WO2025237541A1

WO2025237541A1 - Context dependent imaging and visualisation

Info

Publication number: WO2025237541A1
Application number: PCT/EP2024/063807
Authority: WO
Inventors: Benedikt VON UNOLD; Ferdinand STORCH
Original assignee: Brainlab SE
Current assignee: Brainlab SE
Priority date: 2024-05-17
Filing date: 2024-05-17
Publication date: 2025-11-20
Anticipated expiration: 2026-11-17

Abstract

A computer implemented method of catheter data dependent visualization and/or imaging and a corresponding medical system is presented. The method comprises the steps acquiring a vascular data set, which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient's anatomy (step S1), wherein the segmented tubular structure is partitioned in the vascular data set in several different parts, the method further comprising the steps receiving catheter data, which are position data and/or velocity data of a catheter (step S2), determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located (step S3), and generating, based on a result of the determination of step S3, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user (step S4a) and/or generating, based on a result of the determination of step S3, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step S4b).

Description

CONTEXT DEPENDENT IMAGING AND VISUALISATION

FIELD OF THE INVENTION

The present invention relates to a computer implemented method of catheter data dependent visualization and/or imaging, relates to a computer program, a program storage medium and relates to a medical system for controlling visualization of medical imaging data based on catheter data and/or for controlling imaging based on catheter data.

TECHNICAL BACKGROUND

In vascular surgery, there are currently no established workflows that provide proper assistance. Visualizations and imaging parameters are typically manually chosen and are independent from the specific surgical context. X-ray devices might provide presets for different anatomical areas or interventions, e.g., abdominal, peripheral, etc., but do not dynamically adjust them. Visualization solutions provide insights based on pre-OP image data, but are not dynamically linked to the intervention.

In the prior art, the concept of a „Desired View" is known where several, clinically relevant, options for desired views of C-arm in endovascular/intravascular procedures can be shown to the user before imaging, like e.g. a „pre-view“.

However, the inventors of the present invention have identified the need for an improved method and a medical system for visualizing imaging data and/or generation of imaging data during endovascular/intravascular interventions. EXEMPLARY SHORT DESCRIPTION OF THE INVENTION

The object of the present invention is solved by the subject-matter of the independent claims. Further embodiments and advantages of the invention are incorporated in the dependent claims.

In the following, a short description of the specific features of the present invention is given which shall not be understood to limit the invention only to the features or a combination of the features described in this section.

The described embodiments similarly pertain to the computer implemented method of catheter data dependent visualization and/or imaging, the program, the program storage medium and the medical system for controlling visualization of medical imaging data based on catheter data and/or for controlling imaging based on catheter data as presented herein. Note that, unless explicitly stated differently hereinafter, the medical system of the present invention and disclosed herein is configured to carry out the computer implemented method of the present invention. Synergetic effects may arise from different combinations of the embodiments although they might not be described in detail.

The disclosed computer implemented method, program and medical system facilitate an advantageous controlling or adaption of the visualization of imaging data of an intravascular procedures to the user and/or facilitate an advantageous controlling of the imaging of a tubular structure, preferably a segmented vessel tree, of a patient’s anatomy for intravascular procedures. As will be explained in detail hereinafter a method of controlling or adapting the visualization of medical imaging data based on catheter data and/or a method of controlling or adapting imaging based on catheter data is presented.

Using the vascular data set as suggested herein together with catheter data allows for an improved, particularly a more context dependent visualization of imaging data, and allows for an improved, particularly a more context dependent generation of imaging data. As will be explained in detail hereinafter, the context may be the spatial context, spatial surrounding or location or may be the current state of an intravascular procedure, and based on this determined context the visualisation control signal and/or imaging control signal can be generated.

The vascular data set suggested by the present invention represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy. Moreover, the segmented tubular structure is partitioned in the vascular data set in several different parts. For these different parts desired visualization parameters and/or desired imaging parameters can be stored in said vascular data set. Based on received, i.e. , acquired, catheter data, it can be calculated or determined by the presented method/system where the current location of the catheter is, i.e., in which particular one of said several different parts of the segmented tubular structure the catheter is located. Based on this calculation or determination and based on what the vascular data set defines as visualization parameters and/or as imaging parameters for said particular part, the method and system disclosed herein suggests generating a corresponding visualization instruction signal and/or a corresponding imaging instruction signal. In this way, the method and system disclosed herein facilitates a context-dependent imaging and a context-dependent visualization.

As will be described in detail hereinafter, the presented method and system allow for automated imaging and visualization during endovascular interventions while reducing the radiation dose for OR personnel and patients. The method and system can provide the right controlling of the visualization and of the image generation such that relevant views for the user with the right fidelity at any given point on the catheter pathway are realized. It will be explained in the context of particular embodiments that based on, for example, tip-tracking, and preferably other input parameters, the method and system automatically know the center of surgical attention and hence know or can derive the context. Note that context in vascular is mostly limited to vessel tree.

The method and system of the present invention can not only propose clinically relevant views to the user, but can also add more or less information tailored to a certain context. Part of particular embodiments of the invention is also that the user can plan the surgery, i.e. the views per segments in the vessel tree in advance which can lead to either further pre-operative imaging such as e.g., high-resolution images, or intra-visualizing imaging data and/or generation of imaging data during endovascular/intravascular interventions operative notifications as a reminder for tasks like acquiring intra-operative images, e.g., ultrasound.

GENERAL DESCRIPTION OF THE INVENTION

In this section, a description of the general features of the present invention is given for example by referring to possible embodiments of the invention. Again, while the following disclosure will be rather focused on the method of the present invention, it is explicitly made clear and the skilled reader will appreciate that this method can be carried out by the medical system of the present invention.

According to a first aspect of the present invention, a computer implemented method of catheter data dependent visualization and/or imaging is presented. The method comprises the steps of acquiring a vascular data set, which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy (step S1 ), wherein the segmented tubular structure is partitioned in the vascular data set in several different parts, the method further comprising the steps receiving catheter data, which are position data and/or velocity data of a catheter of an intravascular procedure (step S2), determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located (step S3), and generating, based on a result of the determination of step S3, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user (step S4a) and/or generating, based on a result of the determination of step S3, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step S4b).

Thus, a computer implemented method of catheter data dependent visualization and/or catheter data dependent imaging is presented. The method and the corresponding system allow for controlling visualization of medical imaging data based on catheter data and/or allow for controlling an imaging device based on catheter data. As will be explained in detail hereinafter, presented method and medical system allow for a beneficial control to show relevant views of the medical image data to the user with the right fidelity at any given point per part of the segmented tubular structure, which is partitioned in the vascular data set in several different parts. This can be used to optimize towards as many information for the user as needed, and as less radiation and/or contrast agent as possible.

As is understood by the skilled reader, the presented method generically defines that based on the received catheter data the visualization and/or generation of medical imaging data can be controlled or adapted. The catheter data shall be understood broadly and can be any kind of catheter position data or catheter velocity data. As is clear to the skilled reader, with the velocity data one can calculate the current catheter position/location. The catheter data may be guidewire data, preferably guidewire position data and/or guidewire speed data. Moreover, the catheter data received in step S2 described hereinbefore may be derived from imaging data, like e.g., derived from fluoroscopy. The catheter data are thus indicative for a current context of the catheter in said intravascular procedure, hence, using these catheter data allows for a context dependent visualization and/or imaging.

As mentioned, the method also uses a “vascular data set”, in which the tubular structure is partitioned into several, i.e. , at least two, different parts or sections. The method may use the information stored in the prepared vascular data set defining which visualization for the user of the imaging data and/or which imaging parameters shall be used at which location in the tubular structure. A non-limiting example of such a vascular data set having such defined parts is shown in Figure 1 . With the presented method the vessel tree is partitioned/divided in logical parts, i.e., in discrete parts/segment. Thus, instead of a continuous adaption of visualization and/or imaging depending on the catheter data, a discrete, partition-dependent visualization and/or imaging is presented.

Note that the vascular data set may comprise parts which make use of the present invention and other parts which do not make use of the present invention. In other words, it is sufficient if two parts are provided in the segmented tubular structure, while other sections of the segmented tubular structure are not partitioned, and hence these sections do not make use of the present invention. In other words, the tubular structure does not have to be completely partitioned. However, in a preferred embodiment all sections of the segmented tubular structure make use of the present invention and are thus partitioned. Two parts, three parts, four parts, or more of even all parts of the of the segmented tubular structure may make use of the present invention.

Further, the method may also comprise the steps of acquiring image data/imaging data and carrying out a segmentation of the tubular structure in the acquired image data/imaging data. This results in segmented imaging/image data in which the tubular structure is segmented. Additionally, the method may comprise to use said segmented imaging/image data to partition the segmented tubular structure in/into said several different parts. In this way, spatial boundaries of each of said several different parts can be defined. This may then result in the vascular data set that can be acquired in step S1 as detailed hereinbefore and hereinafter. In other words, the method may preferably comprise in an embodiment the step of partitioning the tubular structure thereby defining spatial boundaries of each of said several different parts.

In one example, adjusting only the visualization of the medical imaging data for the user without changing the imaging parameters is one of many options. In another example, adjusting one or more imaging parameters of an imaging device can be done based on the imaging instruction signal generated with the presented method. The adjustment of one or more imaging parameters can also be combined with visualization adaptions. As is clear to the skilled reader, the presented method in general generates an instruction signal for controlling a medical system, wherein the medical system may be or comprise a display/visualization device and/or an imaging device.

