DE102014219581A1 - A method, apparatus and computer program for registering a medical image with an anatomical structure - Google Patents

Abstract

The present invention describes methods (1) for registering a medical image (10) with a real anatomical structure (20 '), the method (1) comprising the method steps: - receiving a medical image (10) of an anatomical structure (20) 20), examination region (22) of an examination subject (24); - Determining at least one anatomy position coordinates (30 ') of the real anatomical structure (20') of the examination area (22) of the examination subject (24) by means of a robotic means (40), and receiving the at least one anatomy position coordinates (30 ') of the real anatomical structure (20 '); Receiving at least one image position coordinate (30) corresponding to the at least one anatomy position coordinate (30 '); Calculating a transformation rule, wherein the at least one anatomy position coordinate (30 ') and the at least one image position coordinate (30) are included in the calculation of the transformation instruction; - Registration of the medical image (10) with the real anatomical structure (20 ') using the transformation rule. Furthermore, a corresponding device and a corresponding computer program are described.

Description

The present invention relates to a method for registering a medical image with an anatomical structure. Moreover, the present invention relates to a corresponding device and a computer program for registering a medical image with an anatomical structure.

Robotic robotic systems or navigation systems are increasingly being used intraoperatively, i. during a e.g. surgical, intervention, used. These systems often use images of different acquisition modalities, such as computed tomography, CT, magnetic resonance imaging, MR, ultrasound imaging or X-ray imaging, which were obtained intraoperatively or preoperatively from a patient. These pictures can be used, for example, for planning and guidance. Guidance, used by interventions or as an additional source of information during the procedure. When using autonomously acting, but also in most cases in assisted robotic systems during an intervention, they must be brought into conformity with a patient or an image data record of a patient. This process is also called initial registration. If a robot, for example, support the insertion of a biopsy needle, the relationship between the position of the patient or in particular the location of the relevant points in the image data set of the patient and in his, i. be known in the robotic, coordinate system. The same applies, for example, to the supported placement of pedicle screws in spine surgery using a robotic assistance system. There, the robot must be aware of where the screw must be placed on the patient's spine and, for this, it is necessary to know the position of the patient and the associated images of the spine in relation to the robot coordinate system.

Another application of robots in intraoperative imaging is augmented reality, the computer-aided extension of the perception of reality. In this connection, data obtained preoperatively and / or intraoperatively can be used, for example, to overlay a laparoscopic image with radiological data. If the laparoscope is held by a robot, then this robot must also be first, i. initially, to the patient. During an intervention, it may happen that a patient is being moved or, for example, being moved by a doctor. By doing so or by other processes, e.g. By removing a tumor or by other morphological, anatomical or physiological effects, it may happen that an initial registration between a robot coordinate system and a patient or an image of a patient is no longer correct, i. e. the image data set of the patient originally registered with the robot no longer corresponds to the reality. In addition to a change in position and / or a change in position, which can generally be described mathematically by a transformation with a translation component and a rotational component, deformations of anatomical structures can also occur due to the named causes. Both changes in position and position changes of the patient or deformations within the patient can lead to the fact that the initial registration between robot and patient or the image data set of the patient is no longer correct. In order for the robot to continue to work with the image data set of the patient, the registration must be restored. For this purpose, for example, a new image data set of an examination area of the patient can be made and the robot can be registered again for this updated image data set. This is often not possible intraoperatively with every modality or it is associated with an application of an additional radiation dose. In addition, a robot docked to the patient may interfere with intraoperative recording and reimaging due to collisions between the robot and the imaging device may not be possible. Another possibility for re-registration or continuous registration is to place markers on anatomically relevant points, to detect them by sensors, such as in commercially available optical tracking systems, and thereby to re-assign a transformation between the patient's coordinate system and that of the robot calculate or update. A disadvantage of this method is the complicated application of markers, in particular with regard to the stability and the use of tissue adhesive, if it is deformable soft tissue.

The object of the present invention is therefore to provide a method for registering a medical image with an anatomical structure that does not have the disadvantages mentioned or less. Furthermore, it is an object of the invention to describe a corresponding device and a corresponding computer program for registering a medical image with an anatomical structure.

The invention achieves this object with a method for registering a medical image with a real anatomical structure having the features of the first independent patent claim, a device for registering a medical image with a real anatomical structure with the features of the second independent patent claim and a computer program for registering a medical image with a real anatomical structure having the features of the third independent claim. Advantageous embodiments are described in subclaims.

