DE102008006516A1 - X-ray device for determining position and orientation of medical object, has x-ray apparatus for preparation of x-ray image of living entity, where certain medical object is guided in body of living entity - Google Patents

Abstract

The x-ray device has an x-ray apparatus for preparation of an x-ray image of a living entity (P), where a certain medical object (10) is guided in a body of the living entity. A data storage (14) is provided with a defined specimen of a partial area (11) of multiple different medical objects. A computing unit (13) is provided for determining a position and an orientation of the living entity. A unique bar code or a Radio-frequency identification (RFID)transponder (17) is assigned to every medical objects. An independent claim is included for a method for an x-ray device.

Description

The The invention relates to an X-ray device and a method for an X-ray device for determining the Position and / or orientation of a person in a body of a living thing imported medical object.

Minimally invasive Medical interventions are becoming increasingly important. So are for example, in the treatment of coronary heart disease the Surgical bypass surgery on the heart clearly in favor of Balloon Dilatation (PTCA = Percutaneous Transluminal Coronary Angioplasty) and the insertion of a stent decreased.

at a minimally invasive procedure z. B. one or more medical Instruments in the body of a patient for therapy or diagnostics. After the introduction of a medical instrument in the body of the patient this is visually for a perform the intervention Doctor no longer visible. To navigate the instrument in the body The patient must therefore use this in a suitable manner the doctor will be visualized in image information. For position determination of the instrument in the patient's body in minimally invasive medical interventions, which for visualization of the instrument, in particular the tip of the instrument, in image information is required from the inside of the patient's body, stand nowadays various systems and methods available.

In the US 5,042,486 For example, a method for locating a catheter in a vessel of a living being by means of non-ionizing fields is described. For this, the catheter tip is equipped with a transmitter for electromagnetic or acoustic fields or waves. A receiver detects these waves by means of sensors or antennas coupled to the body of the living being and converts these waves into electrical locating or image signals. For the purpose of localizing the catheter tip relative to the vasculature, the locating signals are combined on a viewing device with a different image (e.g., X-ray) of vascular architecture. The procedure therefore requires that each catheter tip must be equipped with a transmitter and in addition several antennas including receivers must be installed in the examination room.

In the DE 10 2005 034 167 A1 For example, an implant, a method and a device for determining the position of the implant in the body of a living being are described. To improve the accuracy of determining the position of the implant in the body of the living being, it is proposed to provide a transponder suitable for determining the position on the implant. A suitable transponder is understood to be a transponder whose coordinates can be determined in a coordinate system based on an electromagnetic radiation transmitted by the transponder and received by a receiver.

Of Further allow advances in 3D X-ray imaging now 3D images of organs and also of instruments, which are in the body of a living being. However, that is it still difficult in the x-ray image between instruments, Distinguish organs and bones and at the same time as possible to use little X-ray radiation for imaging.

In this context is from the DE 10 2005 030 607 A1 a special interventional instrument known. The instrument, which may be a catheter, is provided with marker elements that are recognizable in an X-ray image. In this way, the catheter can be localized better in an X-ray image. Examples of Markierungsele elements are spherical and annular marking elements, wherein the annular marking elements can identify the catheter in the manner of a bar code and so different catheters can distinguish each other in the X-ray image. Nevertheless, the distinction between instruments, organs and bones in an X-ray image can remain difficult.

From the DE 102 10 647 A1 a method is known for imaging a medical instrument introduced into a body region of a patient, in which the position, in particular the tip, of the medical instrument is determined from two 2D x-ray images recorded at a specific angle from the medical instrument's body region. An image of the tip of the medical instrument may eventually be faded into a 3D image of the patient's body region.