One or even several different visualization devices and displays may be controlled with the generated visualization instruction signal. Also, different kinds of imaging devices may be controlled with the visualization instruction signal generated with the presented method, for example a computed tomograph (CT) and cone beam computed tomograph (CBCT, such as volumetric CBCT), an x-ray tomograph, magnetic resonance tomograph (MRT or MRI), a conventional x-ray, a sonograph and/or ultrasound device, and positron emission tomograph. Other imaging devices and methods may also be used.

As was described hereinbefore, in step S3 the current location of the catheter is calculated based on the received catheter data, i.e. , the current location of the catheter in the segmented tubular structure may be determined.

Further, with the step S4a of generating the visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user, controlling the visualization of the medical imaging data to the user when the catheter is in said determined part of the segmented tubular structure is facilitated. Moreover, controlling the visualization of medical imaging data from said determined part of the segmented tubular structure to a user is facilitated. If desired, also other parts of the segmented tubular structure can be visualized to the user.

Note that in some particular embodiments the instruction signal generated in step S4a can be shown to the user. However, in most embodiments, the instruction signal generated in step S4a defines a certain visualization without specific instructions shown to the user.

The visualization instruction signal which is generated in steps S4a shall be understood as an "instruction signal", which is generated, and which is then used to control the visualization of said medical imaging data to the user in said determined part of the segmented tubular structure. Thus, this generated signal defines that a certain visualization is used that is suited for a certain part of the vessel tree, i.e., the part of the vessel tree where the catheter is currently located. This information or link between the location or position or coordinates, preferably x-, y-, and z-coordinates, vectorized coordinates and/or polar coordinates, and the pre-selected or desired visualization parameters may be stored in the vascular data set disclosed herein. However, as is clear to the skilled reader it is typically more important where in the vessel one is, not in x/y/z. In other words, this visualization instruction signal may be used to adjust the visualization of data to a specific, clinically relevant view. To mention one non-limiting example, at a stenosis a so called “stenosis view” could be used, where a 3D or 2,5D visualization is better, while in the so called "translational view" the 2D is enough. More detailed embodiments entailing the use of such particular views, like the “stenosis view” and the "translational view" will be explained in more detail hereinafter.

With the steps S4a and S4b, particular instruction signals are generated. With the imaging instruction signal, one or more imaging parameters can be set, i.e., can be adjusted or also only be suggested to the user by way of, for example, outputting the suggested imaging parameters on a screen to the user. Said imaging parameters may then be used for said determined part of the segmented tubular structure, i.e. may be used for imaging when the catheter is located in said determined part of the tubular structure. As will be detailed hereinafter in the context of particular embodiments, the visualization and the imaging using the instruction signals generated with the method presented herein can be carried out by e.g. a display of the medical system of the present invention and/or by an imaging device of the medical system of the present invention. This will be elucidated in more detail hereinafter.

As is apparent from the present disclosure, the presented method allows for an improved visualizing of imaging data and/or for an improved generation of imaging data/medical images. The imaging data can be visualized for the user during the intravascular procedure in an improved and in a catheter position dependent manner that is at least in part defined before the procedure has begun. The same holds true for the imaging parameters for imaging the tubular structure during the intravascular procedure. In this way, the presented method and medical system allow for a beneficial control to show relevant views of the medical image data to the user with the right fidelity at any given point per part of the segmented tubular structure, which is partitioned in the vascular data set in several different parts. This can be used to optimize towards as many information for the user as needed, and as less radiation and/or contrast agent as possible.

The concept of context-dependent display and/or context-dependent imaging as disclosed herein is not known, especially not for using the parts of a vessel structure and/or a list of explicitly predefined views relevant for the clinical use case, such as e.g., the stenosis view, in combination with the use of catheter or guidewire position data and/or catheter or guidewire velocity data. Positively, the method and system catheter or guidewire herein can consider the focus of attention via the use of the catheter data, preferably tracking data of the catheter (in anatomy/vessel tree location) and thereby enables automatic switching from one “clinically relevant segment”, i.e. , from on of said several different parts to the other. In this way, one part of the segmented tubular structure (being partitioned in the vascular data set in several different parts) can correspond to a certain set of defined views and/or imaging parameters pre-selected to be used there. In this way, the presented method and medical system allow, e.g., for dynamically setting imaging parameters, like the collimation, the framerate, the voltage of an x-ray tube and even further modalities or special views created in advance. Also, the volume of contrast agent needed for imaging purposes can be controlled in this way. The presented method may also automatically or semi-automatically detect critical points and/or lesions in images of the tubular structure of the patient.

In a particular embodiment, the presented method can also suggest additional preoperative image acquisition based on the anatomical situation.

Additionally, the method may comprise in a particular embodiment receiving or acquiring data describing the shape of the catheter and/or geometric dimensions, like, e.g. the diameter, of the catheter.

As was detailed hereinbefore and will be explained in the context of specific embodiments hereinafter, the presented method and medical system may apply or use particular views depending on the catheter position. General view possibilities are imaging parameters (like e.g. collimation, contrast, framerate, etc.), preferably of the imaging device Loop-X; 2D with max. plague projection; 2-planes view; 3D or semi-3D view; augmentation of fluoro with (segmented) vessels and guidewire/catheter one slice with CBCT (3D); and IVUS-like view. Furthermore, a specific view example is a translation view, in which the collimation and/or field of view (FoV) may be depending on the catheter speed/guidewire speed, and preferably using a rather low quality scan. Another specific view example is an intersection view, e.g. using Loop-X angle so that the intersection is co-planar, preferably using a a high-quality scan. Another specific view example is a stenosis check view, in which a 3D-scan or intra-operative imaging like ultrasound is carried out. Another specific view example is a treatment I stenosis view, in which a high-signal to noise ratio, high-framerate, and high contrast could be used such that an increase in radiation but stronger collimation to relevant FoV is achieved, and/or using high-resolution imaging views taken pre-operatively. Regarding the clinical relevance note that stenosis is not rotation-symmetric, and hence a 3D scan is suggested by this embodiment. Furthermore, a reduction of radiation and contrast-agent is achievable by optimizing and/or individualizing the views set by the user. Positively, with the presented method less interaction and distraction for the user is achieved.

According to an exemplary embodiment, the segmented tubular structure is partitioned by said several different parts into several different 2D sections and/or several different 3D sections.

In this embodiment it is emphasized that the “several different parts” divide the tubular structure into several different 2D and/or 3D sections of the vessel tree. In this way, a spatial division of the tubular structure into clinically relevant 2D/3D sections is achieved. An non-limiting, exemplary embodiment thereof can be gathered from Figure 1 and its description.

According to an exemplary embodiment, the method further comprises the step using the generated visualization instruction signal to adapt a visualization of the medical imaging data to a current location of the catheter, preferably to a current location of a catheter tip, in the segmented tubular structure.

In this embodiment it is detailed that the generated visualization instruction signal of step S4a is used for adapting the visualization of the medical image data to the desired visualization pre-defined in the vascular data set for the location in the tubular structure, at which the catheter currently is. It is noted that the visualization instruction signal is generated based on the visualization information comprised in the vascular data set. This can be used to optimize towards as many information for the user as needed. Thus, based on the several different parts, into which the tubular structure is divided or partitioned in the vascular data set, the visualization instruction signal may be different, but preferably within each part the visualisation instruction signal and/or the visualisation parameters to be used don't change. Thus, as is clear to the skilled reader, with the presented method the vessel tree is partitioned/divided in logical parts, i.e., discrete parts/segments, instead of a continuous adaption of visualization depending on the catheter data, preferably the catheter location.

As will be appreciated by the skilled person from this disclosure, the presented method may comprise the following steps. Choosing or determining, based on the catheter data, preferably on the catheter tip position, which part of the partitioned tubular structure shall be visualized for the user. And the method may also comprise the step of choosing or determining how to visualize this chosen or determined part.

According to an exemplary embodiment, the method further comprises the step using the generated imaging instruction signal to adapt said one or more imaging parameters to a current location of the catheter, preferably of a catheter tip, in the segmented tubular structure.

In this embodiment it is detailed that the generated imaging instruction signal of step S4b is used for adapting the imaging, i.e., the image generation, to the desired imaging parameters pre-defined in the vascular data set for the location in the tubular structure, at which the catheter currently is. It is noted that the imaging instruction signal is generated based on the imaging information comprised in the vascular data set. This can be used to optimize towards as less radiation and/or as less contrast agent as possible.

Thus, based on the several different parts, into which the tubular structure is divided or partitioned in the vascular data set, the imaging instruction signal may be different, but preferably within each part the imaging instruction signal and/or the imaging parameters to be used don't change. Thus, as is clear to the skilled reader, with the presented method the vessel tree is partitioned/divided in logical parts, i.e., discrete parts/segments, instead of a continuous adaption of imaging depending on the catheter data, preferably the catheter location.

As will be appreciated by the skilled person from this disclosure, the presented method may comprise the following steps. Choosing or determining, based on the catheter data, preferably on the catheter tip position, which part of the partitioned tubular structure shall be imaged for the user. And the method may also comprise the step of choosing or determining how to image this chosen or determined part.