• – Entgegennahme eines medizinischen Bildes eines, eine anatomische Struktur umfassenden, Untersuchungsbereiches eines Untersuchungsobjektes;
• – Bestimmen wenigstens einer Anatomiepositionskoordinaten der realen anatomischen Struktur des Untersuchungsbereiches des Untersuchungsobjektes mit Hilfe eines robotischen Mittels, und Entgegennahme der wenigstens einen Anatomiepositionskoordinaten der realen anatomischen Struktur;
• – Entgegennahme wenigstens einer, mit der wenigstens einen Anatomiepositionskoordinaten korrespondierenden, Bildpositionskoordinaten;
• – Berechnen einer Transformationsvorschrift, wobei in die Berechnung der Transformationsvorschrift die wenigstens eine Anatomiepositionskoordinate und die wenigstens eine Bildpositionskoordinate eingehen;
• – Registrierung des medizinischen Bildes mit der anatomischen Struktur mit Hilfe der Transformationsvorschrift.

A basic idea of the invention is a method for registering a medical image with a real anatomical structure, comprising the following method steps:

• Receiving a medical image of an examination area of an examination subject comprising an anatomical structure;
• Determining at least one anatomy position coordinate of the real anatomical structure of the examination region of the examination subject by means of a robotic means, and accepting the at least one anatomy position coordinate of the real anatomical structure;
• Receiving at least one image position coordinate corresponding to the at least one anatomy position coordinate;
• Calculating a transformation rule, wherein in the calculation of the transformation rule the at least one anatomy position coordinate and the at least one image position coordinate are received;
• - Registration of the medical image with the anatomical structure using the transformation rule.

An anatomical structure is understood in particular as meaning macroscopic body parts of an examination subject such as organs, tissue, vessels or bones. An examination subject may be, for example, a human or animal patient. An examination area is an area comprising at least a part of the anatomical structure of interest. An aim of this basic idea of the invention is registration of a medical image with a real anatomical structure. By registering an image with an anatomical structure, a method comparable to an image registration of two images in digital image processing can be understood, with the aid of which the image and the anatomical structure of at least one similar scene are matched in the best possible way. For the image, a transformation is determined which optimally adapts the image to the anatomical structure. It is therefore an optimization problem. Similar to image registration, various solutions can be used. Examples of suitable optimization methods for registration methods are gradient descent methods, downhill simplex methods, hillclimb methods and simulated annealing.

In a method step of the first basic concept of the invention, a medical image or a medical data record is received, loaded or obtained, for example, from an imaging device or from a database. The medical image includes the examination area, e.g. the abdomen, the object under examination, e.g. of a human patient, where the examination area is the anatomical structure, e.g. the stomach, includes.

In a further method step, at least one anatomical position coordinate of the real anatomical structure of the examination region of the examination subject is determined and accepted with the aid of a robotic means. The robotic means may be, for example, an assistant robot having multiple degrees of freedom and an end effector suitable for determining a coordinate of the tip of the end effector. Also conceivable is a robotic means in the form of a robot having a plurality of links, which are rotatably connected to each other by joints, in which by determining the angular deflections by means of geometrical calculations, the position of the robot tip can be determined. If the tip of the end effector is guided to the surface of the real anatomical structure, its coordinate can be determined and loaded, received or obtained.

In a further method step, at least one image position coordinate corresponding to the at least one anatomy position coordinate is accepted, acquired or loaded. That at least one image coordinate from the medical image that corresponds to or belongs to the at least one anatomy position coordinate of the real anatomical structure of the examination region of the examination subject is accepted. This may be done, for example, by a user by selecting points on the medical image displayed on a display means, e.g. a computer monitor, is shown done.

In a subsequent method step, a transformation rule is calculated, the at least one anatomy position coordinate and the at least one image position coordinate being included in the calculation of the transformation instruction. For example, in order to determine the transformation law, methods known in the field of image registration may be used. The transformation rule may, for example, be a transformation matrix, which in the case of a rigid registration term for rotations and translations. In the case of non-rigid registration, the transformation matrix may include a deformation field.

In a next method step, the registration of the medical image with the anatomical structure takes place with the aid of the transformation instruction. This step may include, for example, multiplying the coordinates of the medical image by the transformation rule so that the relationship between the coordinate system of the robotic agent and the coordinate system of the medical image of the examination subject is restored.

