JP2014144053A - X-ray diagnostic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an X-ray diagnostic apparatus capable of automatically setting an optimum ROI for spot fluoroscoping.SOLUTION: An X-ray diagnostic apparatus 100 is configured as follows to generate image data representing a fluoroscopic image of a subject with a treatment instrument inserted thereinto. The X-ray diagnostic apparatus 100 is provided with: a treatment instrument detection unit 23 for detecting the tip part of the treatment instrument from image data; a system control unit 13 for estimating a movement arrival position of the tip part of the treatment instrument moving within the body of the subject, on the basis of the detection result of the treatment instrument detection unit 23; an ROI processing unit 25 for determining the position and size of a region of interest, i.e. the region related to the tip part of the treatment instrument, on the basis of the estimation result; an X-ray diaphragm device 3 for confining an irradiation field where the subject is irradiated with X rays to within the region of interest determined by the ROI processing unit 25; an image merge unit 27 for generating a merged image data by merging LIH image data and ROI image data; and a display unit 29 for displaying the merged image data.

Description

  Embodiments of the present invention relate to an X-ray diagnostic apparatus that generates fluoroscopic image data of a subject P into which a treatment tool is inserted, for example.

  In treatment under fluoroscopy such as catheterization, long-time X-ray irradiation is required. For this reason, there are contrivances such as protection with a protective plate or reduction of the imaging rate, but the exposure reduction effect is not sufficient.

  On the other hand, a technique called ROI (Region Of Interest) imaging is known. This is to perform X-ray imaging limited to a partial region designated by the operator. The function of setting an ROI in a portion to be seen through and performing the see-through is also referred to as a SPOT see-through function.

JP 2012-75782 A

  By the way, the ROI is usually displayed in a predetermined size in the central portion of the image data display screen by default setting. For this reason, when performing the SPOT fluoroscopy, the operator needs to specify an observation target region and a size that the SPOT fluoroscopy is desired to perform. This can lead to a prolonged operation time.

  Further, the size of the ROI when performing the SPOT fluoroscopy directly determines the exposure dose of the subject. Therefore, the operator must set the size of the ROI to a size that can suppress the exposure dose to the minimum necessary amount, and to be able to appropriately grasp the site to be observed.

  Furthermore, when performing SPOT fluoroscopy of a subject into which a treatment instrument such as a catheter is inserted, it is necessary to reset the ROI in accordance with the moving speed of the treatment instrument.

  The present invention has been made in view of the above circumstances, and an object thereof is to provide an X-ray diagnostic apparatus that automatically performs optimal ROI setting at the time of SPOT fluoroscopy.

An X-ray diagnostic apparatus according to one embodiment
An X-ray diagnostic apparatus for generating image data indicating a fluoroscopic image of a subject into which a treatment tool is inserted,
An imaging system comprising: an X-ray irradiator that irradiates the subject with X-rays; and an X-ray detector that detects X-rays transmitted through the subject;
An image data generation unit that generates image data based on the data detected by the X-ray detection unit;
A storage unit that holds final image data that is fluoroscopic image data relating to the subject generated last by the image data generation unit;
A treatment instrument detection unit for detecting a distal end portion of the treatment instrument from the image data;
A treatment tool position estimation unit that estimates a movement arrival position of a distal end portion of the treatment tool that moves within the subject based on a detection result by the treatment tool detection unit;
A region-of-interest determination unit that determines the position and size of a region of interest that is a region related to the distal end portion of the treatment tool, based on the estimation result by the treatment tool position estimation unit;
An X-ray diaphragm unit for limiting an X-ray irradiation field irradiated from the X-ray irradiation unit to the subject to the region of interest determined by the region of interest determination unit;
An image composition unit that synthesizes the final image data and the region-of-interest image data to generate composite image data;
A display unit for displaying the composite image data;
It is characterized by comprising.

FIG. 1 is a diagram showing a system configuration diagram of an X-ray diagnostic apparatus according to an embodiment of the present invention. FIG. 2 is a diagram illustrating a display example of composite image data including LIH image data and ROI image data. FIG. 3 is a diagram illustrating a flowchart of processing related to ROI setting and processing related to updating LIH image data by the system control unit of the X-ray diagnostic apparatus according to the embodiment of the present invention. FIG. 4 is a diagram illustrating a flowchart of processing related to ROI setting and processing related to update of LIH image data by the system control unit of the X-ray diagnostic apparatus according to the embodiment of the present invention.

