Shortening image registration time using a deep neural network for patient positional verification in radiotherapy

We sought to accelerate 2D/3D image registration computation time using image synthesis with a deep neural network (DNN) to generate digitally reconstructed radiographic (DRR) images from X-ray flat panel detector (FPD) images. And we explored the feasibility of using our DNN in the patient setup verification application. Images of the prostate and of the head and neck (H&N) regions were acquired by two oblique X-ray fluoroscopic units and the treatment planning CT. DNN was designed to generate DRR images from the FPD image data. We evaluated the quality of the synthesized DRR images to compare the ground-truth DRR images using the peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM). Image registration accuracy and computation time were evaluated by comparing the 2D-3D image registration algorithm using DRR and FPD image data with DRR and synthesized DRR images. Mean PSNR values were 23.4 ± 3.7 dB and 24.1 ± 3.9 dB for the pelvic and H&N regions, respectively. Mean SSIM values for both cases were also similar (= 0.90). Image registration accuracy was degraded by a mean of 0.43 mm and 0.30°, it was clinically acceptable. Computation time was accelerated by a factor of 0.69. Our DNN successfully generated DRR images from FPD image data, and improved 2D-3D image registration computation time up to 37% in average.