The medical image is preferably spatial and at least three linearly independent anatomical position coordinates of the real anatomical structure of the examination region of the examination subject and at least three image position coordinates corresponding to the at least three position coordinates are accepted or determined.

By accepting at least three anatomy position coordinate image position coordinate pairs, a spatial change of translational and / or rotational nature can be compensated. In general, a plurality of anatomy position coordinates and a plurality of image position coordinates may also be determined. Since the former belongs to the real anatomical structure, the latter to the anatomical structure of the medical image, the image position coordinates correspond to the anatomy position coordinates.

In an advantageous development, the robotic means is controlled by a user to determine the at least one anatomy position coordinates of the real anatomical structure with the aid of the robotic means.

In this embodiment, a user, for example a doctor, controls the robotic means to points of the anatomical structure. For this purpose, the robotic means may for example comprise motors integrated in joints of a telescopic support arm and by which the robotic means can be operated and moved. It is also conceivable that the robotic means comprises an input means by the actuation thereof, e.g. by a user, a current anatomy position coordinate is determined. Thus, the robotic means would be adapted to be guided to positions of the real anatomical structure and to determine the associated anatomy position coordinates and, for example, to provide a computing and control unit.

In a further advantageous embodiment, the robotic means for measuring a force acting on an end effector is designed to determine the at least one anatomical position coordinate of the real anatomical structure with the aid of the robotic means, and a force acting on the end effector is involved in the determination of the at least one Anatomy position coordinates of the real anatomical structure.

To capture the anatomy position coordinates, the robotic means can be controlled to the desired locations. If the robotic means has sensor means which can measure forces acting, for example, on the end effector, it is possible to obtain a scan of the anatomy with a freely definable contact force. As a result, parts of the anatomy can be reconstructed, for example by interpreting transitions from a low contact force to a high contact force as the boundary to an anatomical structure.

With particular advantage, at least one force threshold value enters the determination of the at least one anatomy position coordinate of the real anatomical structure.

The robotic means is designed to measure a force acting on an end effector. The result of a comparison of a force measurement with the force threshold is included in the determination of the at least one anatomy position coordinates of the real anatomical structure. By setting a maximum stiffness and / or by a force measurement, this approach can also be used for soft tissue. It can be determined with a minimum contact force, whether the current position is on the surface of the organ. This can also be a deformation of soft tissue, which results from the contact can be reduced. Furthermore, stiffness and contact force can minimize tissue damage. It is also conceivable to provide an anatomy position coordinate, for example, to a computing and control unit when the result of a force measurement is greater than a set force threshold value.

It is proposed that the at least one anatomical position coordinate of the real anatomical structure enter into a model of the anatomical structure and that the model of the anatomical structure is included in the calculation of the transformation instruction.

It is conceivable, for example, to form a surface model from acquired anatomical position coordinates, which allows the calculation of further anatomy position coordinates by interpolation. The coordinates of the model of the anatomical structure can be the Form anatomy position coordinates of the real anatomical structure. Also, a model may, for example, contain additional information, such as an expected shape, which facilitates the calculation of the transformation rule.

A further advantageous embodiment provides that at least one anatomical structure of the medical image is segmented or segmented and that the at least one segmented anatomical structure of the medical image is included in the calculation of the transformation instruction.

Segmentation is a common procedure in medical image processing. In this context, this can be understood as the exclusion of an anatomical object or an anatomical structure of image components that do not belong to the anatomical object, such as surrounding tissue. The anatomical object is, for example, an organ or a vessel that is encompassed by the examination area. A simple segmentation method is e.g. a threshold method. Pixels of the at least one segmented anatomical structure of the medical image may form the image position coordinates corresponding to the anatomical position coordinates. In particular, when a surface model of a real anatomical structure is formed from anatomy position coordinates, the calculation of the transformation instruction can be facilitated by means of a segmented anatomical structure of the medical image. The at least one segmented anatomical structure of the medical image can be understood as an image model of the anatomical structure, so that advantageously methods from medical image registration can be used for this purpose.

In an alternative embodiment of the invention, the at least one anatomy position coordinate of the real anatomical structure of the examination region of the examination subject is determined automatically by means of a robotic means.