  Hereinafter, an X-ray diagnostic apparatus according to an embodiment of the present invention will be described with reference to the drawings.

  FIG. 1 is a diagram showing a system configuration diagram of an X-ray diagnostic apparatus according to an embodiment of the present invention. As shown in FIG. 1, the X-ray diagnostic apparatus 100 includes an X-ray source 1, an X-ray diaphragm device 3, an X-ray detector 5, a holding device 7, a bed 9, and a control device 10. To do. Here, a system including the X-ray source 1 that irradiates the subject P with X-rays and the X-ray detector 5 that detects the X-rays transmitted through the subject P is collectively referred to as an imaging system.

  The X-ray source 1 is connected to a high voltage generator (not shown), and generates an X-ray by supplying a current (filament current) to the filament by the high voltage generator (not shown).

  The X-ray diaphragm device 3 is a device for limiting an X-ray irradiation field irradiated to the subject P from the X-ray source 1. Specifically, the X-ray diaphragm device 3 includes a plurality of individually movable shielding plates, for example. These shielding plates are typically lead plates having X-ray shielding properties, and are essentially wedges having translucency for X-rays, such as molybdenum-containing plates, for changing the quality of X-rays. Also good. That is, the X-ray diaphragm device 3 is controlled by the system control unit 13 via the diaphragm device control unit 17 during X-ray imaging for generating ROI image data (described later) indicating the region of interest. The X-ray source 1 functions as an X-ray diaphragm unit for limiting the X-ray irradiation field irradiated from the X-ray source 1 to the region of interest determined by the ROI processing unit 25.

  The X-ray detector 5 is disposed so as to face the X-ray source 1 (for example, attached to the other end of the C arm), detects incident X-rays, and generates fluoroscopic image data. The X-ray detector 5 may be, for example, a combined structure of an image intensifier and a TV camera, or a plurality of detection elements (pixels) that convert incident X-rays directly or indirectly into electric charges are arranged two-dimensionally. It may be a flat detector (flat panel detector). At the time of imaging, the subject P is placed between the X-ray source 1 and the X-ray detector 5 while being placed on the couch top. In other words, the X-ray detector 5 functions as an image data generation unit that generates image data based on the detected projection data.

  The holding device 7 is an arm that holds the X-ray source 1 and the X-ray detector 5.

  The couch 9 includes a couch top on which the subject P lies between the X-ray source 1 and the X-ray detector 5.

  The control device 10 includes an input unit 11, a system control unit 13, a holding device control unit 15, a diaphragm device control unit 17, a bed control unit 19, an LIH creation / storage unit 21, and a treatment instrument detection unit 23. And an ROI processing unit 25, an image composition unit 27, and a display unit 29.

  The input unit 11 receives an instruction from an operator made by an operation member such as a keyboard, a mouse, and a touch panel, for example, and transmits the instruction of the operator to the system control unit 13.

  The system control unit 13 comprehensively controls each unit of the X-ray diagnostic apparatus based on an instruction from the input unit 11.

  Although details will be described later, as a process unique to the X-ray diagnostic apparatus according to the present embodiment, the system control unit 13 performs, for example, the following process.

  That is, the system control unit 13 determines, for example, the moving speed and moving direction of the distal end portion of the catheter based on the history of the position of the distal end portion of the treatment instrument (catheter in this example) stored in the treatment instrument detection unit 23. Calculation (vectorization of the movement of the distal end portion of the catheter) is performed, and the arrival position of the distal end portion of the catheter is estimated based on the calculation result.

  In other words, the system control unit 13 functions as a treatment instrument position estimation unit that estimates the movement arrival position of the distal end portion of the catheter that moves within the subject P based on the detection result by the treatment instrument detection unit 23. . That is, the system control unit 13 serves as a treatment tool position estimation unit, a vector calculation unit that calculates the movement speed and movement direction of the distal end portion of the catheter based on the detection result by the treatment tool detection unit 23, and Based on this, it functions as a position estimation unit that estimates the movement arrival position of the distal end portion of the treatment instrument that moves within the subject P.

