Monoplane 3D-2D registration of cerebral angiograms based on multi-objective stratified optimization

Registration of 3D pre-interventional to 2D intra-interventional medical images has an increasingly important role in surgical planning, navigation and treatment, because it enables the physician to co-locate depth information given by pre-interventional 3D images with the live information in intrainterventional 2D images such as X-ray. Most tasks during image-guided interventions are carried out under a monoplane X-ray, which is a highly illposed problem for state-of-the-art 3D to 2D registration methods. To address the problem of rigid 3D-2D monoplane registration we propose a novel multi-objective stratified parameter optimization, wherein a small set of highmagnitude intensity gradients are matched between the 3D and 2D images. The stratified parameter optimization matches rotation templates to depth templates, first sampled from projected 3D gradients and second from the 2D image gradients, so as to recover 3D rigid-body rotations and out-of-plane translation. The objective for matching was the gradient magnitude correlation coefficient, which is invariant to in-plane translation. The in-plane translations are then found by locating the maximum of the gradient phase correlation between the best matching pair of rotation and depth templates. On twenty pairs of 3D and 2D images of ten patients undergoing cerebral endovascular image-guided intervention the 3D to monoplane 2D registration experiments were setup with a rather high range of initial mean target registration error from 0 to 100 mm. The proposed method effectively reduced the registration error to below 2 mm, which was further refined by a fast iterative method and resulted in a high final registration accuracy (0.40 mm) and high success rate (>96%). Taking into account a fast execution time below 10 s, the observed performance of the proposed method shows a high potential for application into clinical image-guidance systems.