Lung registration with improved fissure alignment by integration of pulmonary lobe segmentation

Accurate registration of human lungs in CT images is required for many applications in pulmonary image analysis and used for example for atlas generation. While various registration approaches have been developed in the past, the correct alignment of the interlobular fissures is still challenging for many reasons, especially for inter-patient registration. Fissures are depicted with very low contrast and their proximity in the image shows little detail due to the lack of vessels. Moreover, iterative registration algorithms usually require the objects to be overlapping in both images to find the right transformation, which is often not the case for fissures. In this work, a novel approach is presented for integrated lobe segmentation and intensity-based registration aiming for a better alignment of the interlobular fissures. To this end, level sets with a shape-based fissure attraction term are used to formulate a new condition in the registration framework. The method is tested for pairwise registration of lung CT scans of nine different subjects and the results show a significantly improved matching of the pulmonary lobes after registration.