According to an exemplary embodiment, the method further comprises the step of determining a current location of the catheter, preferably of a catheter tip, in the segmented tubular structure based on the received catheter data.

In this embodiment it is explicitly defined that the determination or calculation of the current catheter position, preferably the position of the catheter tip is carried out by the presented method. The catheter data may be tracking data, which are indicative of the current position and/or speed of the catheter/guidewire. In particular embodiments thereof, the catheter data are fluoro tracking data of the catheter position and/or of the catheter velocity; or the catheter data are electromagnetic tracking data of the catheter position and/or of the catheter velocity. Also, other kinds of tracking may be used. In Figure 5 a schematic tracking of a catheter is disclosed.

According to an exemplary embodiment, said one or more imaging parameters are selected from the group comprising a collimation of an imaging device; a framerate of an imaging device; a voltage of an imaging device; a position of an isocenter of an imaging device with respect to the patient's anatomy; a position, size and/or shape of an imaging region with respect to the patient's anatomy; a position, size and/or shape of an imaging region with respect to one or more objects coupled the patient's anatomy; a position, size and/or shape of an imaging region with respect to the imaging device; a position of a scan trajectory with respect to the patient's anatomy, a position of a scan trajectory with respect with respect to one or more objects coupled the patient's anatomy; a position of an imaging device with respect to the patient's anatomy and/or with respect to one or more objects coupled the patient's anatomy; a position, size and/or shape of a collimator opening of the imaging device; a scan voltage and/or scan current of an x-ray tube; a dose modulation; a selection of a reconstruction kernel and algorithm; a metal artefact reduction modality; a subtraction angiography modality; a dual-energy imaging modality; a number of x-ray pulses per second; a number of acquired projections; a modality and/or setting for post-processing at least one image obtained with an imaging device; a current of an imaging device; an angulation; a binning; a zoom; and a postprocessing.

In this embodiment, exemplary imaging parameters than can be adapted with the present invention, are disclosed. This embodiment allows the user to detail the optimization towards the goal of imaging as many information for the user as needed, and at the same time to use as less radiation and/or as less contrast agent as possible. Different imaging parameters that can be used in this embodiment can be gathered by the skilled person from e.g. the following patent application of the Brainlab EP3824475 A1 , especially from paragraphs [0033] to [0045], This further improves the intervention. According to an exemplary embodiment, the vascular data set comprises visualization information defining for at least one of said several different parts of the segmented tubular structure how said medical imaging data used for the intravascular procedure shall be visualized to the user, and the method further comprises the step of using said visualization information of the vascular data set for generating the visualization instruction signal during the step S4a.

In this embodiment the vascular data set defines with stored “visualization information”, respectively, how the visualization shall be carried out when the catheter is at the corresponding location within the tubular structure. In other words, the “visualization information” may be seen as catheter location dependent visualisation instruction or guidance. This visualisation information may define how to display the imaging data when the catheter is at the respective/corresponding position/location within the tubular structure. This embodiment also defines that this “visualization information” is used for generating the visualisation instruction signal as detailed hereinbefore with respect to step S4a.

According to an exemplary embodiment, the method further comprising the step of receiving a user input about suggested changes in the visualization information, and preferably adapting the vascular data set based on the received user input.

This embodiment relates to the aspect of user provided feedback, which may change with his/her input which “visualization information” is stored in the vascular data set. The user input may be received via an appropriate user interface like e.g., a touch screen or an input via a computing device, which may be part of the medical system disclosed herein. This embodiment involves the possibility that the method and the respective software can learn from these adaptations, i.e. , from the user input. If a critical mass of adaptations by the user exists, this can become the standard imaging and/or visualization. If desired, a threshold could be used. One may also use saving the "presets" on a user basis or even making it available for others in the clinic or beyond, like e.g., the "Prof, xxx Preset". According to an exemplary embodiment, the vascular data set comprises imaging information defining for at least one of said several different parts of the segmented tubular structure how medical imaging data used for the intravascular procedure shall be generated, and the method further comprising the step of using said imaging information of the vascular data set for generating the imaging instruction signal during the step S4b.

In this embodiment the vascular data set defines with stored “imaging information”, respectively, how the imaging shall be carried out when the catheter is at the corresponding location within the tubular structure. In other words, the “imaging information” may be seen as catheter location dependent imaging instruction or guidance. It may define how medical imaging data used for the intravascular procedure shall be generated, and thus may be seen as location-dependent imaging information. It determines which imaging parameters shall be used when the catheter is at the respective or corresponding position or location within the tubular structure. This embodiment also defines that this “imaging information” is used for generating the imaging instruction signal as detailed hereinbefore with respect to step S4b.

According to an exemplary embodiment, the method further comprises the step of receiving a user input about suggested changes in the imaging information, and preferably adapting the vascular data set based on the received user input.

Similar to the embodiment described hereinbefore regarding the feedback about visualization suggestion, this embodiment describes that a user may provide feedback and may change with his/her input which “imaging information” is stored in the vascular data set. The user input may be received via an appropriate user interface like e.g., a touch screen or an input via a computing device, which may be part of the medical system disclosed herein. This embodiment involves the possibility that the method and the respective software can learn from these adaptations, i.e. , from the user input. If a critical mass of adaptations by the user exists, this can become the standard imaging. If desired, a threshold could be used. One may also use saving the "presets" on a user basis or even making it available for others in the clinic or beyond, like e.g., the "Prof, xxx Preset". According to an exemplary embodiment, the method further comprises the step of receiving a user input about suggested changes in the partitioning of the segmented tubular structure in several different parts, for example about a bounding box of one or more different parts, and preferably adapting the vascular data set based on the received user input.

With this embodiment, the user can provide feedback and desired changes of the bounding box of one or more parts of the partitioning of the tubular structure. The partitioning into “several different parts” divides the tubular structure into several different 2D and/or 3D sections of the vessel tree. In this way, a spatial division of the tubular structure into clinically relevant 2D/3D sections is achieved. A non-limiting, exemplary embodiment thereof can be gathered from Figure 1 . The user may thus change this partitioning by amending the spatial boundaries of one or more of said parts. One may use, for example, a graphical user display, on which the vascular data set is shown with said portioning, see e.g. Figure 1 , and in which the user may move or shift the spatial boundaries, i.e. , the bounding boxes of these parts. These changes may be saved and used in the next iteration or use of the presented method.

According to an exemplary embodiment, in the vascular data set it is defined for said several different parts of the segmented tubular structure what kind of view is to be used when imaging the medical imaging data. The view for said several different parts is selected from a translation view, an intersection view, a stenosis check view, and a treatment stenosis view. Therein a) in the translation view imaging parameters are used, which lead to a lower image quality compared to the image quality of the, but which lead to less imaging radiation compared to the treatment stenosis view, and b) in the intersection view an imaging angle of an imaging device is used, preferably of a robotic X-ray imaging device, that is perpendicular to a vascular intersection present in said part of the tubular structure, and c) in the stenosis check view a 3D-scan or an intra-operative imaging like ultrasound is used, and d) in the treatment stenosis view a comparatively high signal to noise ratio, a comparatively high-framerate, a comparatively high contrast, preferably by increasing radiation but stronger collimation to a relevant field of view and/or a comparatively high-resolution images taken pre-operation are used.

With this embodiment the aspect is covered that one or more of the translation view, the intersection view, the stenosis check view, and a treatment stenosis view are used. As is clear to the skilled reader, the translation view is about getting from A to B quickly. No major obstacles are expected on the way, and thus, among other things, imaging settings are selected that have poorer image quality, but are low in radiation For example, in the translation view imaging collimation and/or imaging field of view may depend on catheter velocity. A high SNR means that the signal is clear and easy to detect or interpret, while a low SNR means that the signal is corrupted or obscured by noise and may be difficult to distinguish or recover. In the non-limiting, exemplary embodiment shown in Figure 1 , the vascular data set shown there comprises nine different parts 101 to 109 shown with their respective spatial boundaries, and which all are assigned to a particular view like e.g., the translation view, the intersection view, the stenosis check view or the treatment/stenosis view. Note that in the translation view, the velocity can be used to widen/close the field of view, e.g. in case of a faster velocity, the field of view is adapted to be larger or suggested to be larger.

According to an exemplary embodiment, the method comprises the steps of acquiring first pre-operative imaging data of the patient’s anatomy, preferably in form of CT-A, CBCT, DSA images, 2D ultrasound, and/or 3D ultrasound, segmenting the tubular structure in the first pre-operative imaging data, and identifying in the acquired first pre-operative imaging data one or more lesions and/or one or more critical structures.

With this embodiment the use of pre-operative data for segmenting the tubular structure and the identification of lesions and/or critical structures in the segmented data set is achieved. This identification can be done manually and a corresponding input from a user may be received. Moreover, a semi-automatic or fully automated identification of lesions or other critical structures based on software, preferably using Al or machine learning models may be applied in the context of this embodiment. As an example, the subject matter of this embodiment is also comprised by the embodiment shown in Figure 3 with steps 302 and 303, as well as in Figure 4 with steps 402 and 403.

According to an exemplary embodiment, the method comprises the step of identifying in the acquired first pre-operative imaging data a pathway for the catheter from entry into the tubular structure to a target of the intravascular procedure in the tubular structure.

