An unsupervised 2D–3D deformable registration network (2D3D-RegNet) for cone-beam CT estimation

Abstract Acquiring CBCTs from a limited scan angle can help to reduce the imaging time, save the imaging dose, and allow continuous target localizations through arc-based treatments with high temporal resolution. However, insufficient scan angle sampling leads to severe distortions and artifacts in the reconstructed CBCT images, limiting their clinical applicability. 2D–3D deformable registration can map a prior fully-sampled CT/CBCT volume to estimate a new CBCT, based on limited-angle on-board cone-beam projections. The resulting CBCT images estimated by 2D–3D deformable registration can successfully suppress the distortions and artifacts, and reflect up-to-date patient anatomy. However, traditional iterative 2D–3D deformable registration algorithm is very computationally expensive and time-consuming, which takes hours to generate a high quality deformation vector field (DVF) and the CBCT. In this work, we developed an unsupervised, end-to-end, 2D–3D deformable registration framework using convolutional neural networks (2D3D-RegNet) to address the speed bottleneck of the conventional iterative 2D–3D deformable registration algorithm. The 2D3D-RegNet was able to solve the DVFs within 5 seconds for 90 orthogonally-arranged projections covering a combined 90° scan angle, with DVF accuracy superior to 3D–3D deformable registration, and on par with the conventional 2D–3D deformable registration algorithm. We also performed a preliminary robustness analysis of 2D3D-RegNet towards projection angular sampling frequency variations, as well as scan angle offsets. The synergy of 2D3D-RegNet with biomechanical modeling was also evaluated, and demonstrated that 2D3D-RegNet can function as a fast DVF solution core for further DVF refinement.