3D-2D registration for surgical guidance: Effect of projection view angles on registration accuracy

A. Uneri, Y. Otake, A. S. Wang, G. Kleinszig, S. Vogt, A. J. Khanna, J. H. Siewerdsen

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


An algorithm for intensity-based 3D-2D registration of CT and x-ray projections is evaluated, specifically using single- or dual-projection views to provide 3D localization. The registration framework employs the gradient information similarity metric and covariance matrix adaptation evolution strategy to solve for the patient pose in six degrees of freedom. Registration performance was evaluated in an anthropomorphic phantom and cadaver, using C-arm projection views acquired at angular separation, Δθ, ranging from ∼0°-180° at variable C-arm magnification. Registration accuracy was assessed in terms of 2D projection distance error and 3D target registration error (TRE) and compared to that of an electromagnetic (EM) tracker. The results indicate that angular separation as small as Δθ ∼10°-20° achieved TRE <2 mm with 95% confidence, comparable or superior to that of the EM tracker. The method allows direct registration of preoperative CT and planning data to intraoperative fluoroscopy, providing 3D localization free from conventional limitations associated with external fiducial markers, stereotactic frames, trackers and manual registration.

Original languageEnglish (US)
Pages (from-to)271-287
Number of pages17
JournalPhysics in medicine and biology
Issue number2
StatePublished - Jan 20 2014


  • 3D-2D image registration
  • image-guided surgery
  • target registration error

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging


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