Deformable Lung Registration for Pulmonary Image Analysis of MRI and CT scans

Medical imaging has seen a rapid development in its clinical use in assessment of treatment outcome, disease monitoring and diagnosis over the last few decades. Yet, the vast amount of available image data limits the practical use of this potentially very valuable source of information for radiologists and physicians. Therefore, the design of computer-aided medical image analysis is of great importance to imaging in clinical practice. This thesis deals with the problem of deformable image registration in the context of lung imaging, and addresses three of the major challenges involved in this challenging application, namely: designing an image similarity for multi-modal scans or scans of locally changing contrast, modelling of complex lung motion, which includes sliding motion, and approximately globally optimal mathematical optimisation to deal with large motion of small anatomical features. The two most important contributions made in this thesis are: the formulation of a multi-dimensional structural image representation, which is independent of modality, robust to intensity distortions and very discriminative for different image features, and a discrete optimisation framework, based on an image-adaptive graph structure, which enables a very efficient optimisation of large dense displacement spaces and deals well with sliding motion. The derived methods are applied to two different clinical applications in pulmonary image analysis: motion correction for breathing-cycle computed tomography (CT) volumes, and deformable multi-modal fusion of CT and magnetic resonance imaging chest scans. The experimental validation demonstrates improved registration accuracy, a high quality of the estimated deformations, and much lower computational complexity, all compared to several state-of-the-art deformable registration techniques.