Abstract: An orthosis (1) for a lower extremity of a wearer, in particular for a foot and a lower leg of a wearer, preferably for wearers with diabetic foot syndrome or a neuropathic osteoarthropathy relating to the foot, comprising: a first orthosis part (2) which is to be arranged or which can be arranged on a lower leg of a wearer, a second orthosis part (3) which is to be arranged or which can be arranged on a foot of a wearer, and a third orthosis part (4) which connects the first and second orthosis part to one another, wherein at least one of the orthosis parts (2-4) has a geometric-constructive design, at least in portions, possibly completely, which is individually configured on the basis of data describing a foot and/or a lower leg of a wearer.

Abstract: The present invention utilizes external motion sensors to determine a periodic motion of a patient being examined when generating a series of projected images with a C-arm X-ray device. Three-dimensional images are assembled based on the position information provided by the external motion sensors, and a corresponding four-dimensional image is constructed therefrom.

Abstract: In a method and apparatus for image support of an operative procedure implemented with a medical instrument, a two-dimensional x-ray image of a volume region to be treated is generated and stored with a C-arm x-ray apparatus in at least one pivot position of the C-arm. With a position detection device, the position of an apparatus reference system and the position of a reference system in the image generation are at least indirectly detected. Between the reference system and an image coordinate system of the x-ray image, a transformation rule is determined using known, apparatus-specific mapping rules that are measured and stored in a preceding calibration. During the subsequent procedure, with the position detection device the position of an instrument reference system is detected in the reference system and the instrument is mixed into the stored two-dimensional x-ray image with accurate position by means of this transformation rule.

Abstract: In an image post-processing method and apparatus for 3D visualization of 2D/3D fused image data for use in catheter angiography in an endovascular interventional procedure, upon forward movement of a micro-catheter through blood vessel in the interventional procedure, x-ray images are acquired from different projection directions and are subjected to a pattern recognition algorithm for edge-based segmentation of the image regions filled by the micro-catheter, with all remaining image regions being masked out. The segmented projection exposures are prepared by a 3D reconstruction algorithm to obtain an image data set for (pseudo-) three-dimensional representation of the micro-catheter. This image data set are intraoperatively registered and fused with an image data set acquired from an angiographic pre-examination for three-dimensional visualization of the vessel topography.

Abstract: In a method for the intraoperative generating of an updated volume dataset, a first volume dataset is reconstructed from a series of n 2D X-ray projections (of a patient that are acquired at different angles. During a medical intervention, m 2D X-ray projections (m<n) of the patient are acquired from different angles. In a first version of the method, m 2D X-ray projections of the series of n 2D X-ray projections are replaced by the intraoperatively acquired m 2D X-ray projections, and an updated volume dataset is reconstructed using the intraoperatively acquired m 2D X-ray projections and n?m 2D X-ray projections that were not replaced in the series of n 2D X-ray projections. In a second version of the method, a second volume dataset is reconstructed with the intraoperatively acquired m 2D X-ray projections and is fused with the first volume dataset to form an updated volume dataset.

Abstract: An apparatus for determining a coordinate transformation for mixing an image of a first subject into an X-ray image of a second subject has an arrangement for fastening the apparatus to the second subject, markers that can be acquired by a navigation system, and X-ray-positive marks. The positions and orientations of the markers that can be acquired with the navigation system and the positions and orientations of the X-ray-positive marks relative to one another are thus known, so a coordinate transformation can be determined between a coordinate system allocated to the navigation system and a coordinate system allocated to the X-ray image. Thus an image of the first subject that can be acquired with the navigation system can be mixed into an X-ray image of the second subject.

Abstract: In a method and apparatus for automatic marker-free fusion (matching) of 2D fluoroscopic C-arm images with preoperative 3D images using an intraoperatively acquired 3D data record, an intraoperative 3D image is obtained using a C-arm x-ray system, image-based matching of an existing preoperative 3D image in relation to the intraoperative 3D image is undertaken, which generates a matching matrix of a tool plate attached to the C-arm system is matched in relation to a navigation system, a 2D fluoroscopic image to be matched is obtained, with the C-arm of the C-arm system in any arbitrary location, a projection matrix for matching the 2D fluoroscopic image in relation to the 3D image is obtained, and the 2D fluoroscopic image is fused (matched) with the preoperative 3D image on the basis of the matching matrix and the projection matrix.

