Learning a Metric for Multimodal Medical Image Registration without Supervision Based on Cycle Constraints

Deep learning based medical image registration remains very difficult and often fails to improve over its classical counterparts where comprehensive supervision is not available, in particular for large transformations-including rigid alignment. The use of unsupervised, metric-based registration networks has become popular, but so far no universally applicable similarity metric is available for multimodal medical registration, requiring a trade-off between local contrast-invariant edge features or more global statistical metrics. In this work, we aim to improve over the use of handcrafted metric-based losses. We propose to use synthetic three-way (triangular) cycles that for each pair of images comprise two multimodal transformations to be estimated and one known synthetic monomodal transform. Additionally, we present a robust method for estimating large rigid transformations that is differentiable in end-to-end learning. By minimising the cycle discrepancy and adapting the synthetic transformation to be close to the real geometric difference of the image pairs during training, we successfully tackle intra-patient abdominal CT-MRI registration and reach performance on par with state-of-the-art metric-supervision and classic methods. Cyclic constraints enable the learning of cross-modality features that excel at accurate anatomical alignment of abdominal CT and MRI scans.