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Title: MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery

Abstract

At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such asmore » neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.« less

Authors:
 [1]
  1. Johns Hopkins University (United States)
Publication Date:
OSTI Identifier:
22649542
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 61 RADIATION PROTECTION AND DOSIMETRY; 60 APPLIED LIFE SCIENCES; BIOMEDICAL RADIOGRAPHY; FINANCING; IMAGE PROCESSING; LEARNING; SURGERY

Citation Formats

Siewerdsen, J. MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery. United States: N. p., 2016. Web. doi:10.1118/1.4957226.
Siewerdsen, J. MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery. United States. doi:10.1118/1.4957226.
Siewerdsen, J. 2016. "MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery". United States. doi:10.1118/1.4957226.
@article{osti_22649542,
title = {MO-DE-202-02: Advances in Image Registration and Reconstruction for Image-Guided Neurosurgery},
author = {Siewerdsen, J.},
abstractNote = {At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504 Disclosure and CoI: IGI Technologies, small-business partner on the grants.},
doi = {10.1118/1.4957226},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: A promising patient positioning technique is based on registering computed tomographic (CT) or magnetic resonance (MR) images to cone-beam CT images (CBCT). The extra radiation dose delivered to the patient can be substantially reduced by using fewer projections. This approach results in lower quality CBCT images. The purpose of this study is to evaluate a number of similarity measures (SMs) suitable for registration of CT or MR images to low-quality CBCTs. Methods and Materials: Using the recently proposed evaluation protocol, we evaluated nine SMs with respect to pretreatment imaging modalities, number of two-dimensional (2D) images used for reconstruction, andmore » number of reconstruction iterations. The image database consisted of 100 X-ray and corresponding CT and MR images of two vertebral columns. Results: Using a higher number of 2D projections or reconstruction iterations results in higher accuracy and slightly lower robustness. The similarity measures that behaved the best also yielded the best registration results. The most appropriate similarity measure was the asymmetric multi-feature mutual information (AMMI). Conclusions: The evaluation protocol proved to be a valuable tool for selecting the best similarity measure for the reconstruction-based registration. The results indicate that accurate and robust CT/CBCT or even MR/CBCT registrations are possible if the AMMI similarity measure is used.« less
  • The authors developed a fast and accurate two-dimensional (2D)-three-dimensional (3D) image registration method to perform precise initial patient setup and frequent detection and correction for patient movement during image-guided cranial radiosurgery treatment. In this method, an approximate geometric relationship is first established to decompose a 3D rigid transformation in the 3D patient coordinate into in-plane transformations and out-of-plane rotations in two orthogonal 2D projections. Digitally reconstructed radiographs are generated offline from a preoperative computed tomography volume prior to treatment and used as the reference for patient position. A multiphase framework is designed to register the digitally reconstructed radiographs with themore » x-ray images periodically acquired during patient setup and treatment. The registration in each projection is performed independently; the results in the two projections are then combined and converted to a 3D rigid transformation by 2D-3D geometric backprojection. The in-plane transformation and the out-of-plane rotation are estimated using different search methods, including multiresolution matching, steepest descent minimization, and one-dimensional search. Two similarity measures, optimized pattern intensity and sum of squared difference, are applied at different registration phases to optimize accuracy and computation speed. Various experiments on an anthropomorphic head-and-neck phantom showed that, using fiducial registration as a gold standard, the registration errors were 0.33{+-}0.16 mm (s.d.) in overall translation and 0.29 deg. {+-}0.11 deg. (s.d.) in overall rotation. The total targeting errors were 0.34{+-}0.16 mm (s.d.), 0.40{+-}0.2 mm (s.d.), and 0.51{+-}0.26 mm (s.d.) for the targets at the distances of 2, 6, and 10 cm from the rotation center, respectively. The computation time was less than 3 s on a computer with an Intel Pentium 3.0 GHz dual processor.« less