Furthermore, in the DE 10 2005 028 746 A1 a method for determining the position and orientation of an object, in particular a catheter, described from two-dimensional X-ray images. In this case, a three-dimensional pattern of the catheter is generated on the basis of the known structural properties of the catheter. To determine the position and the orientation of the catheter in the body of a living being, the three-dimensional pattern is projected onto a two-dimensional plane and the generated projection image is compared with an X-ray image in which the catheter is imaged. Subsequently, initially set parameters for the position and the orientation iteratively changes the pattern in the space and determines a similarity measure used to determine the position and orientation of the catheter. A disadvantage of this method is that, first of all, a pattern of a catheter that is actually used in the current medical intervention must be found out of a multiplicity of existing patterns of various catheters available for medical intervention. As a result, the computational effort is very high and it is either very powerful and therefore expensive computing units required or the position determination takes a relatively long time.

Of the The invention is therefore based on the object, an X-ray device and to provide a method of the type mentioned above such that the Investigations of the position and / or orientation of a medical Object is simplified.

To According to the invention, this object is achieved by an X-ray device to determine the position and / or orientation of a medical Object containing an X-ray machine for extraction at least one x-ray image of a living being, in whose body introduced a specific medical object has been, at least one defined data storage Pattern of at least a subset of a variety of different ones medical objects, a computing unit for determining the position and / or the orientation of the particular in the body of the living being introduced medical object based on the at least an X-ray image, the pattern of the particular medical object and a pattern recognition algorithm, and identifying means to identify the particular medical object before Determining the position and / or orientation of the particular medical Object. According to the invention, the X-ray device So identification means, so that the arithmetic unit of the X-ray device before beginning the determination of position and / or orientation of the specific medical object the type of used used medical object can be communicated. Used in this way the pattern recognition algorithm from the beginning only the pattern of identified medical object to the position and / or the orientation of the medical object in the body of the living being to determine what causes the investigation of the position and / or the orientation of the medical object simplistic, in particular accelerated, because not only from a variety of eligible Patterns included in the data store associated with the currently used medical object belonging pattern must be found in the course of pattern recognition. The pattern, which can also be referred to as a template, recorded thereby typically the structures of the medical object that are in Radiographs are usually visible. One Such pattern is usually a 3D dataset containing the shape and structure the medical object, in particular its metal parts etc., mimics.

To In a variant of the invention, the identification means have administrative numbers on, with each medical object a unique administrative number assigned. Preferably, the unique management number is on the medical object or on a packaging of the medical Object arranged. The data memory of the X-ray device preferably has a list the medical used in the X-ray device Objects identifiable by unique administrative numbers are. Thus, over a management number, a specific one of the pattern to be used for the pattern recognition algorithm become.

To an embodiment of the invention, the Identification means also have pattern numbers, each one Pattern of a medical object a unique pattern number assigned. Accordingly, also by entering a Pattern number a particular one of the pattern recognition algorithm to be used. A certain Medical object can therefore also be identified by its pattern number which are also on the medical object or one Packaging of the medical object can be arranged.

A Variant of the invention provides that the identification means Have input and / or read-in means, preferably with the arithmetic unit are connected. Using the input means, which a keyboard, a mouse or other input device can, can by a user of the x-ray device the management numbers or the pattern number for further use the assigned pattern for the determination of the position and / or orientation of the medical object can be entered.

To Another variant of the invention is the various medical Objects each have a unique barcode and / or an RFID transponder assigned, wherein the reading means a bar code reader and / or a reader of an RFID system. Of the Barcode stands for the unique administrative number. In the case of using an RFID transponder is the respective Management number stored in the transponder and is using read in the reader.

An embodiment of the invention sees in that the X-ray device additionally has an optical scanner for recording a pattern of a medical object that has not yet been recorded. If, therefore, a medical object previously not used at the x-ray device is to be used on the x-ray device, a corresponding pattern of the new medical object can be generated with the aid of the optical scanner and stored in the data memory of the x-ray device. Preferably, a unique administration number and / or the generated pattern of the newly acquired medical object is also assigned a unique pattern number to the new acquired medical object.

To In a variant of the invention, the medical object is a medical one Instrument, such as a catheter, or an implant, for example a stent.