  The system control unit 13 functions as a control unit that controls the ROI processing unit 25 so as to change (determine) the region of interest based on the estimation result.

  Further, the system control unit 13 generates data for controlling the X-ray diaphragm device 3 based on the size and position of the region of interest set by the ROI processing unit 25 and transmits the data to the diaphragm device control unit 17. .

  Here, the system control unit 13 causes the ROI processing unit 25 to set the size of the region of interest according to the moving speed of the distal end portion of the catheter (the higher the moving speed, the larger the size of the region of interest), and The region of interest is enlarged in the direction of movement of the distal end portion of the catheter. After the region of interest enlargement setting, the system control unit 13 causes the ROI processing unit 25 to reduce the region of interest in the direction opposite to the moving direction of the distal end portion of the catheter, and to set the size of the region of interest before the enlargement. Return to size.

In other words, the system control unit 13 controls the ROI processing unit 25 so as to set the size of the region of interest based on the moving speed of the distal end portion of the catheter. In addition, the system control unit 13 controls the ROI processing unit 25 so that the region of interest is enlarged and set in the moving direction of the distal end portion of the catheter. Specifically, the system control unit 13 sets the ROI processing unit 25 so as to reduce the region of interest on the side opposite to the movement direction after the region of interest is enlarged and set the size before the enlargement. The holding device control unit 15 to be controlled is an arm rotation / movement control unit that controls rotation / movement of the holding device 7.

  The diaphragm control unit 17 individually controls movement of a plurality of shielding plates provided in the X-ray diaphragm apparatus 3. Thereby, the center position of the opening and the size of the opening, for example, the diagonal length and diameter of the opening surrounded by the shielding plates are arbitrarily changed.

  The bed control unit 19 controls the movement of the bed top plate of the bed 9.

  The LIH creating / storing unit 21 stops rewriting of an image memory (not shown) in synchronization with the X-ray OFF signal from the system control unit 13 during X-ray imaging of the subject P, and the X-ray is turned on. The final image (LIH (Last Imaging Hold) image data) is held. The LIH image data is continuously displayed on the display unit 29 by the system control unit 13. In other words, the LIH creation / storage unit 21 functions as a storage unit that holds LIH image data.

  The treatment instrument detection unit 23 detects the distal end portion of the catheter from image data that is a fluoroscopic image generated by the X-ray detector 5 and stores the position (history) of the distal end portion of the catheter. That is, the treatment instrument detection unit 23 functions as a treatment instrument detection unit that detects the treatment instrument (the history of the position of the distal end portion thereof) from the image data generated by the X-ray detector 5.

  Here, the LIH creation / storage unit 21 updates the LIH image data based on data from the system control unit 13, the holding device control unit 15, the treatment instrument detection unit 23, and the bed control unit 19. Specifically, as the timing of updating the LIH image data, for example, when the relative position between the imaging system and the subject P changes, and in the generation of composite image data described later, the ROI image data is the LIH image data. For example, a region that does not fit within the region (a region that does not overlap) is generated. Of course, the LIH image data may be updated at a predetermined cycle.

  The ROI processing unit 25 determines the position and size of the region of interest based on the history of the position of the distal end portion of the catheter (moving direction) and the moving speed. The ROI processing unit 25 stores the size of an appropriate region of interest (ROI) set according to the moving speed of the distal end portion of the catheter. In other words, the ROI processing unit 25 determines the position and size of the region of interest that is the region related to the distal end portion of the catheter, based on the estimation result by the system control unit 13 that functions as the treatment instrument position estimating unit. Functions as a determination unit.

  By the way, the imaging which irradiates X-rays limited to a part of the light receiving surface of the X-ray detector 5 is called ROI imaging, and is defined as a partial area in the imaging area where attention is focused with high interest. ROI image data indicating the region of interest to be obtained is generated.

  The image combining unit 27 combines the LIH image data and the ROI image data to generate combined image data, and outputs the combined image data to the display unit 29. The display unit 29 displays the composite image data.

  Hereinafter, a process related to ROI setting by the X-ray diagnostic apparatus according to the present embodiment will be described. FIG. 2 is a diagram illustrating a display example of composite image data obtained by combining the LIH image data and the ROI image data displayed on the display unit 29. FIGS. 3 and 4 are flowcharts showing a process related to ROI setting and a process related to updating LIH image data by the system control unit 13 of the X-ray diagnostic apparatus 100 according to the embodiment of the present invention. In this example, it is assumed that the subject P undergoes cardiac coronary angioplasty (PCI) using a catheter.