This embodiment relates to the aspect of defining a “pathway” from entry to the target within the tubular structure. This identification can be done manually and a corresponding input from a user may be received. Moreover, a semi-automatic or fully automated identification of lesions or other critical structures based on software, preferably using Al or machine learning models may be applied in the context of this embodiment. As an example, the subject matter of this embodiment is also comprised by the embodiment shown in Figure 3 with step 303, as well as in Figure 4 with step 403.

According to an exemplary embodiment, the method comprises the step of simulating a pathway of a catheter through the segmented tubular structure thereby using one or more visualization instruction signals generated in step S4a.

The simulation of a pathway of the catheter through the tubular structure allows e.g., showing the planned visualisation, i.e., the recommended views or other visualisation details, to the user at a pre-operation stage. This allows the user to adjust the planned visualisation according to his/her needs or preferences or according to the present particular patient and/or intervention. The user may then give feedback and the adjustments to the visualization instructions signals and/or the imaging instruction signal generated by the method in steps S4a and S5a can be stored. Alternatively, or in addition, the adjustments could be stored in the vascular data set, e.g., in the form of amended visualization information and/or amended imaging information stored in the vascular data set. In this way, the simulated pathway allows to optimize and individualize the presented method by the user. An accordingly amended vascular data set may thus generated more individualized instruction signals in steps S4a and S4b. On particular embodiment using this aspect is shown in Figure 4 with step 406. In general, this allows show in a pre-view to the user the relevant views with the right fidelity at any given point part of the tubular structure the catheter/device pathway. This pre-view in combination with the possibility to provide feedback and/or adjustments by the user further optimizes the method towards the goal of providing as many information as needed, and as less radiation and/or contrast agent CA as possible.

According to an exemplary embodiment, the method comprises the step of acquiring second pre-operative imaging data of the identified one or more lesions and/or the one or more critical structures, preferably by using CBCT and/or US (ultrasound), and by preferably using a higher image quality as compared to the acquired first imaging data.

This embodiment relates to the generation of second pre-operative data with a higher imaging quality as the first imaging data. Preferably, this image generation is carried out automatically by the imaging device, i.e. , based on the result of an automatic identification of the catheter pathway in the tubular structure, as explained hereinbefore, and/or based on the result of the automatic detection lesions/critical structures in first imaging data. The presented method may thus generate an instruction signal sent to the imaging device in order to trigger the automatic acquisition of high-quality images, preferably by carrying out local scans. This may involve preferably CBCT and US modalities. In one particular example, a Loop X imaging device is used. Further, an exemplary embodiment thereof is shown in Figure 3 by step 305.

According to an exemplary embodiment, the method comprises the step of partitioning the tubular structure thereby defining spatial boundaries of each of said several different parts.

This embodiment relates to the preparation of the segmented tubular structure by partitioning the tubular structure in said several different parts or sections by spatially defining the boundaries of each part. A non-limiting, exemplary embodiment of such a partition into parts with spatial boundaries can be gathered from Figure 1 and the respective description. In a particular embodiment, this preparation is done manually by the user, e.g., by drawing into the displayed vessel tree with a digital pen the spatial boundaries of said parts. In another embodiment, an algorithm, preferably using Al or machine learning, suggests such a partition and the user may amend or adapt the suggested partition. This prepared vascular data set may then be sent or provided to the device carrying out the presented method, like the medical system disclosed herein.

According to an exemplary embodiment, the method comprises the step of defining and/or calculating desired views for said several parts of the segmented tubular structure.

As is appreciated by the skilled reader a “view” as used herein is understood as a particular way of displaying the data, and this embodiment relates to the definition or calculation of such “views”. This definition of one or more views can be done manually by the user, or can be done by an algorithm, preferably using Al or machine learning, suggesting a view for one or more, preferably all of said several different parts of the partition.

In the context of the present invention the term “view” shall be understood as comprising one or more visual representations of the patient anatomy derived from imaging data. Those visual representations may be generated by following discrete depiction principles. Examples are: coaxial slices, 3D volume renderings, cropped 3D volume renderings, MIPs, etc.. A view may comprise patient data and optionally contextual data/meta data derived from/based on the patient data or derived from a database based on the patient data.

According to an exemplary embodiment, the method comprises the step of acquiring a digital representation of the intravascular procedure, wherein the digital representation of the intravascular procedure describes the clinical process or clinical workflow of the intravascular procedure with different intravascular procedure steps, and using the digital representation of the intravascular procedure, together with the result of the result of the determination in step S3, for the generation of the visualization instruction signal in step S4a and/or for the generation of the imaging instruction signal in step S4b.

This embodiment describes how a “digital representation of an intravascular procedure” can be used in the context of the present invention. A digital representation of the intravascular procedure may be seen as the digital twin of the intravascular procedure. It describes or defines the induvial clinical steps of the intravascular procedure. In a non-limiting, exemplary embodiment, such a digital representation may, for example, look like:

An exemplary, non-limiting example of a digital representation of an intravascular procedure is the following step-wise description or summary:

1 . vessel access

2. angiographic imaging of the relevant anatomy

3. lesion identification

4. lesion approach

5. lesion crossing

6. atherectomy

7. balloon angioplasty

8. stenting

9. control angiography

10. closure of vessel access

In an embodiment, the aim is to create a digital representation, i.e. , a digital twin, of the workflow including the planned imaging and visualization values in order to give the user the opportunity to review and modify the imaging and visualization plan, and in order to learn from the user's adjustments and optimize the imaging and visualization plan in the future.

According to an exemplary embodiment, at least one of the several different parts of the partitioned segmented tubular structure of the vascular data set is assigned to at least one of said different intravascular procedure steps of the digital representation of the intravascular procedure. According to another exemplary embodiment, all of the several different parts of the partitioned segmented tubular structure of the vascular data set are assigned to at least one of said different intravascular procedure steps of the digital representation of the intravascular procedure.

According to an exemplary embodiment, at least one of said different intravascular procedure steps is assigned to at least one of said several different parts of the partitioned segmented tubular structure of the vascular data set. According to an exemplary embodiment, all of said different intravascular procedure steps are assigned to at least one of said several different parts of the partitioned segmented tubular structure of the vascular data set.

According to an exemplary embodiment, the method comprises the step of acquiring or receiving the medical imaging data.

The medical imaging data may be received by the medical system of the present invention from an imaging device, and a calculation unit, processor or computer of the medical system may then carry out the steps S1 to S4a/S4b as disclosed herein. As is detailed hereinbefore and hereinafter, several different imaging modalities may be used. The acquired or received image data may be used to prepare the partition within the vascular data set, may be used to identify in the imaging data a pathway for the catheter from entry into the tubular structure to a target of the intravascular procedure in the tubular structure, and/or may be used to identify in the imaging data one or more lesions and/or one or more critical structures. The imaging device may generate the imaging data, which may be sent to or provided to the device carrying out the presented method, like the medical system disclosed herein. These imaging data can of course also be visualized to the user while using the method presented herein.

According to an exemplary embodiment, the method comprises the step of visualizing the acquired medical imaging data based on the generated visualization instruction signal, and/or imaging the tubular structure based on the imaging instruction signal for. According to an exemplary embodiment, the catheter data are tracking data indicative of a current position of the catheter. According to an exemplary embodiment, the catheter data are fluoro tracking data of the catheter position and/or of the catheter velocity; and/or the catheter data are electromagnetic tracking data of the catheter position and/or of the catheter velocity.

It should be noted that in the context of the present invention the term “fluoro tracking data” shall be understood as fluoroscopic imaging based tracking and/or video analysis within fluoroscopic live video streams,

According to an exemplary embodiment, the method comprises the step of sending catheter data to an imaging device, initiating a movement of the imaging device to the current position of the catheter, and generating imaging data of the tubular structure at the current position of the catheter by the imaging device.

This embodiment defines that the imaging device, like e.g. the Loop X of Brainlab AG, receives the catheter tracking data and automatically moves to the corresponding position where the catheter currently is and images the tubular structure there.

According to an exemplary embodiment, the method comprises the step of tracking imaging parameter changes suggested by the user, and/or tracking visualization changes suggested by the user.

In this embodiment imaging parameter changes suggested by the user are tracked and/or stored. Alternatively, or in addition, visualization changes suggested by the user are tracked and/or stored.

According to an exemplary embodiment, the method comprises the step of using the tracked visualization changes for an improved signal generation in step S4a. This embodiment relates to using the user suggested changes of the tracked visualization changes by the method and corresponding medical system to learn and to improve the results/suggestions of the claimed method in the next round, i.e. , when the method is carried out in the future/ in another loop. Note that machine learning can be used for this aspect of the present invention. One may also use tracked visualization changes on a user basis or even making it available for others in the clinic or beyond, like e.g., the "Prof, xxx Preset".

According to an exemplary embodiment, the method comprises the step of using the tracked imaging parameter changes for an improved signal generation in step S4b.

This embodiment relates to using the user suggested changes of the imaging parameters by the method and corresponding medical system to learn and to improve the results/suggestions of the claimed method in the next round, i.e., when the method is carried out in the future/ in another loop. Note that machine learning can be used for this aspect of the present invention. One may also use tracked visualization changes on a user basis or even making it available for others in the clinic or beyond, like e.g., the "Prof, xxx Preset".