The The object relating to the method is solved by Method for an X-ray device, as before described in which the particular medical object before the beginning determining the position and / or orientation of the particular introduced into the body of the living medical Object based on a pattern of the particular medical Object, at least one x-ray image of that in the body of the living thing imported medical object and one Pattern recognition algorithm is identified. As already mentioned can in this way the determination of position and / or orientation of the medical object using a pattern recognition algorithm simplified, in particular accelerated.

• a) Vorverarbeitung des Röntgenbildes zur Hervorhebung von Abbildungsstrukturen des bestimmten Objektes,
• b) Initialisierung von je drei Parametern für die Position und/oder von je drei Parametern für die Orientierung des Musters des bestimmten medizinischen Objekts im Raum,
• c) Erzeugung einer zweidimensionale Projektion des Musters anhand der drei Parameter für die Position und/oder der drei Parameter für die Orientierung des Musters,
• d) Vergleich der zweidimensionalen Projektion des Musters mit den Abbildungsstrukturen des vorverarbeiteten Röntgenbildes und Ermittlung eines diesbezüglichen Ähnlichkeitsmaßes aufgrund des Vergleichs,
• e1) Verwendung der aktuellen drei Parameter für die Position und/oder der aktuellen drei Parameter für die Orientieund/oder rung zur Bestimmung von Position Orientierung des bestimmten medizinischen Objektes im Röntgenbild, wenn das Ähnlichkeitsmaß einen Abbruch des Verfahrens rechtfertigt, oder
• e2) Anpassung des Satzes aus drei Parametern für die Position und/oder der Satz aus drei Parametern für die Orientierung und Wiederholung der Schritte c) bis e) in einer Optimierungsschleife, bis das Ähnlichkeitsmaß einen Abbruch des Verfahrens rechtfertigt.

According to a variant of the invention, the method also comprises the following method steps:

• a) preprocessing the X-ray image to highlight imaging structures of the particular object,
• b) initialization of three parameters for the position and / or of three parameters for the orientation of the pattern of the particular medical object in the room,
• c) generating a two-dimensional projection of the pattern on the basis of the three parameters for the position and / or the three parameters for the orientation of the pattern,
• d) comparison of the two-dimensional projection of the pattern with the image structures of the preprocessed X-ray image and determination of a similar degree of similarity based on the comparison,
• e1) using the current three parameters for the position and / or the current three parameters for the orientation and / or tion for determining position orientation of the particular medical object in the X-ray image, if the similarity measure justifies a termination of the method, or
• e2) adaptation of the set of three parameters for the position and / or the set of three parameters for the orientation and repetition of steps c) to e) in an optimization loop until the similarity measure justifies a termination of the method.

Different as a method of the prior art, in which only every unusual Structure, in some way, also in the x-ray distinguished bones, etc., counted as recognized structure becomes, after the present procedure a pattern of the determined medical object specified, which automatic pattern recognition or the pattern recognition algorithm in the X-ray image has to recognize.

To A variant of the invention comprises the preprocessing of the X-ray image a high pass filtering and / or a binarization of the X-ray image, d. H. from the gray scale radiograph becomes a binary image. As a result of the binarization or the high-pass filtering are sharp structures or imaging structures relatively good to see. By the Pre-processing of the X-ray image becomes pattern recognition simplified.

outgoing from the pattern of the particular medical object, that is, the what should be recognizable on the X-ray image, is now the position and / or orientation of the medical object determined, as in the pre-processed X-ray image you can see. This is done iteratively.

It In each case a so-called matching is performed, d. H. the two-dimensional projection of the pattern becomes with the image structures of the preprocessed X-ray image and it becomes determined a similar measure of similarity. For Such a measure of similarity are in the state of Technique common similarity metrics available (Mutual Information, Correlation etc.). The similarity measure is a measure of goodness for the match. In iterations you will be depending on the used measure Aim for maximum or minimum. For such iterations usual methods are available. For example can change the parameters first be started with the change of the translation parameters and then with a change of the rotation parameter etc ..

