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Non-rigid Registration of Pre-procedural MR Images with Intra- procedural Unenhanced CT Images for Improved Targeting of Tumors During Liver Radiofrequency Ablations

Archip N.¹, Tatli S.², Morrison P.R.², Jolesz F.A.², Warfield S.K.¹, Silverman S.G.²


Institution:	¹Computational Radiology Laboratory, Departments of Radiology, Children’s Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA. ²Department of Radiology, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA.
Publisher:	Med Image Comput Comput Assist Interv. MICCAI 2007
Publication Date:	Oct-2007
Volume Number:	10
Issue Number:	2
Pages:	696-77
Citation:	Int Conf Med Image Comput Comput Assist Interv. 2007;10(Pt 2):969-77.
PubMed ID:	18044662
Keywords:	non-rigid registration, biomechanical model, b-splines, demons, radiofrequency ablation, targeting
Appears in Collections:	NCIGT, CRL, SLICER
Sponsors:	NSF ITR 0426558 NIH R03 EB006515 NIH U41 RR019703 NIH P01 CA067165 NIH R01 021885
Generated Citation:	Archip N., Tatli S., Morrison P.R., Jolesz F.A., Warfield S.K., Silverman S.G. Non-rigid Registration of Pre-procedural MR Images with Intra- procedural Unenhanced CT Images for Improved Targeting of Tumors During Liver Radiofrequency Ablations. Int Conf Med Image Comput Comput Assist Interv. 2007;10(Pt 2):969-77. PMID: 18044662.
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In the United States, unenhanced CT is currently the most common imaging modality used to guide percutaneous biopsy and tumor ablation. The majority of liver tumors such as hepatocellular carcinomas are visible on contrast-enhanced CT or MRI obtained prior to the procedure. Yet, these tumors may not be visible or may have poor margin conspicuity on unenhanced CT images acquired during the procedure. Non-rigid registration has been used to align images accurately, even in the presence of organ motion. However, to date, it has not been used clinically for radiofrequency ablation (RFA), since it requires significant computational infrastructure and often these methods are not sufficient robust. We have already introduced a novel finite element based method (FEM) that is demonstrated to achieve good accuracy and robustness for the problem of brain shift in neurosurgery. In this current study, we adapt it to fuse pre-procedural MRI with intra-procedural CT of liver. We also compare its performance with conventional rigid registration and two non-rigid registration methods: b-spline and demons on 13 retrospective datasets from patients that underwent RFA at our institution. FEM non-rigid registration technique was significantly better than rigid (p<10-5), non-rigid b-spline (p<10- 4) and demons (p<10-4) registration techniques. The results of our study indicate that this novel technology may be used to optimize placement of RF applicator during CT-guided ablations.

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