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Fast intraoperative 2D/3D head registration for image-guided interventions using biplane x-ray angiography
Donghyeon Lee1, Shalini Subramanian2, Jingyan Xu1
1The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Medical Physics
|November 29, 2025
Summary
This study introduces a faster 2D/3D image registration method for endovascular therapy (EVT), significantly reducing computation time while maintaining accuracy. The novel approach enhances procedural safety and precision in image-guided interventions.
Area of Science:
- Medical Imaging
- Image-Guided Interventions
- Computational Anatomy
Background:
- Accurate 2D/3D registration is crucial for image-guided interventions like endovascular therapy (EVT).
- Current methods face challenges in achieving real-time precision due to high computational demands.
Purpose of the Study:
- To develop a computationally efficient 2D/3D registration method for improved procedural safety and precision.
- To optimize in-plane alignment between digitally reconstructed radiographs (DRRs) and x-ray angiography images, reducing computational load.
Main Methods:
- A novel registration method estimates in-plane transformation parameters via a 2D/2D registration problem.
- Utilizes a skull region-of-interest (ROI) map and normalized cross-correlation (NCC) for iterative alignment.
- Evaluated using numerical simulations (XCAT phantom) and clinical angiography data.
Main Results:
- Reduced runtime by over 10x in simulations and ~6x in clinical studies compared to conventional 2D/3D registration.
- Achieved a 100% success rate in non-truncated clinical cases, with strong agreement to manual estimations.
- Outperformed 2D/3D registration in truncated cases, demonstrating robustness.
Conclusions:
- The proposed fast 2D/3D registration method significantly reduces runtime and enhances accuracy.
- Shows promise for real-time clinical applications in image-guided interventions, despite limitations to rigid registration.