  First, the system control unit 13 controls the X-ray source 1 and the X-ray detector 5 to perform X-ray imaging, generates fluoroscopic image data for the subject P, and displays the data on the display unit 29 (step S1). ). Here, the operator inserts a treatment tool (a catheter (not shown) in this example) into the subject P.

  The system control unit 13 uses the LIH creation / storage unit 21 to generate and store LIH image data for the subject P (step S2). After the LIH image data is stored in the processing in step S2, the system control unit 13 detects the position and movement (movement speed) of the distal end portion of the catheter on the fluoroscopic image data by the treatment instrument detection unit 23 (step). S3).

  Further, the system control unit 13 causes the ROI processing unit 25 to determine the size (magnification ratio) of the region of interest based on the moving speed of the distal end portion of the catheter detected by the treatment instrument detection unit 23 (step S4).

  Specifically, in this step S4, the size (size) of the ROI is determined from the speed of movement of the catheter (movement speed), for example. That is, a value obtained by adding the moving amount of the catheter to the minimum necessary region size within a range that does not adversely affect the operation is set as a new ROI size (an amount corresponding to the moving amount). Only enlarge the area of interest).

  Here, the region of interest has a rectangular shape, and the length of one side of the region of interest after enlargement is La, and the length of the other side is Lb. In addition, the length of one side of the minimum necessary region of interest within a range that does not adversely affect the operation is La1, and the length of the other side is Lb1. Further, let the amount of movement of the catheter along the La (La1) direction be La2, and let the amount of movement of the catheter along the Lb (Lb1) direction be Lb2.

Then, the length La of one side of the region of interest after expansion is
La = La1 + La2 (Formula 1)
And
Similarly, the length Lb of the other side of the region of interest after enlargement is
Lb = Lb1 + Lb2 (Formula 2)
It is expressed.

  Here, it is assumed that the values of “La1” and “Lb1” are determined in advance according to the specification / use and the like and stored in a memory (not shown) or the like.

Note that the method of calculating the size of the region of interest is not limited to the above (Formula 1) and (Formula 2), and is a calculation method that can appropriately reflect the amount of movement of the catheter in the size of the region of interest. Any calculation method may be used as long as it is present. For example,
La = La1 + La2 / 2 (Formula 3)
Lb = Lb1 + Lb2 / 2 (Formula 4)
Of course, a calculation formula such as

  Then, the system control unit 13 calculates the moving speed and moving direction of the distal end portion of the catheter based on the detection result by the treatment instrument detecting unit 23, and the distal end portion of the catheter arrives after the current movement based on the calculated result. The position (movement arrival position) to be performed is estimated (step S5).

  Further, the system control unit 13 calculates the position of the region of interest based on the estimation result in step S5, and based on the calculated position and the size (enlargement ratio) set in step S4, the diaphragm control unit 17 Then, the X-ray diaphragm 3 is controlled to narrow the fluoroscopic region, and the SPOT fluoroscopy is executed to generate ROI image data (step S6).

  Subsequently, the system control unit 13 causes the image combining unit 27 to combine the ROI image data and the LIH image data to generate combined image data (step S7).

  Then, the system control unit 13 displays the composite image data generated in step S7 on the display unit 29 and performs the next display switching setting (step S8). That is, in this step S8, the system control unit 13 sets the display / non-display switching setting of the frame (outer frame) 107 indicating the region of interest and the display / non-display switching setting of the locus 111 of the distal end portion of the catheter. (See FIG. 2). These switching settings are performed based on an operator instruction input to the input unit 11.

  In the example shown in FIG. 2, the frame 101 indicating the region of interest and the trajectory 111 of the distal end of the catheter are displayed in the composite image data displayed on the display unit 29. Here, an enlarged frame 103 indicated by a broken line in FIG. 2 indicates a frame of the region of interest immediately after being enlarged according to the moving speed of the catheter. Further, the trajectory prediction dot 113 indicated by a dot in FIG. 2 indicates each position of the estimated movement destination of the distal end portion of the catheter.