Abstract: The present invention utilizes external motion sensors to determine a periodic motion of a patient being examined when generating a series of projected images with a C-arm X-ray device. Three-dimensional images are assembled based on the position information provided by the external motion sensors, and a corresponding for-dimensional image is constructed therefrom.

Abstract: A registration method and an apparatus for navigation-guided interventions employing an X-ray device and a position acquisition system and avoid the use of patient-associated markers. By means of a defined arrangement of a carrying arm proceeding from a support mount at the X-ray device and a defined arrangement of an X-ray calibration phantom at the carrying arm, the coordinate transformation between a coordinate system allocated to the support mount and a coordinate system allocated to the X-ray calibration phantom is known. On the basis of the acquisition and evaluation of 2D projections of the X-ray calibration phantom with the X-ray device, a coordinate transformation between the coordinate system allocated to the support mount and a coordinate system allocated to a measurement volume of the X-ray device is produced.

Abstract: In a method and apparatus for image support of an operative procedure implemented with a medical instrument, a two-dimensional x-ray image of a volume region to be treated is generated and stored with a C-arm x-ray apparatus in at least one pivot position of the C-arm. With a position detection device, the position of an apparatus reference system and the position of a reference system in the image generation are at least indirectly detected. Between the reference system and an image coordinate system of the x-ray image, a transformation rule is determined using known, apparatus-specific mapping rules that are measured and stored in a preceding calibration. During the subsequent procedure, with the position detection device the position of an instrument reference system is detected in the reference system and the instrument is mixed into the stored two-dimensional x-ray image with accurate position by means of this transformation rule.

Abstract: To intraoperatively generate an updated volume data set in which a image information of biological tissue is volume data set representing reconstructed from a series of n 2D biological tissue x-ray projections, one version, in intraoperatively acquired m 2D biological tissue x-ray projections the biological tissue 2D contour is segmented and this is back-projected in the reconstructed volume data set. In another version, in the volume data set the biological tissue 3D contour is segmented and this is projected in intraoperatively acquired m biological tissue 2D x-ray projections. The 3D contour is visually repositioned by projection in the m 2D x-ray projections in the volume data set, until its projection is substantially congruent with the biological tissue image information in the respective 2D x-ray projections. In both versions, a volume data set updated around the intraoperatively determined biological tissue 3D contour is generated.

Abstract: In a registration method for navigation-guided medical interventions using a position acquisition system, an X-ray device and an X-ray calibration phantom having X-ray-positive marks, the coordinates of marks of the X-ray calibration phantom that are present in the measurement volume of the X-ray device and imaged in the reconstructed volume are determined in a coordinate system allocated to the measurement volume of the X-ray device) and in a coordinate system allocated to the position acquisition system. The coordinate transformation between the coordinate system allocated to the measurement volume and the coordinate system allocated to the position acquisition system is determined on the basis of the coordinates of the X-ray-positive marks in the coordinate system allocated to the measurement volume and on the basis of the coordinates of the X-ray-positive marks in the coordinate system allocated to the position acquisition system.

Abstract: In a method and apparatus for the automatic merging of 2D fluoroscopic C-arm images with preoperative 3D images with a one-time use of navigation markers, markers in a marker-containing preoperative 3D image are registered relative to a navigation system, a tool plate fixed on the C-arm system is registered in a reference position relative to the navigation system, a 2D C-arm image (2D fluoroscopic image) that contains the image of at least a medical instrument is obtained in an arbitrary C-arm position, a projection matrix for a 2D-3D merge is determined on the basis of the tool plate and the reference position relative to the navigation system, and the 2D fluoroscopic image is superimposed with the 3D image on the basis of the projection matrix.

