Deformable registration for image-guided spine surgery: Preserving rigid body vertebral morphology in free-form transformations

S. Reaungamornrat, A. S. Wang, A. Uneri, Y. Otake, Z. Zhao, A. J. Khanna, J. H. Siewerdsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Purpose: Deformable registration of preoperative and intraoperative images facilitates accurate localization of target and critical anatomy in image-guided spine surgery. However, conventional deformable registration fails to preserve the morphology of rigid bone anatomy and can impart distortions that confound high-precision intervention. We propose a constrained registration method that preserves rigid morphology while allowing deformation of surrounding soft tissues. Method: The registration method aligns preoperative 3D CT to intraoperative cone-beam CT (CBCT) using free-form deformation (FFD) with penalties on rigid body motion imposed according to a simple intensity threshold. The penalties enforced 3 properties of a rigid transformation - namely, constraints on affinity (AC), orthogonality (OC), and properness (PC). The method also incorporated an injectivity constraint (IC) to preserve topology. Physical experiments (involving phantoms, an ovine spine, and a human cadaver) as well as digital simulations were performed to evaluate the sensitivity to registration parameters, preservation of rigid body morphology, and overall registration accuracy of constrained FFD in comparison to conventional unconstrained FFD (denoted uFFD) and Demons registration. Result: FFD with orthogonality and injectivity constraints (denoted FFD+OC+IC) demonstrated improved performance compared to uFFD and Demons. Affinity and properness constraints offered little or no additional improvement. The FFD+OC+IC method preserved rigid body morphology at near-ideal values of zero dilatation (D = 0.05, compared to 0.39 and 0.56 for uFFD and Demons, respectively) and shear (S = 0.08, compared to 0.36 and 0.44 for uFFD and Demons, respectively). Target registration error (TRE) was similarly improved for FFD+OC+IC (0.7 mm), compared to 1.4 and 1.8 mm for uFFD and Demons. Results were validated in human cadaver studies using CT and CBCT images, with FFD+OC+IC providing excellent preservation of rigid morphology and equivalent or improved TRE. Conclusions: A promising method for deformable registration in CBCT-guided spine surgery has been identified incorporating a constrained FFD to preserve bone morphology. The approach overcomes distortions intrinsic to unconstrained FFD and could better facilitate high-precision image-guided spine surgery.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2014
Subtitle of host publicationImage-Guided Procedures, Robotic Interventions, and Modeling
PublisherSPIE
ISBN (Print)9780819498298
DOIs
StatePublished - 2014
EventMedical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling - San Diego, CA, United States
Duration: Feb 18 2014Feb 20 2014

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume9036
ISSN (Print)1605-7422

Other

OtherMedical Imaging 2014: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/TerritoryUnited States
CitySan Diego, CA
Period2/18/142/20/14

Keywords

  • Demons registration
  • cone-beam CT
  • deformable registration
  • free-form deformation
  • image-guided surgery

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging
  • Biomaterials

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