According to an exemplary embodiment, wherein the catheter data are live tracking data, preferably relative to the tubular structure, and are indicative of a current location of a tip of the catheter in the tubular structure.

This embodiment introduces the use of live data and that it is the catheter tip which is preferably tracked. As was mentioned before, several different kinds of tracking can used in the context of this embodiment.

According to an exemplary embodiment, the method comprises the step of displaying imaging data to the user during the intravascular procedure, which imaging data were previously generated during said intravascular procedure.

This embodiment emphasizes that data can be displayed to the user during the intravascular procedure which imaging data were generated before, but in said/during said intravascular procedure. According to an exemplary embodiment, the method comprises the step of sending the visualization instruction signal to a display device and visualizing the medical imaging data on said display accordingly.

According to this embodiment, the one or more or all instruction signals are sent to the respective device, like e.g., a display and/or an imaging device, which carry out the respective instructions. Thus, said display and/or imaging device act according to the received one or more instruction signals.

According to an exemplary embodiment, the method comprises the step of sending the imaging instruction signal to an imaging device and imaging the tubular structure with the imaging device accordingly.

According to a second aspect of the present invention, a program or program element is presented which, when running on a computer or when loaded onto a computer, causes the computer to perform the method steps of the method as disclosed herein.

The program or program element may be part of a computer program, but it can also be an entire program by itself. For example, the program may be used to update an already existing computer program to get to the present invention.

In this second aspect, the invention is directed to a computer program or software which, when running on at least one processor (for example, a processor) of at least one computer (for example, a computer) or when loaded into at least one memory (for example, a memory) of at least one computer (for example, a computer), causes the at least one computer to perform the above-described method according to the first aspect. The invention may alternatively or additionally relate to a (physical, for example electrical, for example technically generated) signal wave, for example a digital signal wave, carrying information which represents the program, for example the aforementioned program, which for example comprises code means which are adapted to perform any or all of the steps of the method according to the first aspect. A computer program stored on a disc is a data file, and when the file is read out and transmitted it becomes a data stream for example in the form of a (physical, for example electrical, for example technically generated) signal. The signal can be implemented as the signal wave which is described herein. For example, the signal, for example the signal wave is constituted to be transmitted via a computer network, for example LAN, WLAN, WAN, for example the internet. The invention according to the second aspect therefore may alternatively or additionally relate to a data stream representative of the aforementioned program.

According to a third aspect of the present invention, a program storage medium on which a program or program element is stored, which, when running on a computer or when loaded onto a computer, causes the computer to perform the method steps of the method as disclosed herein.

The computer readable medium may be seen as a storage medium, such as for example, a USB stick, a CD, a DVD, a data storage device, a hard disk, or any other medium on which a program as described above can be stored. Also a server on which the program is stored, preferably for being downloaded, is covered by this third aspect of the present invention.

According to a fourth aspect of the present invention, a medical system for controlling visualization of medical imaging data based on catheter data and/or for controlling imaging based on catheter data is presented. The medical system is configured for receiving/acquiring a vascular data set, which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy (step S1 ), wherein the segmented tubular structure is partitioned in the vascular data set in several different parts, wherein the medical system is configured for receiving catheter data, which are position data and/or velocity data of a catheter (step S2), determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located (step S3), generating, based on a result of the determination of step S3, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user (step S4a) and/or generating, based on a result of the determination of step S3, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step S4b).

A particular embodiment thereof is shown in Figure 5. The medical system may comprise a calculation unit, processor or a computer which is/are accordingly configured to carry out the computer implemented method presented herein.

According to an embodiment, the medical system comprises the program described herein and/or the program storage medium described herein.

According to an embodiment, the medical system comprises at least one electronic data storage device storing the vascular data set; and at least one communication interface configured for receiving/acquiring the catheter data.

According to an embodiment, the medical system comprises a display for displaying said medical image data and for carrying out or processing said visualization instruction signals generated by the medical system in step S4a.

According to an embodiment, the medical system comprises an imaging device for generating medical image data and for carrying out or processing said one or more imaging instruction signals generated by the medical system in step S4b.

Thus, the one or more or all instruction signals generated in steps S4a and/or S4b can be provided to the respective device, like e.g., the display and/or the imaging device, which carry out the respective instructions. Thus, said display and/or imaging device act according to the received one or more instruction signals.

According to an embodiment, the medical system comprises at least one computer (for example, a computer), comprising at least one processor (for example, a processor) and at least one memory (for example, a memory), wherein the program according to the second aspect is running on the processor or is loaded into the memory, or wherein the at least one computer comprises the computer-readable program storage medium according to the third aspect. Note that the invention does not involve or in particular comprise or encompass an invasive step which would represent a substantial physical interference with the body requiring professional medical expertise to be carried out and entailing a substantial health risk even when carried out with the required professional care and expertise.. More particularly, the invention does not involve or in particular comprise or encompass any surgical or therapeutic activity. For this reason alone, no surgical or therapeutic activity and in particular no surgical or therapeutic step is necessitated or implied by carrying out the invention.

DEFINITIONS

In this section, definitions for specific terminology used in this disclosure are offered which also form part of the present disclosure.

Computer implemented method

The method in accordance with the invention is for example a computer implemented method. For example, all the steps or merely some of the steps (i.e. less than the total number of steps) of the method in accordance with the invention can be executed by a computer (for example, at least one computer). An embodiment of the computer implemented method is a use of the computer for performing a data processing method. An embodiment of the computer implemented method is a method concerning the operation of the computer such that the computer is operated to perform one, more or all steps of the method.

The computer for example comprises at least one processor and for example at least one memory in order to (technically) process the data, for example electronically and/or optically. The processor being for example made of a substance or composition which is a semiconductor, for example at least partly n- and/or p-doped semiconductor, for example at least one of II-, III-, IV-, V-, Vl-sem iconductor material, for example (doped) silicon and/or gallium arsenide. The calculating or determining steps described are for example performed by a computer. Determining steps or calculating steps are for example steps of determining data within the framework of the technical method, for example within the framework of a program. A computer is for example any kind of data processing device, for example electronic data processing device. A computer can be a device which is generally thought of as such, for example desktop PCs, notebooks, netbooks, etc., but can also be any programmable apparatus, such as for example a mobile phone or an embedded processor. A computer can for example comprise a system (network) of "sub-computers", wherein each sub-computer represents a computer in its own right. The term "computer" includes a cloud computer, for example a cloud server. The term "cloud computer" includes a cloud computer system which for example comprises a system of at least one cloud computer and for example a plurality of operatively interconnected cloud computers such as a server farm. Such a cloud computer is preferably connected to a wide area network such as the world wide web (WWW) and located in a so-called cloud of computers which are all connected to the world wide web. Such an infrastructure is used for "cloud computing", which describes computation, software, data access and storage services which do not require the end user to know the physical location and/or configuration of the computer delivering a specific service. For example, the term "cloud" is used in this respect as a metaphor for the Internet (world wide web). For example, the cloud provides computing infrastructure as a service (laaS). The cloud computer can function as a virtual host for an operating system and/or data processing application which is used to execute the method of the invention. The cloud computer is for example an elastic compute cloud (EC2) as provided by Amazon Web Services™. A computer for example comprises interfaces in order to receive or output data and/or perform an analogue-to-digital conversion. The data are for example data which represent physical properties and/or which are generated from technical signals. The technical signals are for example generated by means of (technical) detection devices (such as for example devices for detecting marker devices) and/or (technical) analytical devices (such as for example devices for performing (medical) imaging methods), wherein the technical signals are for example electrical or optical signals. The technical signals for example represent the data received or outputted by the computer. The computer is preferably operatively coupled to a display device which allows information outputted by the computer to be displayed, for example to a user. One example of a display device is a virtual reality device or an augmented reality device (also referred to as virtual reality glasses or augmented reality glasses) which can be used as "goggles" for navigating. A specific example of such augmented reality glasses is Google Glass (a trademark of Google, Inc.). An augmented reality device or a virtual reality device can be used both to input information into the computer by user interaction and to display information outputted by the computer. Another example of a display device would be a standard computer monitor comprising for example a liquid crystal display operatively coupled to the computer for receiving display control data from the computer for generating signals used to display image information content on the display device. A specific embodiment of such a computer monitor is a digital lightbox. An example of such a digital lightbox is Buzz®, a product of Brainlab AG. The monitor may also be the monitor of a portable, for example handheld, device such as a smart phone or personal digital assistant or digital media player.

The invention also relates to a program which, when running on a computer, causes the computer to perform one or more or all of the method steps described herein and/or to a program storage medium on which the program is stored (in particular in a non- transitory form) and/or to a computer comprising said program storage medium and/or to a (physical, for example electrical, for example technically generated) signal wave, for example a digital signal wave, carrying information which represents the program, for example the aforementioned program, which for example comprises code means which are adapted to perform any or all of the method steps described herein.