Preferably, an area, e.g. the examination area, within which the surface is defined by means of the robotic means, e.g. its end effector is automatically or automatically traversed or scanned point by point. In particular, when the end effector has a sensor means for measuring a force acting on the end effector, the robotic means can automate an anatomical structure or quasi autonomously depart and in particular determine a plurality of anatomy position coordinates of the real anatomical structure of the examination area of the examination subject. The automated determination of anatomy position coordinates then advantageously comprises a comparison of a measured value of the sensor means for measuring a force acting on the end effector with a force threshold value. For example, if the contact force measured by the sensor means is greater than the force threshold, the current coordinate of the end effector is determined as the anatomy position coordinate. A method step may then be that the contact force is continued at an adjacent coordinate. As a result, a surface of an anatomical structure can be traced by point-wise detection of co-tactile forces and their anatomy position coordinates can be determined. Furthermore, a method would be conceivable in which a surface is scanned in a grid-like manner by an end effector, the end effector being extended in the direction of an anatomical structure until a measured contact force exceeds a predefinable threshold value, whereupon the end effector is retracted and scanning at the next grid position will continue. A uniform palpation of the anatomical structures would also be conceivable in that the robot "glides" over the corresponding anatomy with constant contact pressure. In general, automatically executed methods also offer the advantage that fewer interventions by an operator are necessary, which are often time-consuming and error-prone. For example, the determined anatomy position coordinates and corresponding image position coordinates may be automatically transmitted to a calculation and control means which automatically calculates the transformation law.

It is conceivable that the method is carried out repeatedly.

In particular, in a surgical intervention, when an examination object can not be fixed, movements can not be ruled out, so that a repeated execution of the method according to the invention is advantageous to keep the registry always up to date. In this case, an abort criterion, such as the pressing of a cancel key, can be queried. The procedure is repeated until the termination criterion is met. Repetitive execution may also include initial or initial registration in which large deviations are expected, and re-registrations where minor deviations are to be expected, in which case generally less anatomical position coordinates need to be determined. This can be taken into account, for example, by specifying two different numbers of anatomical position coordinates to be determined.

It has proved to be advantageous if, in the calculation of the transformation rule, a change in position, a change in position and / or a deformation of the anatomical structure are taken into account.

In general, one can distinguish in particular non-elastic and elastic registration methods. A non-elastic registration method is understood to mean a registration method in which rigid transformations such as translation and rotation, affine transformations such as scaling and shear, and projective transformations are usable. An elastic registration method is understood as a registration method in elastic transformations. also called "non-rigid transformations", such as spline- or polynomial-based transformations, are applicable. In general, registration after a change of position and / or a change of position is easier and in particular possible with the determination of fewer anatomical position coordinates and image position coordinates than a registration after a deformation of the anatomical structure. By determining or recording a sufficiently large number of coordinates, however, a deformation of the anatomy can be determined. The determined anatomy position coordinates are registered non-rigidly to the image position coordinates in the image data set for this purpose.

In addition, it is advantageous if the method comprises a compliance control of the robotic means.

In a compliance control or impedance control contact force and position are linked in an object contact and regulated accordingly. Generally, compliance is defined as the "measure of robotic ability to counteract contact forces". If a robotic device is used which has a sensor device for force measurement and / or torque measurement, an impedance regulation known per se can be implemented which, depending on the tissue type, models a stiffness which additionally protects against deformations and damage to the tissue.

• – zur Entgegennahme ein medizinisches Bild des, die anatomische Struktur umfassenden, Untersuchungsbereiches des Untersuchungsobjektes;
• – zur Entgegennahme der wenigstens einen Anatomiepositionskoordinaten der realen anatomischen Struktur;
• – zur Entgegennahme wenigstens einer, mit der wenigstens einen Anatomiepositionskoordinaten korrespondierenden, Bildpositionskoordinaten;
• – zur Berechnen einer Transformationsvorschrift, wobei in die Berechnung der Transformationsvorschrift die wenigstens eine Anatomiepositionskoordinate und die wenigstens eine Bildpositionskoordinate eingehen und
• – zur Registrierung des medizinischen Bildes mit der anatomischen Struktur mit Hilfe der Transformationsvorschrift.

Another basic idea of the invention is a device for registering a medical image with a real anatomical structure. The device comprises a robotic means for determining at least one anatomy position coordinate of a real anatomical structure of an examination region of an examination subject and providing the at least one anatomy position coordinate of the real anatomical structure. Furthermore, the device comprises a computing and control unit which is designed

• For receiving a medical image of the examination area of the examination subject comprising the anatomical structure;
• To receive the at least one anatomy position coordinate of the real anatomical structure;
• To receive at least one image position coordinate corresponding to the at least one anatomy position coordinate;
• For calculating a transformation rule, wherein in the calculation of the transformation rule the at least one anatomy position coordinate and the at least one image position coordinate are received and
• - To register the medical image with the anatomical structure using the transformation rule.