According to one embodiment of the invention, a second X-ray image is under a different projection from the first X-ray image angle, for example, with a biplane X-ray system won and steps a) to e) performed using the second X-ray image. In determining the three new parameters for the position and / or the three new parameters for the orientation of the pattern relative to the pre-processed second X-ray image, preferably the set of the parameters obtained for the position and / or orientation from the first X-ray image is taken into account.

Based the known by calibration of the X-ray device Projection parameter of the X-ray device can be a Rear projection of the in the respective X-ray image pictured particular medical object, for example the Top of the medical object, in the three-dimensional space be performed. Due to an uncertainty in the Parameter that describes the depth is the particular medical Object by matching the mapping structures of the particular medical Object with the projection of the pattern in three-dimensional space not exactly localized, but you get a projection line.

A such projection line based on the first X-ray image may be due to the calibrated x-ray machine be faded in the second X-ray image, so that to obtain the three or six parameters due to the second X-ray image only the surroundings of the projection line must be taken into account, which takes a lot of time and computational effort is saved.

It is also possible based on the second x-ray image also to calculate such a projection line.

To a variant of the invention are therefore using the obtained with the first X-ray image parameters, a back projection of the particular medical object from the first X-ray image performed in the three-dimensional space, due to one receives the mentioned first projection line, using the data obtained with the second X-ray image Parameters a backprojection of the particular medical Object from the second x-ray image in the three-dimensional Room performed due to which you have a second projection line gets, and the point with the smallest square distance to the two projection lines or ideally the intersection the projection lines used to locate the particular medical object in three-dimensional space. The smallest Distance can be done using a quadratic method in the usual way be determined, where the sum of the squares of the two distances must be minimized to the respective projection lines.

Preferably serves the smallest distance of the two projection lines from each other as a measure of the quality of localization of the particular medical object. Is the location ideal, so intersect the two projection lines, d. H. the smallest Distance is zero.

One Embodiment of the invention is shown in the attached schematic drawings shown. Show it:

1 an X-ray device according to the invention and

2 the tip of a catheter.

In 1 An X-ray device according to the invention is shown schematically. In the case of the present exemplary embodiment, the X-ray device comprises an X-ray device in the form of a biplanar X-ray system with two C-arms (not shown). The first C-arm has a first X-ray system with an X-ray source 1 and an X-ray receiver 2 on. In a corresponding manner, the second C-arm has a second X-ray system with an X-ray source 3 and an X-ray receiver 4 on. With the two X-ray systems can be successively and simultaneously 2D X-ray projections or 2D X-ray images of a body region K of a in 1 schematically shown, arranged on a storage device, not shown, patients P are obtained.

The Biplan X-ray system is calibrated, d. H. the projection geometries the Biplan X-ray system in relation to the two X-ray systems were, for example, in an offline calibration process with the help of a calibration phantom and are therefore known.

The two x-ray systems are connected to a data bus 5 connected to the X-ray device, so that with the two X-ray receivers 2 . 4 recorded image data of an image processing unit 6 supplied, processed there and on a viewing device 7 can be represented. In addition, the image data is an image data memory 8th to disposal. The user interface of the X-ray device is input means 9 that z. As a keyboard, a computer mouse and / or a touch screen, etc. may include.

The X-ray device is also provided, inter alia, for minimally invasive interventions on living beings, such as the patient P, in which a medical object, eg. B. in the form of a medical instrument, in particular a catheter, or in the form of an implant, in particular a stent, in the body of the patient from one the intervention taking or navigating doctor. In the case of the present embodiment is a catheter 10 in the body of the patient P, in particular the tip 11 of the catheter 10 in the patient's body is navigated under x-ray control. For this purpose, z. B. an image of the top 11 of the catheter 10 in a previously generated, for example, with the biplanar X-ray machine 3D image of the body region K of the patient P appears. To the image of the top 11 of the catheter 10 However, in each case the position and / or the orientation of the tip must be able to fade into the 3D image 11 of the catheter 10 be determined.