  After the processing in step S8, the system control unit 13 determines whether or not the bed 9 has moved beyond a predetermined threshold (arbitrary value; for example, 1 cm) based on a signal from the bed control unit 19. (Step S9). When step S9 is branched to YES, each unit is controlled to update the LIH image data (step S10). On the other hand, when step S9 is branched to NO, the process proceeds to step S11.

  After finishing the process of step S9 or step S10, the system control unit 13 may set the position of the distal end portion of the catheter to a predetermined threshold (arbitrary value) based on the detection result by the treatment instrument detection unit 23; For example, it is determined whether or not it has moved more than 3 cm) (step S11). When step S11 is branched to YES, each unit is controlled to update the LIH image data (step S12). On the other hand, when step S11 is branched to NO, the process proceeds to step S13.

  After completing the processing in step S11 or step S12, the system control unit 13 determines that the relative position between the imaging system and the subject is a predetermined threshold (an arbitrary value) based on a signal from the holding device control unit 15. It may be set; for example, 1 cm) or more is determined (step S13). When step S13 is branched to YES, each unit is controlled to update the LIH image data (step S14). On the other hand, when step S13 is branched to NO, the process proceeds to step S15.

  After completing the process of step S13 or step S14, the system control unit 13 determines that the area indicated by the next ROI image data is within the area indicated by the LIH image data based on the estimation result in step S5 and the LIH image data. It is determined whether it does not fit (step S15). When this step S15 is branched to YES (when the region indicated by the next ROI image data does not fit within the region indicated by the LIH image data), the LIH image data is updated by controlling each unit (step S16). The process proceeds to S3. On the other hand, when step S15 is branched to NO (when the area indicated by the next ROI image data falls within the area indicated by the LIH image data), the process proceeds to step S3.

  Of course, control may be performed separately from the processing in steps S9 to S16 (or instead of the processing in steps S9 to S16) so that the LIH image data is updated at a predetermined cycle.

  As described above, according to the present embodiment, it is possible to provide an X-ray diagnostic apparatus that automatically performs optimal ROI setting at the time of SPOT fluoroscopy. Specifically, according to the X-ray diagnostic apparatus according to the present embodiment, the following actions and corresponding effects can be obtained.

  By changing (magnifying and moving) the size of the region of interest according to the moving speed of the catheter tip, it is possible to minimize the exposure dose to the subject without disturbing the operator's understanding of the situation. it can. The troublesome operation for the operator to specify the range (position and size) in which SPOT is to be seen through is not required, and the operability is greatly improved. Thereby, the operation time can be shortened.

  After taking the whole image for the first time (after obtaining fluoroscopic image data), the future position of the distal end portion is estimated (predicted) from the trajectory of the distal end portion of the catheter in the fluoroscopic image data, and the SPOT is estimated. The region of interest for fluoroscopy is moved in real time, and is superimposed on the entire fluoroscopic image data and presented to the operator.

  Based on the moving speed of the catheter tip, the size of the SPOT fluoroscopic region is moved to the minimum necessary size, so that in addition to the effect of reducing the exposure, the position of the tip of the catheter can be reliably Reflected in the SPOT fluoroscopy area (ROI image data), the surgeon can understand the situation accurately. An appropriate relationship between the moving speed of the distal end portion of the catheter and the size of the region of interest may be acquired (measured) in advance.

  Since the frame (outer frame) 101 of the region of interest can be hidden on the composite image data, it can be displayed easily when the size of the region of interest itself changes. Further, since the locus of the distal end portion of the catheter can be displayed superimposed on the fluoroscopic image data, the operator can easily grasp the entire operation.

  Note that the subject information related to the body shape of the subject P can be input to the X-ray diagnostic apparatus 100 from the input unit 11, and the system control unit 13 sends the subject information to the destination of the distal end portion of the catheter. You may use when estimating the position (movement arrival position). Here, the subject information is information including at least one of the height, weight, abdominal circumference, and chest circumference of the subject P, for example. By using such subject information supplementarily, it is possible to improve the estimation accuracy (prediction accuracy) of the position of the distal end portion of the catheter. This is because the traveling state of the blood vessel of the subject P can be predicted to some extent from the subject information.

  Although several embodiments of the present invention have been described, these embodiments are presented by way of example and are not intended to limit the scope of the invention. These novel embodiments can be implemented in various other forms, and various omissions, replacements, and changes can be made without departing from the scope of the invention. These embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the invention described in the claims and the equivalents thereof.