  • Purpose: Newly emerged four-dimensional (4D) imaging techniques such as 4D-computed tomography (CT), 4D-cone beam CT, 4D-magnetic resonance imaging, and 4D-positron emission tomography are effective tools to reveal the spatiotemporal details of patients' anatomy. To use the 4D data acquired under different conditions or using different modalities, an algorithm for registering 4D images must be in place. We developed an automated 4D-4D registration method to take advantage of 4D information. Methods and Materials: We used 4D-4D matching to find the appropriate three-dimensional anatomy in the fixed image for each phase of the moving image and spatially register them. A search algorithmmore » was implemented to simultaneously find the best phase and spatial match of two 4D inputs. An interpolation scheme capable of deriving an image set based on temporally adjacent three-dimensional data sets was developed to deal with the situation in which the discrete temporal points of the two inputs do not coincide or correspond. Results: In a phantom study, our technique was able to reproduce the known 'ground truth' with high spatial fidelity. The technique regenerated all deliberately introduced 'missing' three-dimensional images at different phases of the input using temporal interpolation. In the registration of gated-magnetic resonance imaging and 4D-CT, the algorithm was able to select the appropriate CT phase. The technique was also able to register 4D-CT with 4D-cone beam CT and two 4D-CT scans acquired at different times. A spatial accuracy of <3 mm was achieved in 98% of voxels in all cases. Conclusion: Automated 4D-4D registration can find the best possible spatiotemporal match between two 4D data sets and is useful for image-guided radiotherapy applications.« less
  • Purpose: In image-guided radiation therapy (IGRT), different computed tomography (CT) modalities with varying image quality are being used to correct for interfractional variations in patient set-up and anatomy changes, thereby reducing clinical target volume to the planning target volume (CTV-to-PTV) margins. We explore how CT image quality affects patient repositioning and CTV-to-PTV margins in soft tissue registration-based IGRT for prostate cancer patients. Methods and Materials: Four CT-based IGRT modalities used for prostate RT were considered in this study: MV fan beam CT (MVFBCT) (Tomotherapy), MV cone beam CT (MVCBCT) (MVision; Siemens), kV fan beam CT (kVFBCT) (CTVision, Siemens), and kVmore » cone beam CT (kVCBCT) (Synergy; Elekta). Daily shifts were determined by manual registration to achieve the best soft tissue agreement. Effect of image quality on patient repositioning was determined by statistical analysis of daily shifts for 136 patients (34 per modality). Inter- and intraobserver variability of soft tissue registration was evaluated based on the registration of a representative scan for each CT modality with its corresponding planning scan. Results: Superior image quality with the kVFBCT resulted in reduced uncertainty in soft tissue registration during IGRT compared with other image modalities for IGRT. The largest interobserver variations of soft tissue registration were 1.1 mm, 2.5 mm, 2.6 mm, and 3.2 mm for kVFBCT, kVCBCT, MVFBCT, and MVCBCT, respectively. Conclusions: Image quality adversely affects the reproducibility of soft tissue-based registration for IGRT and necessitates a careful consideration of residual uncertainties in determining different CTV-to-PTV margins for IGRT using different image modalities.« less
  • Purpose: To develop a new metric for image registration that incorporates the (sub)pixelwise differential importance along spatial location and to demonstrate its application for image guided radiation therapy (IGRT). Methods: It is well known that rigid-body image registration with mutual information is dependent on the size and location of the image subset on which the alignment analysis is based [the designated region of interest (ROI)]. Therefore, careful review and manual adjustments of the resulting registration are frequently necessary. Although there were some investigations of weighted mutual information (WMI), these efforts could not apply the differential importance to a particular spatialmore » location since WMI only applies the weight to the joint histogram space. The authors developed the spatially weighted mutual information (SWMI) metric by incorporating an adaptable weight function with spatial localization into mutual information. SWMI enables the user to apply the selected transform to medically ''important'' areas such as tumors and critical structures, so SWMI is neither dominated by, nor neglects the neighboring structures. Since SWMI can be utilized with any weight function form, the authors presented two examples of weight functions for IGRT application: A Gaussian-shaped weight function (GW) applied to a user-defined location and a structures-of-interest (SOI) based weight function. An image registration example using a synthesized 2D image is presented to illustrate the efficacy of SWMI. The convergence and feasibility of the registration method as applied to clinical imaging is illustrated by fusing a prostate treatment planning CT with a clinical cone beam CT (CBCT) image set acquired for patient alignment. Forty-one trials are run to test the speed of convergence. The authors also applied SWMI registration using two types of weight functions to two head and neck cases and a prostate case with clinically acquired CBCT/MVCT image sets. The SWMI registration with a Gaussian weight function (SWMI-GW) was tested between two different imaging modalities: CT and MRI image sets. Results: SWMI-GW converges 10% faster than registration using mutual information with an ROI. SWMI-GW as well as SWMI with SOI-based weight function (SWMI-SOI) shows better compensation of the target organ's deformation and neighboring critical organs' deformation. SWMI-GW was also used to successfully fuse MRI and CT images. Conclusions: Rigid-body image registration using our SWMI-GW and SWMI-SOI as cost functions can achieve better registration results in (a) designated image region(s) as well as faster convergence. With the theoretical foundation established, we believe SWMI could be extended to larger clinical testing.« less