In the case of the present embodiment of the invention, both the position and the orientation of the tip 11 of the catheter 10 in 3D space by means of 2D X-ray projections or 2D X-ray images and a pattern recognition, which is also referred to as template matching determined. To accomplish this, the tip points 11 of the catheter 10 annular metallic structures 12 which can be seen in 2D X-ray images to distinguish the tip 11 of the catheter 10 of bone or organs of the patient P to simplify. 2 shows the tip 11 of the catheter 10 with the metallic structures 12 ,

For the pattern recognition or the use of a pattern recognition algorithm, a three-dimensional pattern was at least from the top 11 of the catheter 10 based on the known, design-related properties of the tip 11 of the catheter 10 generated. The three-dimensional catheter-specific pattern is generated once before a minimally invasive procedure and can be stored in a binary format. For this purpose, the X-ray device has a computing unit 13 associated data store 14 on, both on the data bus 5 are connected.

As a rule, various medical objects in the form of catheters and stents are used for various minimally invasive procedures on patients on the X-ray device. The X-ray device therefore has identification means for the various medical objects in order to prevent the arithmetic unit from applying the pattern recognition algorithm 13 in that the pattern recognition is performed in order to be able to communicate the type of the currently used medical object, so that only the pattern of the currently used medical object present in the data memory is used for pattern recognition, resulting in faster and reliable recognition of a multiplicity of medical objects , in particular their tips results.

In the case of the present embodiment of the invention, the identification means comprise unique management numbers assigned to the medical objects and unique pattern numbers assigned to the patterns of the medical objects. The administrative number of a medical object and the pattern number of the pattern associated with the medical object are linked. Thus, in the data store 14 a lineup 15 of unique administrative and pattern numbers related to different medical objects.

So is the catheter 10 a unique administrative number and the pattern of the tip 11 of the catheter 10 assigned a unique pattern number.

Preferably, the management number and / or the pattern number are on the catheter 10 or a package of the catheter 10 arranged. In this way, the management number and / or the pattern number, and thus the pattern to be used for the pattern recognition, can be used by a user of the X-ray device before the minimally invasive intervention by means of the input means 9 entered and thus the arithmetic unit 13 in the case of the present embodiment, the pattern of the tip 11 of the catheter 10 from the data store 14 and used for the pattern recognition algorithm.

Alternatively, on the catheter 10 or the packaging of the catheter 10 Also, a unique barcode may be arranged for the unique administrative number of the catheter 10 stands. Additionally or alternatively, on the catheter 10 or the packaging of the catheter 10 a second unique barcode may be arranged corresponding to the pattern number of the catheter 10 assigned pattern stands. To read the barcode, the X-ray device has a barcode reader 16 or a barcode scanner that connects to the data bus 5 connected.

The catheter 10 or the packaging of the catheter 10 but also with an RFID transponder 17 Be provided in or on the catheter 10 or in or on the packaging and has the unique administrative number and / or pattern number. With the help of one to the data bus 5 connected reader 18 of the RFID system, the management number and / or the pattern number can be read coded and the arithmetic unit 13 be communicated.

For medical objects that have not yet been used on the X-ray device and to which no 3D pattern exists, the X-ray device additionally has an optical scanner 19 , For example, a Lasertriangulationseinrich tion, with the help of a 3D pattern of the not yet recorded medical object and recorded in the data memory 14 can be stored. Furthermore, a unique management number and the associated newly recorded pattern can be assigned a unique pattern number to the newly added medical object.

Is the catheter 10 before the minimally invasive procedure on the patient P has been identified by the rake unit 13 the corresponding administrative or pattern number has been communicated by input or read in, then the arithmetic unit 13 for determining the position and orientation of the tip 11 of the catheter 10 in the room only the pattern of the top 11 of the catheter 10 use.

To determine the position and orientation of the tip 11 of the catheter 10 in the room can be essentially like in the room DE 10 2005 028 746 A1 be described described.

With the two X-ray systems of the Biplan X-ray system, a first and a second 2D X-ray image are at a different time at a different projection angle from the one with the tip 11 of the catheter 10 provided body region K of the patient P won.

