Patient-specific biomechanical model as whole-body CT image registration tool

Whole-body computed tomography (CT) image registration is important for cancer diagnosis, therapy planning and treatment. Such registration requires accounting for large differences between source and target images caused by deformations of soft organs/tissues and articulated motion of skeletal structures. The registration algorithms relying solely on image processing methods exhibit deficiencies in accounting for such deformations and motion. We propose to predict the deformations and movements of body organs/tissues and skeletal structures for whole-body CT image registration using patient-specific non-linear biomechanical modelling. Unlike the conventional biomechanical modelling, our approach for building the biomechanical models does not require time-consuming segmentation of CT scans to divide the whole body into non-overlapping constituents with different material properties. Instead, a Fuzzy C-Means (FCM) algorithm is used for tissue classification to assign the constitutive properties automatically at integration points of the computation grid. We use only very simple segmentation of the spine when determining vertebrae displacements to define loading for biomechanical models. We demonstrate the feasibility and accuracy of our approach on CT images of seven patients suffering from cancer and aortic disease. The results confirm that accurate whole-body CT image registration can be achieved using a patient-specific non-linear biomechanical model constructed without time-consuming segmentation of the whole-body images

Fuzzy tissue classification for non-linear patient-specific biomechanical models for whole-body image registration

Comparison of whole-body medical images acquired for a given patient at different times is important for diagnosis, treatment assessment and surgery planning. Prior to comparison, the images need to be registered (aligned) as changes in the patient’s posture and other factors associated with skeletal motion and deformations of organs/tissues lead to differences between the images. For whole-body images, such differences are large, which poses challenges for traditionally used registration methods that rely solely on image processing techniques. Therefore, in our previous studies, we successfully applied image registration using patient-specific biomechanical models in which predicting deformations of organs/tissues is treated as a non-linear problem of computational mechanics. Constructing such models tends to be time-consuming as it involves tedious image segmentation which divides images into non-overlapping constituents with different material properties. To eliminate segmentation, we propose Fuzzy C-Means (FCM) classification to assign material properties at the integration points of a finite element mesh. In this study, we present an application of the FCM tissue classification algorithm and analyse sensitivity of the accuracy of whole-body image registration using non-linear patient-specific finite models to the FCM classification parameters. We show that accurate registration (within two times of the image voxel size) can be achieved