Incorporating tissue excision in deformable image registration: A modified demons algorithm for cone-beam CT-guided surgery

S. Nithiananthan, D. Mirota, A. Uneri, S. Schafer, Y. Otake, J. W. Stayman, J. H. Siewerdsen

Research output: Chapter in Book/Report/Conference proceedingConference contribution

7 Scopus citations


The ability to perform fast, accurate, deformable registration with intraoperative images featuring surgical excisions was investigated for use in cone-beam CT (CBCT) guided head and neck surgery. Existing deformable registration methods generally fail to account for tissue excised between image acquisitions and typically simply "move" voxels within the images with no ability to account for tissue that is removed (or introduced) between scans. We have thus developed an approach in which an extra dimension is added during the registration process to act as a sink for voxels removed during the course of the procedure. A series of cadaveric images acquired using a prototype CBCT-capable C-arm were used to model tissue deformation and excision occurring during a surgical procedure, and the ability of deformable registration to correctly account for anatomical changes under these conditions was investigated. Using a previously developed version of the Demons deformable registration algorithm, we identify the difficulties that traditional registration algorithms encounter when faced with excised tissue and present a modified version of the algorithm better suited for use in intraoperative image-guided procedures. Studies were performed for different deformation and tissue excision tasks, and registration performance was quantified in terms of the ability to accurately account for tissue excision while avoiding spurious deformations arising around the excision.

Original languageEnglish (US)
Title of host publicationMedical Imaging 2011
Subtitle of host publicationVisualization, Image-Guided Procedures, and Modeling
StatePublished - 2011
EventMedical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling - Lake Buena Vista, FL, United States
Duration: Feb 13 2011Feb 15 2011

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2011: Visualization, Image-Guided Procedures, and Modeling
Country/TerritoryUnited States
CityLake Buena Vista, FL


  • 3D imaging
  • C-arm
  • Cone-beam CT
  • Flat-panel detector
  • Head and neck surgery
  • Image registration
  • Image-guided interventions
  • Surgical navigation

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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