The first X-ray image is first used to emphasize imaging structures, in particular the metallic substructures 12 the top 11 of the catheter 10 preprocessed by high pass filtering or binarization. As a result, the imaging structures are highlighted, so that in particular the sharp-edged substructures of the catheter 10 clearly shown. The preprocessed first X-ray image is used to achieve the best possible matching or ideally matching with the three-dimensional pattern of the tip 11 of the catheter 10 to investigate.

For this purpose, in the case of the present embodiment, three parameters each for the position and three parameters for the orientation of the pattern of the tip 11 of the catheter 10 initialized in space and a two-dimensional projection of the pattern of the top 11 of the catheter 10 based on the three parameters for the position and the three parameters for the orientation of the pattern of the tip 11 of the catheter 10 generated.

Subsequently, the two-dimensional projection of the pattern becomes the apex 11 of the catheter 10 compared with the preprocessed X-ray image, in particular with the imaging structures of the preprocessed X-ray image ("matched") and determined a related similarity measure due to the comparison.

If the similarity measure justifies a termination of the method, the current three parameters for the position and the current three parameters for the orientation of the pattern become the apex 11 of the catheter 10 to determine the position and orientation of the tip 11 of the catheter 10 used in the first x-ray image. Otherwise, the set of three parameters for the position and the set of three parameters for the orientation are adapted and the described steps are repeated in an optimization loop until the similarity measure justifies a termination of the method.

The same procedure is also performed using the second X-ray image. When defining the three parameters for the position and the three parameters for the orientation of the pattern of the tip 11 of the catheter 10 with respect to the pre-processed second X-ray image, the set of parameters for the position and orientation obtained from the first X-ray image may be taken into account.

Accordingly, the parameters for the position and the orientation of the tip are now 11 of the catheter 10 known in the first and in the second X-ray image. Finally, based on the six parameters obtained with the first X-ray image and the known projection geometries of the biplane X-ray system, a back projection of the tip is obtained 11 of the catheter 10 from the first X-ray image into the three-dimensional space, on the basis of which a first projection line L1 is obtained. Furthermore, based on the six parameters obtained with the second X-ray image and the known projection geometries of the Biplan X-ray system, a back projection of the tip is obtained 11 of the catheter 10 from the second X-ray image into the three-dimensional space, due to which one obtains a second projection line L2.

Finally, the position of the tip 11 of the catheter 10 in three-dimensional space ideally as the intersection of the two projection lines in three-dimensional space or as the point in three-dimensional space with the smallest square distance to the two projection lines. The smallest distance between the two projection lines serves as a measure of the quality of the localization of the tip 11 of the catheter 10 ,

Is the position of the top 11 of the catheter 10 Determined in three-dimensional space, can be an image of the top 11 of the catheter 10 displayed in a 3D image of the body region K of the patient P and on the viewing device 7 being represented.

Will the procedure be for multiple points of the catheter 10 or even several times in succession for a substantially continuous Naviga tion, wherein after initial detection of the tip of the catheter in an X-ray image by spatial and temporal plausibility criteria of the search space for subsequent catheter detections can be limited - so in chronologically successive recorded X-ray images, the position of the catheter have changed only by a certain distance - can also Orientation of the catheter can be determined.

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - US 5042486 [0004]
• DE 102005034167 A1 [0005]
• DE 102005030607 A1 [0007]
• - DE 10210647 A1 [0008]
• DE 102005028746 A1 [0009, 0047]

Claims (16)