The computing and control unit can be embodied, for example, as a computer which has interfaces for, for example, receiving the medical image.

Conveniently, the device is designed to carry out one of the previously described methods according to the invention.

For this purpose, the device has, for example, a robotic means, which comprises an end effector with a sensor means, which is designed to measure forces and / or torques acting on the end effector and to provide the computing and control unit. Also conceivable is a system for registering a medical image with a real anatomical structure comprising one of the previously described devices for registering a medical image with a real anatomical structure and an imaging device for obtaining and providing a medical image of the examination area comprising the anatomical structure of the examination object.

The invention also relates to a computer program that performs the steps of a method according to the invention when it is executed on a computing device.

The computing device can be, for example, the computing and control unit of a device according to the invention for registering a medical image with an anatomical structure.

Finally, the invention may also relate to a non-transient data carrier, for example a CD-ROM, on which a computer program according to the invention is stored.

The embodiments described in more detail below represent preferred embodiments of the present invention.

Further advantageous developments will become apparent from the following figures, including description. Show it:

1 by way of example a flow diagram of a method according to the invention for registering a medical image with a real anatomical structure;

2 schematically and exemplarily a real anatomical structure, a medical image with an anatomical structure and a medical image with registered anatomical structure;

3 exemplary and schematic of an embodiment of a device for registering a medical image with a real anatomical structure of an examination area of an examination subject;

• S1) Entgegennahme eines medizinischen Bildes eines, eine anatomische Struktur umfassenden, Untersuchungsbereiches eines Untersuchungsobjektes;
• S2) Bestimmen wenigstens einer Anatomiepositionskoordinaten der realen anatomischen Struktur des Untersuchungsbereiches des Untersuchungsobjektes mit Hilfe eines robotischen Mittels, und Entgegennahme der wenigstens einen Anatomiepositionskoordinaten der realen anatomischen Struktur;
• S3) Entgegennahme wenigstens einer, mit der wenigstens einen Anatomiepositionskoordinaten korrespondierenden, Bildpositionskoordinaten;
• S4) Berechnen einer Transformationsvorschrift, wobei in die Berechnung der Transformationsvorschrift die wenigstens eine Anatomiepositionskoordinate und die wenigstens eine Bildpositionskoordinate eingehen;
• S5) Registrierung des medizinischen Bildes mit der anatomischen Struktur mit Hilfe der Transformationsvorschrift;
• S6) Abfrage eines Abbruchkriteriums und falls das Abbruchkriterium erfüllt, „J“, ist, beenden, „Ende“, des Verfahrens, ansonsten, „N“, Sprung zu Verfahrensschritt S2.

1 shows an example of a flowchart of a method according to the invention 1 to register a medical image with a real anatomical structure. The procedure 1 includes the method steps S1 to S6. It begins, "start", with method step S1 and ends, "end", after method step S6. The individual process steps are:

• S1) receiving a medical image of an examination area of an examination subject comprising an anatomical structure;
• S2) determining at least one anatomy position coordinate of the real anatomical structure of the examination region of the examination subject by means of a robotic means, and receiving the at least one anatomy position coordinate of the real anatomical structure;
• S3) receiving at least one image position coordinate corresponding to the at least one anatomy position coordinate;
• S4) calculating a transformation rule, wherein the at least one anatomy position coordinate and the at least one image position coordinate are entered into the calculation of the transformation instruction;
• S5) registration of the medical image with the anatomical structure using the transformation protocol;
• S6) Query of an abort criterion and if the abort criterion is satisfied, "J", is, terminate, "end" of the method, otherwise, "N", jump to step S2.

Under a termination criterion, for example, the pressing of a button or the achievement of a predetermined count of a repetition counter can be understood. By polling the abort criterion, the process can be executed repeatedly. In connection with at least partially automatically executed process steps, a quasi-continuous process can be formed.

