Real-time marker detection in medical imaging of a stent may be provided. A plurality of frames of image data may be obtained. A plurality of candidate markers for the stent may be determined in the plurality of frames of image data. One or more markers from the plurality of candidate markers may be detected. The detecting may be based on automatic initialization using a subset of frames of image data from the plurality of frames of image data. The detecting may be performed in real-time with the obtaining.