X-ray device for determining the position and / or the orientation of a medical object ( 10 ) - an X-ray device for obtaining at least one X-ray image of a living being (P), in whose body a particular medical object ( 10 ), - a data store ( 14 ) comprising at least one defined pattern of at least one subregion ( 11 ) a plurality of different medical objects ( 10 ), - a computing unit ( 13 ) for determining the position and / or orientation of the particular medical object introduced into the body of the animal (P) ( 10 ) based on the X-ray image, a pattern of the particular medical object ( 10 ) and a pattern recognition algorithm, and - identification means ( 9 . 15 - 19 ) for identifying the particular medical object ( 10 ) prior to determining the position and / or orientation of the particular medical object ( 10 ). X-ray device according to Claim 1, in which the identification means ( 9 . 15 - 19 ) Have administrative numbers, each medical object ( 10 ) is assigned a unique administrative number. X-ray device according to claim 2, wherein the unique administrative number on the medical object ( 10 ) or a packaging of the medical object ( 10 ) is arranged. X-ray device according to one of Claims 1 to 3, in which the identification means ( 9 . 15 - 19 ) Have pattern numbers, each pattern of a medical object ( 10 ) is assigned a unique pattern number. X-ray device according to one of claims 1 to 4, in which the identification means input ( 9 ) and / or read-in means ( 16 . 18 ) exhibit. X-ray device according to Claim 5, in which the various medical objects ( 10 ) in each case a unique barcode and / or in each case an RFID transponder ( 17 ), the reading means being a bar code reader ( 16 ) and / or a reader ( 18 ) of an RFID system. X-ray device according to one of claims 1 to 6, which comprises an optical scanner ( 19 ) for receiving a pattern of a not yet detected medical object. X-ray device according to claim 7, wherein an administrative number for the newly acquired medical object and / or the pattern of the newly acquired medical object Pattern number is assignable. X-ray device according to one of claims 1 to 8, in which the medical object is a medical instrument, an implant, a catheter ( 10 ) or a stent. Method for an X-ray device according to one of claims 1 to 9 for determining the position and / or orientation of a specific medical object introduced into a body of a living being (P) ( 10 ), in which the particular medical object ( 10 ) prior to the beginning of the determination of the position and / or orientation of the particular medical object introduced into the body of the animal (P) ( 10 ) based on a pattern of the particular medical object ( 10 ), at least one X-ray image of the medical object introduced into the body of the animal (P) ( 10 ) and a pattern recognition algorithm. Method according to Claim 10, in which a) the X-ray image is used to emphasize imaging structures of the particular object ( 10 b) each three parameters for the position and / or three parameters for the orientation of the pattern in space are initialized, c) a two - dimensional projection of the pattern on the basis of the three parameters for the position and / or the three parameters for the Orientation of the pattern is generated, d) comparing the two-dimensional projection of the pattern with the imaging structures of the preprocessed X-ray image and a related similarity measure is determined based on the comparison, e1) the current three parameters for the position and / or the current three parameters for the orientation of Determination of position and / or orientation of the specific medical object ( 10 ) are used in the X-ray image if the similarity measure justifies termination of the method, or e2) the set of three parameters for the position and / or the set of three parameters for orientation adapts and repeats steps c) to e) in an optimization loop until the similarity measure justifies a termination of the proceedings. The method of claim 11, wherein the preprocessing in step a) high pass filtering and / or binarization of the X-ray image. A method according to claim 11 or 12, wherein a second X-ray image obtained at a different projection angle from the first X-ray image and the steps a) to e) are performed using the second X-ray image. A method according to claim 13, wherein when fixed of the three new parameters for the position and / or the three new parameters for the orientation of the pattern in Referring to the pre-processed second X-ray image of the sentence from the parameters obtained from the first X-ray image considered for the position and / or orientation becomes. A method according to claim 13 or 14, wherein f) based on the parameters obtained with the first X-ray image, a back projection of the specific medical object ( 10 ) is carried out from the first X-ray image into the three-dimensional space, on the basis of which one obtains a first projection line, g) on the basis of the parameters obtained with the second X-ray image, a back projection of the particular medical object ( 10 ) is carried out from the second X-ray image in the three-dimensional space, on the basis of which a second projection line is obtained, and in which h) the point with the smallest square distance to the two projection lines or optionally the intersection point is determined, which is used to localize the object ( 10 ) in three-dimensional space. Method according to Claim 15, in which the smallest distance of the two projection lines from one another is a measure of the quality of the localization of the object ( 10 ) is determined.