Within the framework of the invention, computer program elements can be embodied by hardware and/or software (this includes firmware, resident software, micro-code, etc.). Within the framework of the invention, computer program elements can take the form of a computer program product which can be embodied by a computer-usable, for example computer-readable data storage medium comprising computer-usable, for example computer-readable program instructions, "code" or a "computer program" embodied in said data storage medium for use on or in connection with the instructionexecuting system. Such a system can be a computer; a computer can be a data processing device comprising means for executing the computer program elements and/or the program in accordance with the invention, for example a data processing device comprising a digital processor (central processing unit or CPU) which executes the computer program elements, and optionally a volatile memory (for example a random access memory or RAM) for storing data used for and/or produced by executing the computer program elements. Within the framework of the present invention, a computer-usable, for example computer-readable data storage medium can be any data storage medium which can include, store, communicate, propagate or transport the program for use on or in connection with the instruction-executing system, apparatus or device. The computer-usable, for example computer-readable data storage medium can for example be, but is not limited to, an electronic, magnetic, optical, electromagnetic, infrared or semiconductor system, apparatus or device or a medium of propagation such as for example the Internet. The computer-usable or computer-readable data storage medium could even for example be paper or another suitable medium onto which the program is printed, since the program could be electronically captured, for example by optically scanning the paper or other suitable medium, and then compiled, interpreted or otherwise processed in a suitable manner. The data storage medium is preferably a non-volatile data storage medium. The computer program product and any software and/or hardware described here form the various means for performing the functions of the invention in the example embodiments. The computer and/or data processing device can for example include a guidance information device which includes means for outputting guidance information. The guidance information can be outputted, for example to a user, visually by a visual indicating means (for example, a monitor and/or a lamp) and/or acoustically by an acoustic indicating means (for example, a loudspeaker and/or a digital speech output device) and/or tactilely by a tactile indicating means (for example, a vibrating element or a vibration element incorporated into an instrument). For the purpose of this document, a computer is a technical computer which for example comprises technical, for example tangible components, for example mechanical and/or electronic components. Any device mentioned as such in this document is a technical and for example tangible device.

Acquiring data/an image

The expression "acquiring data" and/or “acquiring an image” (which will be used herein synonymously) for example encompasses (within the framework of a computer implemented method) the scenario in which the data/image data are determined by the computer implemented method or program. Determining data for example encompasses measuring physical quantities and transforming the measured values into data, for example digital data, and/or computing (and e.g. outputting) the data by means of a computer and for example within the framework of the method in accordance with the invention. The meaning of "acquiring data"/” acquiring an image” also for example encompasses the scenario in which the data are received or retrieved by (e.g. input to) the computer implemented method or program, for example from another program, a previous method step or a data storage medium, for example for further processing by the computer implemented method or program. Generation of the data to be acquired may but need not be part of the method in accordance with the invention. The expression "acquiring data" can therefore also for example mean waiting to receive data and/or receiving the data. The received data can for example be inputted via an interface. The expression "acquiring data" can also mean that the computer implemented method or program performs steps in order to (actively) receive or retrieve the data from a data source, for instance a data storage medium (such as for example a ROM, RAM, database, hard drive, etc.), or via the interface (for instance, from another computer or a network). The data acquired by the disclosed method or device, respectively, may be acquired from a database located in a data storage device which is operably to a computer for data transfer between the database and the computer, for example from the database to the computer. The computer acquires the data for use as an input for steps of determining data. The determined data can be output again to the same or another database to be stored for later use. The database or database used for implementing the disclosed method can be located on network data storage device or a network server (for example, a cloud data storage device or a cloud server) or a local data storage device (such as a mass storage device operably connected to at least one computer executing the disclosed method). The data can be made "ready for use" by performing an additional step before the acquiring step. In accordance with this additional step, the data are generated in order to be acquired. The data are for example detected or captured (for example by an analytical device). Alternatively or additionally, the data are inputted in accordance with the additional step, for instance via interfaces. The data generated can for example be inputted (for instance into the computer). In accordance with the additional step (which precedes the acquiring step), the data can also be provided by performing the additional step of storing the data in a data storage medium (such as for example a ROM, RAM, CD and/or hard drive), such that they are ready for use within the framework of the method or program in accordance with the invention. The step of "acquiring data" can therefore also involve commanding a device to obtain and/or provide the data to be acquired. In particular, the acquiring step does not involve an invasive step which would represent a substantial physical interference with the body, requiring professional medical expertise to be carried out and entailing a substantial health risk even when carried out with the required professional care and expertise. In particular, the step of acquiring data, for example determining data, does not involve a surgical step and in particular does not involve a step of treating a human or animal body using surgery or therapy. In order to distinguish the different data used by the present method, the data are denoted (i.e. referred to) as "XY data" and the like and are defined in terms of the information which they describe, which is then preferably referred to as "XY information" and the like.

Imaging methods

In the field of medicine, imaging methods (also called imaging modalities and/or medical imaging modalities) are used to generate image data (for example, two- dimensional or three-dimensional image data) of anatomical structures (such as soft tissues, bones, organs, etc.) of the human body. The term "medical imaging methods" is understood to mean (advantageously apparatus-based) imaging methods (for example so-called medical imaging modalities and/or radiological imaging methods) such as for instance computed tomography (CT) and cone beam computed tomography (CBCT, such as volumetric CBCT), x-ray tomography, magnetic resonance tomography (MRT or MRI), conventional x-ray, sonography and/or ultrasound examinations, and positron emission tomography. For example, the medical imaging methods are performed by the analytical devices. Examples for medical imaging modalities applied by medical imaging methods are: X- ray radiography, magnetic resonance imaging, medical ultrasonography or ultrasound, endoscopy, elastography, tactile imaging, thermography, medical photography and nuclear medicine functional imaging techniques as positron emission tomography (PET) and Single-photon emission computed tomography, as mentioned by Wikipedia. The image data thus generated is also termed “medical imaging data”. Analytical devices for example are used to generate the image data in apparatus-based imaging methods. The imaging methods are for example used for medical diagnostics, to analyse the anatomical body in order to generate images which are described by the image data. The imaging methods are also for example used to detect pathological changes in the human body. However, some of the changes in the anatomical structure, such as the pathological changes in the structures (tissue), may not be detectable and for example may not be visible in the images generated by the imaging methods. A tumor represents an example of a change in an anatomical structure. If the tumor grows, it may then be said to represent an expanded anatomical structure. This expanded anatomical structure may not be detectable; for example, only a part of the expanded anatomical structure may be detectable. Primary/high- grade brain tumors are for example usually visible on MRI scans when contrast agents are used to infiltrate the tumor. MRI scans represent an example of an imaging method. In the case of MRI scans of such brain tumors, the signal enhancement in the MRI images (due to the contrast agents infiltrating the tumor) is considered to represent the solid tumor mass. Thus, the tumor is detectable and for example discernible in the image generated by the imaging method. In addition to these tumors, referred to as "enhancing" tumors, it is thought that approximately 10% of brain tumors are not discernible on a scan and are for example not visible to a user looking at the images generated by the imaging method.

These and other features of the invention will become apparent from and elucidated with reference to the embodiments described hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

In the following, the invention is described with reference to the appended figures which give background explanations and represent specific embodiments of the invention. The scope of the invention is however not limited to the specific features disclosed in the context of the figures, wherein

Fig. 1 illustrates a vascular data set with segmented tubular structure, which is partitioned in the vascular data set in several different parts used in an embodiment of the present invention;

Fig. 2 schematically shows a flow diagram of a computer implemented method of catheter data dependent visualization and/or imaging according to three exemplary embodiments of the present invention; Fig. 3 schematically shows a flow diagram of a computer implemented method of catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention;

Fig. 4 schematically shows a flow diagram of a computer implemented method of catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention;

Fig. 5 schematically shows a medical system for catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention.

DESCRIPTION OF EMBODIMENTS

Figure 1 schematically illustrates a vascular data set, which represents a segmented tubular structure 100, which is s segmented vessel tree, of a patient’s anatomy. The segmented tubular structure 100 is partitioned in the vascular data set in several different parts 101 to 109. Such a data set may be received or acquired in step S1 by the device or system carrying out the presented method. As can be seen from Figure 1 , the segmented tubular structure is partitioned by said several different parts 101 to 109 into several different 2D sections and/or several different 3D sections. The user or an algorithm may carry out a partitioning of the tubular structure thereby defining the spatial boundaries of each of said several different parts 101 to 109. The user may provide input about suggested changes in the partitioning of the segmented tubular structure in several different parts, for example about a bounding box/ the spatial boundaries of one or more different parts. The vascular data set may be adapted accordingly, i.e. , based on the received user input. With this embodiment, the user can provide feedback and desired changes of the bounding box of one or more parts of the partitioning of the tubular structure. One may use, for example, a graphical user display, on which the vascular data set is shown with said portioning, and in which the user may move or shift the spatial boundaries, i.e., the bounding boxes of these parts. These changes may be saved and used in the next iteration or use of the presented method.

In the embodiment shown in Figure 1 , in the vascular data set it is defined for said several different parts of the segmented tubular structure what kind of view is to be used when imaging the medical imaging data. The view for said several different parts is selected from a translation view 110, an intersection view 111 , a stenosis check view 112, and a treatment/ stenosis view 113. As was explained hereinbefore in detail, in the translation view 110 imaging parameters are used, which lead to a lower image quality compared to the image quality of the, but which lead to less imaging radiation compared to the treatment stenosis view. In the intersection view 111 an imaging angle of an imaging device is used, preferably of a robotic X-ray imaging device, that is perpendicular to a vascular intersection present in said part of the tubular structure. In the stenosis check view 112 a 3D-scan or an intra-operative imaging like ultrasound is used, and in the treatment/ stenosis view 113 a comparatively high signal to noise ratio, a comparatively high-framerate, a comparatively high contrast, preferably by increasing radiation but stronger collimation to a relevant field of view and/or a comparatively high-resolution images taken pre-operation are used in this particular, non-limiting example. The vascular data could be stored on a medical system of the present invention, see e.g., Figure 1 , but could also be available via cloud services for computing the steps S1 to S4a/S4b of the presented method. Regarding the clinical relevance note that a stenosis is not rotation-symmetric, and hence a 3D scan is suggested by this embodiment for the stenosis view.