In 2 are schematic and exemplary a real anatomical structure 20 ' , a medical picture 10 with an anatomical structure 20 and a medical picture 10 '' with registered anatomical structure 20 '' shown. The anatomical structure 20 ' , here a vessel, is made by a robotic means 40 , here an endoscopic robot, with an end effector 42 to which a sensor means 44 is arranged, scanned. The sensor means 44 is designed by a force sensor to measure a contact force. If this contact force exceeds a predefinable force threshold, which can be obtained for example by a series of measurements, this is done by means of a connection means 46 between the sensor means 44 and a computing and control unit, not shown, signaled. The robotic means is designed to determine a coordinate of the tip of the end effector. The coordinate becomes when signaling the crossing of the force threshold as Anatomiepositionskoordinate 30 ' the computing and control unit provided. The medical picture 10 symbolizes a spatial image dataset with the spatial anatomical structure 20 , eg the vessel. A point marked by a user, here the exit from the vessel, determines an image position coordinate 30 that can be provided to the computing and control unit. From the anatomy position coordinates 30 ' and the image position coordinates 30 a transformation rule can be determined. For example, the anatomical structure 20 in the medical picture 10 opposite the real anatomical structure 20 rotated, so that the transformation rule has a term that describes this rotation or rotation. The registration of the medical image 10 with the real anatomical structure 20 ' with the help of the transformation instruction leads to the medical picture 10 '' with registered anatomical structure 20 '' ,

3 Finally, by way of example and schematically shows an embodiment of a device 100 to register a medical image with a real anatomical structure 20 ' an examination area 22 an examination object 24 , An imaging device 102 is in this embodiment, an X-ray machine, which is designed as a C-arm X-ray machine, wherein a C-arm 104 is arranged on a tripod. The examination object 24 is a human patient stored on a storage device, here a patient table, and the examination area 22 is the abdomen of the patient. At the C-arm 104 are in opposite position an X-ray source 108 and as image pickup means 106 an x-ray image detector is arranged. The C-arm 104 and thus the X-ray source 108 and the image pickup means 106 are rotatable by means of a joint. Thus, with the C-arm X-ray apparatus, it is also possible, by means of a series of images from different exposure angles, by means of a known rotational angiography method, to obtain a 3D image model data record or a medical image 10 , indicated by a database symbol, of the examination area 22 and the real anatomical structure 20 ' , here the stomach of the examination object 24 to win and a computing and control unit 110 the device 100 to provide. The computing and control unit 110 is designed to receive the medical image. The device 100 further includes a robotic agent 40 here a laparoscopic robot with a telescopic arm having a plurality of links connected by joints for determining at least one anatomical position coordinate of the real anatomical structure 20 ' of the examination area 22 of the examination object 24 , This is the robotic means 40 with an end effector 42 fitted. One end of the telescopic arm is connected to a tripod, at the other end is the end effector 42 arranged. With the telescopic arm can adjust the position and position of the end effector 42 be easily changed, for example by arranged in the joints electric motors. Sensors in the joints are designed in a manner known in principle to measure rotations of the joints and thus the position of the end effector 42 or to determine its peak. The calculation and control means 110 is designed to be the end effector 42 about the real anatomical structure 20 ' to guide while keeping anatomical position coordinates of the real anatomical structure 20 ' to receive or receive. The calculation and control means 110 is further adapted to receive, with the anatomy position coordinates corresponding, image position coordinates designed. The image position coordinates may be from a segmentation method of the anatomical structure of the medical image 10 be won. The calculation and control means 110 is further configured to compute a transformation protocol, wherein the calculation of the transformation protocol includes the anatomy position coordinate and the image position coordinates and the medical image 10 with the real anatomical structure 20 ' to register using the transformation rule.

In summary, further embodiments and advantages of the invention will be described. The invention proposes a method of effecting a re-registration or initial registration of a patient by "scanning" the anatomy of the patient by a robotic system. Further, among other things, a method is proposed in which a position, a position and / or a deformation of any part of an organ are spatially detected by landmarks by means of a robotic means. This position, position and / or deformation are then registered with already recorded image data records to determine the position change, change in position and / or deformation and provide for an updated registration. One of the advantages is that no new image data set has to be recorded, resulting in a dose saving. Another advantage is that no additional resources are needed if the robotic means to support an intervention is in place anyway. This saves space and costs. In addition, the result of registration may be more accurate compared to known methods of registration, as rounding errors can be avoided in computing the transformation used in conventional registration methods through multiple transformation steps calculations, such as using preoperative data, tracking systems, conversion into a robot coordinate system. Furthermore, no predefined points or markers are necessary, which must be defined and optionally applied in known methods, in particular by sticking markers with tissue adhesive. Another advantage can be a higher speed, since, in contrast to image-based registration methods, no further processing of the data record is necessary. Also, optimizing the number of measurement points and selecting a specific section of the organ maximizes speed.

