Registration with Adjacent Anatomical Structures for Cardiac Resynchronization Therapy Guidance

The clinical applications and benefits of multi-modal image registration are wide-ranging and well established. Current image based approaches exploit cross-modality information, such as landmarks or anatomical structures, which is visible in both modalities. A lack of cross-modality information can prohibit accurate automatic registration. This paper proposes a novel approach for MR to X-ray image registration which uses prior knowledge of adjacent anatomical structures to enable registration without cross-modality image information. The registration of adjacent structures formulated as a partial surface registration problem which is solved using a globally optimal ICP method. The practical clinical application of the approach is demonstrated on an image guided cardiac resynchronization therapy procedure. The left ventricle (segmented from pre-operative MR) is registered to the coronary vessel tree (extracted from intra-operative fluoroscopic images). The proposed approach is validated on synthetic and phantom data, where the results show a good comparison with the ground truth registrations. The vertex-to-vertex MAE was 3.28 ± 1.18 mm for 10 X-ray image pairs of the phantom.