Furthermore, a reduction of radiation and contrast-agent is achievable by optimizing and/or individualizing the views set by the user. Positively, with the presented method less interaction and distraction for the user is achieved.

Figure 2 schematically shows a flow diagram of a computer implemented method of catheter data dependent visualization and/or imaging with in three different embodiments. This method could be processed or carried out by e.g., the medical system shown in Figure 5. In the first embodiment the steps S1 to S4a are comprised (left branch of Figure 2), in the second embodiment the steps S1 to S4b are comprised (middle branch of Figure 2), whereas in the third embodiment S1 to S4a and S4b are comprised (right branch of Figure 2). All three embodiments of Figure 3 share the steps S1 to S3 of the computer implemented method of catheter data dependent visualization and/or imaging. In a first step S1 a vascular data set, e.g., the one shown in Figure 1 , which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy is provided. The segmented tubular structure is partitioned in the vascular data set in several different parts, see e.g., part 101 to 109 of the vessel tree 100 of Figure 1. The method of Figure 2 further comprises the step of providing or receiving catheter data, which are position data and/or velocity data of a catheter, i.e. , step S2. In step S3, it is determined, i.e., calculated, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is currently located. Using the vascular data set together with catheter data allows for an improved, particularly a more context dependent visualization of imaging data, and allows for an improved, particularly a more context dependent generation of imaging data. Said context may be the spatial context, spatial surrounding or location or may be the current state of an intravascular procedure, and based on this determined context the visualisation control signal and/or imaging control signal can be generated as follows.

Depending on whether the user desires a control of the visualization, or a control of the imaging parameters, or both steps S4a, S4b, or both S4a and S4b are part of the computer implemented method shown in Figure 2. In step S4a, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user is generated based on the result of the determination of step S3. In step S4b, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure is generated based on the result of the determination of step S3. With the method of Figure 2, the user can define his/her desired optimization towards the goal of imaging as many information for the user as needed, and at the same time to use as less radiation and/or as less contrast agent as possible. Moreover, the method of Figure 2 allows for an automated imaging and visualization during endovascular interventions while reducing the radiation dose for OR personnel and patients. The method and the corresponding medical system can provide the right controlling of the visualization and of the image generation such that relevant views for the user with the right fidelity at any given point on the catheter pathway are realized. As was mentioned before, tip-tracking, and preferably other input parameters, can be applied to provide for the computer implemented method as an input the center of surgical attention and hence the context. As is clear from the present disclosure for the skilled reader, the method of Figure 2 and the correspondingly configured medical system, e.g., the one shown in Figure 5, can not only propose clinically relevant views to the user, but can also add more or less information tailored to a certain context. Part of particular embodiments is also that the user can plan the surgery, i.e. the views per segments in the vessel tree in advance which can lead to either further pre-operative imaging such as e.g., high- resolution images, or notifications as a reminder for tasks like acquiring intraoperative images, e.g., ultrasound.

Figure 3 schematically shows a flow diagram of a computer implemented method 300 of catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention. In step 301 and the method starts by either receiving medical imaging data like CT-A, CBCT, DSA, or the like, or by generating such data by instructing the corresponding imaging device to start imaging, shown as step 302. As is clear to the skilled reader also other imaging modalities can be used. In step 303 the tubular structure is segmented in these first pre-operative imaging data and one or more lesions and/or one or more critical structures as well as a pathway for the catheter from entry into the tubular structure to the target of the intravascular procedure in the tubular structure are identified in these first pre-operative imaging data of step 302. This segmented tubular structure is thus provided in the form of a vascular data set. In the embodiment of Figure 3 this is done manually by the user. Depending on the outcome of the identification of step 303, the method can generate a signal for one or more imaging devices to acquire further imaging data (step 305) with higher quality, if needed. Moreover, in step 304 the segmented tubular structure of the patient’s anatomy of said vascular data set is partitioned in several different parts and desired views for one or more of said parts/segments can be defined and/or calculated. For example, the vascular data set may be provided in step 304 with respective visualization information defining for at least one of said several different parts of the segmented tubular structure how said medical imaging data shall be visualized to the user. This visualization information of the vascular data set may then be used for the generation of the visualization instruction signal in step 308. Alternatively, or in addition, the vascular data set may be provided in step 304 with imaging information defining for at least one of said several different parts of the segmented tubular structure how medical imaging data shall be generated. This imaging information of the vascular data set may then be used for the generating of the imaging instruction signal during the step 307. Figure 3 further shows in step 306 that catheter data are received by the computer or medical system carrying out the method. The received catheter data are position data and/or velocity data of a catheter. The method of Figure 3 also comprises the step of determining, based on the received catheter data of step 306 and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located. Based on the result of this determination the method of Figure 3 generates a visualization instruction signal for visualizing the medical imaging data currently used in said determined part of the segmented tubular structure (step 308). In this way the method adjusts and/or suggests visualization of data depending on the context of the catheter. In addition, the method of Figure 3 generates an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step 307). In this way the method adjusts and/or suggests imaging parameters depending on the context of the catheter. In addition, the method of Figure 3 may notify and/or recommend the generation of further imaging, like for example US, to the user via a signal, prompting or alert (step 309). The method ends in step 310.

Figure 4 schematically shows a flow diagram of a computer implemented method of catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention, which is based on the method of Figure 3 and which is further developed. With respect to the steps 401 , 402, 404, 407 to 410 and 412 it is kindly referred to the detailed description of the corresponding steps 301 , 302, 304, 306 to 310 of Figure 3. As can be gathered from Figures 3 and 4 these steps correspond to each other. In contrast to the method of Figure 3, in step 403 of Figure 4, the tubular structure is automatically segmented in these first pre-operative imaging data and one or more lesions and/or one or more critical structures as well as a pathway for the catheter from entry into the tubular structure to the target of the intravascular procedure in the tubular structure are automatically identified in these first pre-operative imaging data of step 302 using, for example, a segmentation algorithm. This segmented tubular structure is thus provided in the form of a vascular data set. Based on this automatic identification, the method of Figure 4 instructs in step 405 an imaging device, e.g. a Loop X, to automatically acquires high-quality local scans, for example, CBCT, US images. In step 406 a pathway of a catheter through the segmented tubular structure is simulated thereby using one or more visualization instruction signals generated by the presented method. Thus, in step 406 a simulation of a pathway with recommended views (and further possibilities) is provided such that the user can tailor his particular views. In the optional step 411 imaging parameter changes and/or visualization changes desired by the user is tracked. This data may then be used by the method and system for generating improved suggestions, i.e., improved instruction signals.

Figure 5 schematically shows a medical system 500 for catheter data dependent visualization and/or imaging according to an exemplary embodiment of the present invention. The medical system comprises a computer/calculation unit 501 like a processor, which is configured for carrying out the method presented herein, e.g., the method of Figure 2. The medical system 500 comprises a tracking system 506, which is able to track the catheter’s 504 position and/or catheter velocity in the OR. The catheter 504 is provided with a marker 505, but also marker-less tracking methods may be applied. The catheter is hold by a robotic arm 508 which moves the catheter to the desired position. The display 503 is configured to visualize medical imaging data to the user and the display 502 may be controlled or adjusted by instruction signals generated in step S4a (see e.g. Figure 2) by the computer/calculation unit 501. The imaging device 503 is configured to generate medical images of the patient, and the imaging device may be controlled or adjusted by instruction signals generated in step S4b (see e.g. Figure 2) by the computer/calculation unit 501 . As is clear to the skilled reader, the medical system 500 may comprise at least one electronic data storage device storing the vascular data set; and at least one communication interface configured for receiving the catheter data. The medical system 500 is thus configured for acquiring a vascular data set as disclosed herein, which represents a segmented tubular structure, preferably a segmented vessel tree. The system 500 is further configured for receiving catheter data, which are position data and/or velocity data of a catheter, and for determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located. The system is also configured for generating, based on a result of the determination, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user, and is configured for generating an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure. The system 500 of Figure 5 thus can carry out a computer implemented method of catheter data dependent visualization and/or catheter data dependent imaging. The system 500 allows for controlling visualization of medical imaging on display 502 data based on catheter data and/or allows for controlling the imaging device 503 based on the catheter data. This medical system 500 allows for a beneficial control to show relevant views of the medical image data to the user with the right fidelity at any given point per part of the segmented tubular structure, which is partitioned in the vascular data set in several different parts, see e.g., Figure 1. This can be used to optimize towards as many information for the user as needed, and as less radiation and/or contrast agent as possible.

Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from the study of the drawings, the disclosure, and the appended claims. In the claims the word “comprising” does not exclude other elements or steps and the indefinite article “a” or “an” does not exclude a plurality. A single processor or other unit may fulfil the functions of several items or steps recited in the claims. The mere fact that certain measures are recited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. A computer program may be stored/distributed on a suitable medium such as an optical storage medium or a solid- state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems. Any reference signs in the claims should not be construed as limiting the scope of the claims.

