Fast 2D-3D marker-based registration of CT and X-ray fluoroscopy images for image-guided surgery

We propose a fast 2D-3D marker-based registration technique to fuse anatomical structure of 3D CT scans onto 2D Xray fluoroscopy image. Our method is composed of three stages. First, DRRs (Digitally Reconstructed Radiography) are generated by maximum intensity projection based on hardware texture-based volume rendering. This technique is over 200 times faster than software-based one. Second, confirmation markers are automatically segmented in DRRs and Xray fluoroscopy images, respectively. Third, in/out-plane registration is proposed for real-time performance. In out-plane registration, we search for an optimal position of X-ray source in a 3D spherical coordinate system. Then we calculate optimal translation and rotation vectors by using principal axes method in in-plane registration. Our method has been successfully six different CT and X-ray fluoroscopy pairs generated from cardiac phantom datasets. For accuracy evaluation, we calculate root-mean-squared error (RMSE) between confirmation markers of DRRs and X-ray fluoroscopy images. Experimental results show that our DRRs generation method performs very fast and the hierarchical registration effectively finds the matching of DRRs and 2D images.