SLIR: Synthesis, localization, inpainting, and registration for image-guided thermal ablation of liver tumors

Dongming Wei, Sahar Ahmad, Jiayu Huo, Pu Huang, Pew-Thian Yap, Zhong Xue, Jianqi Sun, Wentao Li, Dinggang Shen, Qian Wang

Abstract: Highlights • Overlay of pre-procedural MR image and pre-procedural CT image onto intra-procedural image in an efficient and effective way by SLIR. • Structurally consistent MR-to-CT synthesis when only unpaired data available. • Localization and removal of probe and its artifacts without requiring the voxel-wise annotation. • Deformable registration with near real-time computation at intra-procedural stage. Abstract Thermal ablation is a minimally invasive procedure for treating small or unresectable tumors. Although CT is widely used for guiding ablation procedures, yet the contrast of tumors against normal soft tissues is often poor in CT scans, aggravating the accurate thermal ablation. In this paper, we propose a fast MR-CT image registration method to overlay pre-procedural MR (pMR) and pre-procedural CT (pCT) images onto an intra-procedural CT (iCT) image to guide the thermal ablation of liver tumors. At the pre-procedural stage, the Cycle-GAN model with mutual information constraint is employed to generate the synthesized CT (sCT) image from the input pMR. Then, pMR-pCT image registration is carried out via traditional mono-modal sCT-pCT image registration. At the intra-procedural stage, the region of the probe and its artifacts are automatically localized and inpainted in the iCT image. Then, an unsupervised registration network (UR-Net) is used to efficiently align the pCT with the inpainted iCT (inpCT) image. The final transform from pMR to iCT is obtained by concatenating the two estimated transforms, i.e., (i) from pMR image space to pCT image space (via sCT) and (ii) from pCT image space to iCT image space (via inpCT). The proposed method has been evaluated over a real clinical dataset and compared with state-of-the-art methods. Experimental results confirm that the proposed method achieves high registration accuracy with fast computation speed.