Claims

1 . A computer implemented method of catheter data dependent visualization and/or imaging, the method comprising the steps acquiring a vascular data set, which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy (step S1), wherein the segmented tubular structure is partitioned in the vascular data set in several different parts, the method further comprising the steps receiving catheter data, which are position data and/or velocity data of a catheter (step S2), determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located (step S3), and generating, based on a result of the determination of step S3, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user (step S4a) and/or generating, based on a result of the determination of step S3, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step S4b).

2. Method according to claim 1 wherein the segmented tubular structure is partitioned by said several different parts into several different 2D sections and/or several different 3D sections.

3. Method according to claim 1 or 2, the method further comprising the step using the generated visualization instruction signal to adapt a visualization of the medical imaging data to a current location of the catheter, preferably to a current location of a catheter tip, in the segmented tubular structure.

4. Method according to any of the preceding claims, the method further comprising the step using the generated imaging instruction signal to adapt said one or more imaging parameters to a current location of the catheter, preferably of a catheter tip, in the segmented tubular structure.

5. Method according to any of the preceding claims the method comprising, determining a current location of the catheter, preferably of a catheter tip, in the segmented tubular structure based on the received catheter data.

6. Method according to any of the preceding claims, wherein said one or more imaging parameters are selected from the group comprising a collimation of an imaging device; a framerate of an imaging device; a voltage of an imaging device; a position of an isocenter of an imaging device with respect to the patient's anatomy; a position, size and/or shape of an imaging region with respect to the patient's anatomy; a position, size and/or shape of an imaging region with respect to one or more objects coupled the patient's anatomy; a position, size and/or shape of an imaging region with respect to the imaging device; a position of a scan trajectory with respect to the patient's anatomy, a position of a scan trajectory with respect with respect to one or more objects coupled the patient's anatomy; a position of an imaging device with respect to the patient's anatomy and/or with respect to one or more objects coupled the patient's anatomy; a position, size and/or shape of a collimator opening of the imaging device; a scan voltage and/or scan current of an x-ray tube; a dose modulation; a selection of a reconstruction kernel and algorithm; a metal artefact reduction modality; a subtraction angiography modality; a dual-energy imaging modality; a number of x-ray pulses per second; a number of acquired projections; a modality and/or setting for post-processing at least one image obtained with an imaging device; a current of an imaging device; an angulation; a binning; a zoom; and a postprocessing.

7. Method according to any of the preceding claims, wherein the vascular data set comprises visualization information defining for at least one of said several different parts of the segmented tubular structure how said medical imaging data shall be visualized to the user, and the method further comprising the step using said visualization information of the vascular data set for generating the visualization instruction signal during the step S4a.

8. Method according to claim 7, the method further comprising the step receiving a user input about suggested changes in the visualization information, and preferably adapting the vascular data set based on the received user input.

9. Method according to any of the preceding claims, wherein the vascular data set comprises imaging information defining for at least one of said several different parts of the segmented tubular structure how medical imaging data shall be generated, and the method further comprising the step using said imaging information of the vascular data set for generating the imaging instruction signal during the step S4b.

10. Method according to claim 9, the method further comprising the step receiving a user input about suggested changes in the imaging information, and preferably adapting the vascular data set based on the received user input.

11 . Method according to any of the preceding claims, the method further comprising the step receiving a user input about suggested changes in the partitioning of the segmented tubular structure in several different parts, for example about a bounding box of one or more different parts, and preferably adapting the vascular data set based on the received user input.

12. Method according to any of the preceding claims, wherein in the vascular data set it is defined for said several different parts of the segmented tubular structure what kind of view is to be used when imaging the medical imaging data, wherein the view for said several different parts is selected from a translation view, an intersection view, a stenosis check view, and a treatment stenosis view, and wherein a) in the translation view imaging parameters are used, which lead to a lower image quality compared to the image quality of the treatment stenosis view, but which lead to less imaging radiation compared to the treatment stenosis view, and b) in the intersection view an imaging angle of an imaging device is used, preferably of a robotic X-ray imaging device, that is perpendicular to a vascular intersection present in said part of the tubular structure, and c) in the stenosis check view a 3D-scan or an intra-operative imaging like ultrasound is used, d) in the treatment stenosis view a comparatively high signal to noise ratio, a comparatively high framerate, a comparatively high contrast, preferably by increasing radiation but stronger collimation to a relevant field of view and/or a comparatively high-resolution images taken pre-operation are used.

13. Method according to any of the preceding claims, the method comprising the step acquiring first pre-operative imaging data of the patient’s anatomy, preferably in form of CT-A, CBCT, DSA images, 2D ultrasound, and/or 3D ultrasound, segmenting the tubular structure in the first pre-operative imaging data, and identifying in the acquired first pre-operative imaging data one or more lesions and/or one or more critical structures.

14. Method according to claim 13, the method comprising the step identifying in the acquired first pre-operative imaging data a pathway for the catheter from entry into the tubular structure to a target of an intravascular procedure in the tubular structure.

15. Method according any of the preceding claims, the method comprising the step simulating a pathway of a catheter through the segmented tubular structure thereby using one or more visualization instruction signals generated in step S4a.

16. Method according to any of claims 13 to 15, the method comprising the step acquiring second pre-operative imaging data of the identified one or more lesions and/or the one or more critical structures, preferably by using CBCT and/or US, and by preferably using a higher image quality as compared to the acquired first imaging data.

17. Method according to any of the preceding claims, the method comprising the step partitioning the tubular structure thereby defining spatial boundaries of each of said several different parts.

18. Method according to any of claims 12 to 17, the method comprising the step defining and/or calculating desired views for said several parts of the segmented tubular structure.

19. Method according any of the preceding claims, the method comprising the steps, acquiring a digital representation of an intravascular procedure, wherein the digital representation of the intravascular procedure describes the clinical process or clinical workflow of the intravascular procedure with different intravascular procedure steps, and using the digital representation of the intravascular procedure, together with the result of the result of the determination in step S3, for the generation of the visualization instruction signal in step S4a and/or for the generation of the imaging instruction signal in step S4b.

20. Method according any of the preceding claims, the method comprising the step acquiring the medical imaging data.

21 . Method according any of the preceding claims, the method comprising the step visualizing the acquired medical imaging data based on the generated visualization instruction signal, and/or imaging the tubular structure based on the imaging instruction signal for.

22. Method according any of the preceding claims, wherein the catheter data are tracking data indicative of a current position of the catheter.

23. Method according to any of the preceding claims, wherein the catheter data are fluoro tracking data of the catheter position and/or of the catheter velocity; and/or wherein the catheter data are electromagnetic tracking data of the catheter position and/or of the catheter velocity.

24. Method according to any of the claim 22 and 23, the method further comprising the steps sending catheter data to an imaging device, initiating a movement of the imaging device to the current position of the catheter, and generating imaging data of the tubular structure at the current position of the catheter by the imaging device.

25. Method according any of the preceding claims, the method comprising the step tracking imaging parameter changes suggested by the user, and/or tracking visualization changes suggested by the user.

26. Method according to claim 25, the method comprising the step using the tracked imaging parameter changes for an improved signal generation in step S4a.

27. Method according to claim 25 or 26, the method comprising the step using the tracked visualization changes for an improved signal generation in step S4b.

28. Method according any of the preceding claims, wherein the catheter data are live tracking data, preferably relative to the tubular structure, and are indicative of a current location of a tip of the catheter in the tubular structure.

29. Method according any of the preceding claims, the method further comprising the step displaying imaging data to the user during an intravascular procedure, which imaging data were previously generated during said intravascular procedure.

30. Method according any of the preceding claims, the method further comprising the step sending the visualization instruction signal to a display device and visualizing the medical imaging data on said display accordingly.

31 . Method according any of the preceding claims, the method further comprising the step sending the imaging instruction signal to an imaging device and imaging the tubular structure with the imaging device accordingly.

32. A program which, when running on a computer or when loaded onto a computer, causes the computer to perform the method steps of the method according to any of the preceding claims.

33. A program storage medium on which a program is stored, which, when running on a computer or when loaded onto a computer, causes the computer to perform the method steps of the method according to any of the claims 1 to 31 .

34. A medical system for controlling visualization of medical imaging data based on catheter data and/or for controlling imaging based on catheter data, wherein the medical system is configured for acquiring a vascular data set, which represents a segmented tubular structure, preferably a segmented vessel tree, of a patient’s anatomy (step S1 ), wherein the segmented tubular structure is partitioned in the vascular data set in several different parts, wherein the medical system is configured for receiving catheter data, which are position data and/or velocity data of a catheter (step S2), determining, based on the received catheter data and the acquired vascular data set, in which of said several different parts of the segmented tubular structure the catheter is located (step S3), and generating, based on a result of the determination of step S3, a visualization instruction signal for visualizing medical imaging data in said determined part of the segmented tubular structure to a user (step S4a) and/or generating, based on a result of the determination of step S3, an imaging instruction signal for setting one or more imaging parameters to be used for said determined part of the segmented tubular structure (step S4b).

35. The medical system according to claim 34, the medical system comprising at least one electronic data storage device storing the vascular data set; and at least one communication interface configured for receiving the catheter data.