Vertebrae-based Global X-ray to CT Registration for Thoracic Surgeries

X-ray to CT registration is an essential technique to provide on-site guidance for clinicians and medical robots by aligning preoperative information with intraoperative images. Current methods focus on local registration with small capture ranges and necessitate a manual initial alignment before precise registration. Some existing global methods are likely to fail in thoracic surgeries because of the respiratory motion and the nearly colinear nature of vertebrae landmarks. In this study, we propose a vertebrae-based global X-ray to CT registration method with the assistance of clinical setups for thoracic surgeries. Firstly, vertebrae centroids are automatically localized by CNN-based networks in CT and X-ray for establishing 2D/3-D correspondences. Then, inspired by clinical setup, we address the degradation of colinear landmarks of 6-DoF pose estimation by introducing a 4-DoF solver. Considering the inaccurate priori and landmark mislocalization, the solver is embedded into the Adaptive Error-Aware Estimator (AE<sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup>) to simultaneously estimate weights and aggregate candidate poses. Finally, the whole method is trained in an end-to-end manner for better performance. Evaluations on both the public LIDC-IDRI dataset and clinical dataset demonstrate that our method outperforms existing optimization-based and learningbased approaches in terms of registration accuracy and success rate. Our code: https://github.com/LiuLiluZJU/2P-AE2