraction (6) of the non-anatomical structures (4); g.) Reconstructing an anatomical 3D image (11) from the extraction (13) of the anatomical structures (3) from the second subset (8); h.) Registering the anatomical 3D image (11) with the first 3D image (1) to determine a coordinate transformation (14); i.) Creating a navigation volume (12) from the at least one anatomical model (5) and the non-anatomical 3D image (10) using the determined coordinate transformation (14).