Towards Fully Automatic X-Ray to CT Registration

Javier Esteban, Matthias Grimm, Mathias Unberath, Guillaume Zahnd, Nassir Navab

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review

20 Scopus citations


The main challenge preventing a fully-automatic X-ray to CT registration is an initialization scheme that brings the X-ray pose within the capture range of existing intensity-based registration methods. By providing such an automatic initialization, the present study introduces the first end-to-end fully-automatic registration framework. A network is first trained once on artificial X-rays to extract 2D landmarks resulting from the projection of CT-labels. A patient-specific refinement scheme is then carried out: candidate points detected from a new set of artificial X-rays are back-projected onto the patient CT and merged into a refined meaningful set of landmarks used for network re-training. This network-landmarks combination is finally exploited for intraoperative pose-initialization with a runtime of 102 ms. Evaluated on 6 pelvis anatomies (486 images in total), the mean Target Registration Error was 15.0 ± 7.3 mm. When used to initialize the BOBYQA optimizer with normalized cross-correlation, the average (± STD) projection distance was 3.4 ± 2.3 mm, and the registration success rate (projection distance < 2.5 % of the detector width) greater than 97 %.

Original languageEnglish
Title of host publicationMedical Image Computing and Computer Assisted Intervention – MICCAI 2019 - 22nd International Conference, Proceedings
EditorsDinggang Shen, Pew-Thian Yap, Tianming Liu, Terry M. Peters, Ali Khan, Lawrence H. Staib, Caroline Essert, Sean Zhou
PublisherSpringer Science and Business Media Deutschland GmbH
Number of pages9
ISBN (Print)9783030322250
StatePublished - 2019
Event22nd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2019 - Shenzhen, China
Duration: 13 Oct 201917 Oct 2019

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume11769 LNCS
ISSN (Print)0302-9743
ISSN (Electronic)1611-3349


Conference22nd International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2019


  • Neural network
  • Patient-specific training
  • Projective geometry
  • X-ray to CT Registration


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