    DESCRIPTION OF SYMBOLS 1 ... X-ray source, 3 ... X-ray aperture device, 5 ... X-ray detector, 7 ... Holding device, 9 ... Bed, 10 ... Control device, 11 ... Input part, 13 ... System control part, 15 ... Holding device control Unit, 17 ... diaphragm device control unit, 19 ... bed control unit, 21 ... LIH creation / storage unit, 23 ... treatment instrument detection unit, 25 ... ROI processing unit, 27 ... image composition unit, 29 ... display unit, 100 ... X Line diagnosis apparatus, 103 ... enlarged frame, 107 ... frame, 111 ... trajectory, 113 ... trajectory prediction dot.

Claims (11)

An X-ray diagnostic apparatus for generating image data indicating a fluoroscopic image of a subject into which a treatment tool is inserted,
An imaging system comprising: an X-ray irradiator that irradiates the subject with X-rays; and an X-ray detector that detects X-rays transmitted through the subject;
An image data generation unit that generates image data based on the data detected by the X-ray detection unit;
A storage unit that holds final image data that is fluoroscopic image data relating to the subject generated last by the image data generation unit;
A treatment instrument detection unit for detecting a distal end portion of the treatment instrument from the image data;
A treatment tool position estimation unit that estimates a movement arrival position of a distal end portion of the treatment tool that moves within the subject based on a detection result by the treatment tool detection unit;
A region-of-interest determination unit that determines the position and size of a region of interest that is a region related to the distal end portion of the treatment tool, based on the estimation result by the treatment tool position estimation unit;
An X-ray diaphragm for limiting an X-ray field irradiated to the subject to the region of interest determined by the region of interest determination unit;
An image composition unit that synthesizes the final image data and the region-of-interest image data to generate composite image data;
A display unit for displaying the composite image data;
An X-ray diagnostic apparatus comprising: The treatment instrument position estimating unit
A vector calculation unit that calculates a moving speed and a moving direction of the distal end portion of the treatment tool based on a detection result by the treatment tool detection unit;
A position estimation unit that estimates a movement arrival position of a distal end portion of the treatment instrument that moves within the subject based on a calculation result by the vector calculation unit;
The X-ray diagnostic apparatus according to claim 1, comprising: The X-ray diagnosis apparatus according to claim 2, wherein the region of interest determination unit sets the size of the region of interest based on the moving speed calculated by the vector calculation unit. The X-ray diagnostic apparatus according to claim 2, wherein the region-of-interest determination unit expands the region of interest in the movement direction calculated by the vector calculation unit. 5. The X according to claim 4, wherein the region-of-interest setting unit reduces the region of interest in a direction opposite to the moving direction after the region of interest is expanded, and returns the region to the size before the expansion. Line diagnostic equipment. A subject information acquisition unit that acquires subject information related to the body type of the subject,
The treatment instrument position estimation unit estimates a movement arrival position of a distal end portion of the treatment instrument moving within the subject based on a detection result by the treatment tool detection unit and the subject information. The X-ray diagnostic apparatus according to claim 1. The X-ray diagnostic apparatus according to claim 6, wherein the subject information is information including at least one of the height, weight, abdominal circumference, and chest circumference of the subject. A moving mechanism for relatively moving the imaging system and the subject along the body axis of the subject;
An LIH image update control unit that updates the final image data when a relative position between the imaging system and the subject changes;
The X-ray diagnostic apparatus according to claim 1, comprising: A moving mechanism for moving at least one of the imaging system and the subject;
If the region-of-interest image data does not fit in the final image data in the generation of the composite image data, the final image data is updated after moving the imaging system and / or the subject by the moving mechanism. An update controller;
The X-ray diagnostic apparatus according to claim 1, comprising: The X-ray diagnostic apparatus according to claim 1, further comprising an update control unit configured to update the final image data at a predetermined cycle. A moving mechanism for moving at least one of the imaging system and the subject;
An update control unit for updating the final image data after moving the imaging system and / or the subject by the moving mechanism when the moving distance of the distal end portion of the treatment instrument is equal to or greater than a predetermined threshold; ,
The X-ray diagnostic apparatus according to claim 1, comprising:

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