Abstract: In an image post-processing method and apparatus for 3D visualization of 2D/3D fused image data for use in catheter angiography in an endovascular interventional procedure, upon forward movement of a micro-catheter through blood vessel in the interventional procedure, x-ray images are acquired from different projection directions and are subjected to a pattern recognition algorithm for edge-based segmentation of the image regions filled by the micro-catheter, with all remaining image regions being masked out. The segmented projection exposures are prepared by a 3D reconstruction algorithm to obtain an image data set for (pseudo-) three-dimensional representation of the micro-catheter. This image data set are intraoperatively registered and fused with an image data set acquired from an angiographic pre-examination for three-dimensional visualization of the vessel topography.

Abstract: In a method for marker-less navigation of a medical instrument in preoperative 3D images using an intraoperatively acquired 3D C-arm image, an intraoperative 3D Image is acquired with a C-arm system, the medical instrument brought into registration with regard to the intraoperative 3D image D, whereby a registration matrix MDN is obtained. The intraoperative 3D image is brought into registration with regard to an existing preoperative 3D image by means of image-based registration, whereby a registration matrix is obtained. Navigation of the medical instrument in the preoperative 3D image can then proceed.

Abstract: In a method and apparatus for automatic marker-free fusion (matching) of 2D fluoroscopic C-arm images with preoperative 3D images using an intraoperatively acquired 3D data record, an intraoperative 3D image is obtained using a C-arm x-ray system, image-based matching of an existing preoperative 3D image in relation to the intraoperative 3D image is undertaken, which generates a matching matrix of a tool plate attached to the C-arm system is matched in relation to a navigation system, a 2D fluoroscopic image to be matched is obtained, with the C-arm of the C-arm system in any arbitrary location, a projection matrix for matching the 2D fluoroscopic image in relation to the 3D image is obtained, and the 2D fluoroscopic image is fused (matched) with the preoperative 3D image on the basis of the matching matrix and the projection matrix.

Abstract: In a method and an apparatus for generating a volume dataset of a subject taking a movement of the subject into consideration, a referencing base is arranged at the subject, so that the positions and the orientations of the referencing base can be acquired during a registration of a series of 2D projections of the subject. The volume dataset of the subject is generated on the basis of the series of 2D projections as well as based on the deviations of the positions and of the orientations of the referencing base from a fixed reference position of the referencing base that are determined for all 2D projections of the series.

Abstract: In a method for the intraoperative generating of an updated volume dataset, a first volume dataset is reconstructed from a series of n 2D X-ray projections (of a patient that are acquired at different angles. During a medical intervention, m 2D X-ray projections (m<n) of the patient are acquired from different angles. In a first version of the method, m 2D X-ray projections of the series of n 2D X-ray projections are replaced by the intraoperatively acquired m 2D X-ray projections, and an updated volume dataset is reconstructed using the intraoperatively acquired m 2D X-ray projections and n−m 2D X-ray projections that were not replaced in the series of n 2D X-ray projections. In a second version of the method, a second volume dataset is reconstructed with the intraoperatively acquired m 2D X-ray projections and is fused with the first volume dataset to form an updated volume dataset.

Abstract: To intraoperatively generate an updated volume data set in which a volume data set representing image information of biological tissue is reconstructed from a series of n 2D x-ray projections of the biological tissue, one version, in intraoperatively acquired m 2D x-ray projections of the biological tissue the 2D contour of the biological tissue is segmented and this is back-projected in the reconstructed volume data set. In another version, in the volume data set the 3D contour of the biological tissue is segmented and this is projected in intraoperatively acquired m 2D x-ray projections of the biological tissue. The 3D contour is virtually repositioned by projection in the m 2D x-ray projections in the volume data set, until its projection is substantially congruent with the image information of the biological tissue in the respective 2D x-ray projections. In both versions, a volume data set updated around the intraoperatively determined 3D contour of the biological tissue is generated.

Abstract: In a method for reconstructing 3D image data, a number of 2D central projections from different projection directions is acquired with a planar detector and radiation emanating from a radiation source, and a volume of interest of an examination subject to be three-dimensionally reconstructed is identified by mixing in variable and mutually dependent marks into at least two 2D central projections.