Unsupervised learning for deformable registration of thoracic CT and cone-beam CT based on multiscale features matching with spatially adaptive weighting.

Purpose: Cone-beam computed tomography (CBCT) is a common on-treatment imaging widely used in image-guided radiotherapy. Fast and accurate registration between the on-treatment CBCT and planning CT is significant for and precise adaptive radiotherapy treatment (ART). However, existing CT-CBCT registration methods, which are mostly affine or time-consuming intensity- based deformation registration, still need further study due to the considerable CT-CBCT intensity discrepancy and the artifacts in low-quality CBCT images. In this paper, we propose a deep learning-based CT-CBCT registration model to promote rapid and accurate CT-CBCT registration for radiotherapy.

Methods: The proposed CT-CBCT registration model consists of a registration network and an innovative deep similarity metric network. The registration network is a novel fully convolution network adapted specially for patch-wise CT-CBCT registration. The metric network, going beyond intensity, automatically evaluates the high-dimensional attribute-based dissimilarity between the registered CT and CBCT images. In addition, considering the artifacts in low-quality CBCT images, we add spatial weighting (SW) block to adaptively attach more importance to those informative voxels while inhibit the interference of artifact regions. Such SW-based metric network is expected to extract the most meaningful and discriminative deep features, and form a more reliable CT-CBCT similarity measure to train the registration network.

Results: We evaluate the proposed method on clinical thoracic CBCT and CT dataset, and compare the registration results with some other common image similarity metrics and some state-of-the-art registration algorithms. The proposed method provides the highest Structural Similarity index (86.17 ± 5.09), minimum Target Registration Error of landmarks (2.37 ± 0.32 mm), and the best DSC coefficient (78.71 ± 10.95) of tumor volumes. Moreover, our model also obtains comparable distance error of lung surfaces (1.75 ± 0.35 mm).

Conclusion: The proposed model shows both efficiency and efficacy for reliable thoracic CT-CBCT registration, and can generate the matched CT and CBCT images within few seconds, which is of great significance to clinical radiotherapy.