Claims (14)

Procedure ( 1 ) for registering a medical image ( 10 ) with a real anatomical structure ( 20 ' ), the process ( 1 ) comprises the following procedural steps: receiving a medical image ( 10 ), an anatomical structure ( 20 ), study area ( 22 ) of an examination object ( 24 ); Determining at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) of the examination area ( 22 ) of the examination object ( 24 ) using a robotic means ( 40 ) and receiving the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ); Receiving at least one with at least one anatomy position coordinate ( 30 ' ), image position coordinates ( 30 ); - Computing a transformation rule, wherein in the calculation of the transformation rule the at least one anatomy position coordinate ( 30 ' ) and the at least one image position coordinate ( 30 ) enter; - Registration of the medical image ( 10 ) with the real anatomical structure ( 20 ' ) using the transformation rule. Procedure ( 1 ) according to claim 1, wherein the medical image ( 10 ) is spatially and at least three linearly independent anatomy position coordinates of the real anatomical structure ( 20 ' ) of the examination area ( 22 ) of the examination object ( 24 ) and at least three, corresponding to the at least three position coordinates, image position coordinates are accepted or determined. Procedure ( 1 ) according to claim 1 or claim 2, wherein for determining the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) using the robotic means ( 40 ) the robotic agent ( 40 ) is controlled by a user. Procedure ( 1 ) according to one of the preceding claims, wherein for determining the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) using the robotic means ( 40 ) the robotic agent ( 40 ) for measuring one, to an end effector ( 42 ), force and one on the end effector ( 42 ) acting force in the determination of the at least one anatomy position coordinates ( 30 ' ) of the real anatomical structure ( 20 ' ) received. Procedure ( 1 ) according to claim 4, wherein in determining the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) receives at least one force threshold. Procedure ( 1 ) according to one of the preceding claims, wherein the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) into a model of the anatomical structure ( 20 ' ) and where in the calculation of the transformation rule the model of the anatomical structure ( 20 ' ) received. Procedure ( 1 ) according to one of the preceding claims, wherein at least one anatomical structure ( 20 ) of the medical image ( 10 ) is segmented or segmented and wherein in the calculation of the transformation rule the at least one segmented anatomical structure of the medical image ( 10 ) received. Procedure ( 1 ) according to one of the preceding claims, wherein the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ) of the examination area ( 22 ) of the examination object ( 24 ) using the robotic means ( 40 ) is determined automatically. Procedure ( 1 ) according to any one of the preceding claims, wherein the method ( 1 ) is repeatedly executed. Procedure ( 1 ) according to one of the preceding claims, wherein in the calculation of the transformation rule a change in position, a change in position and / or a deformation of the anatomical structure are taken into account. Procedure ( 1 ) according to any one of the preceding claims, wherein the method ( 1 ) a compliance control of the robotic agent ( 40 ). Contraption ( 100 ) for registering a medical image ( 10 ) with a real anatomical structure ( 20 ' ) comprising a robotic agent ( 40 ) for determining at least one anatomy position coordinate ( 30 ' ) of a real anatomical structure ( 20 ' ) of an examination area ( 22 ) of an examination object ( 24 ) and providing the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ), and comprising a computing and control unit ( 110 ), which - to receive a medical picture ( 10 ), the anatomical structure ( 20 ), study area ( 22 ) of the examination object ( 24 ); For receiving the at least one anatomy position coordinate ( 30 ' ) of the real anatomical structure ( 20 ' ); For receiving at least one with at least one anatomy position coordinate ( 30 ' ), image position coordinates ( 30 ); For calculating a transformation rule, wherein in the calculation of the transformation rule the at least one anatomy position coordinate ( 30 ' ) and the at least one image position coordinate ( 30 ) and - for registration of the medical image ( 10 ) with the real anatomical structure ( 20 ' ) is designed with the help of the transformation rule. Contraption ( 110 ) according to claim 12, wherein the device ( 110 ) is designed to provide a method ( 1 ) according to one of claims 2 to 11. Computer program that is a procedure ( 1 ) according to one of claims 1 to 11, when it is stored on a computing device ( 110 ) is performed.

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