A comparison of three methods of ultrasound to computed tomography registration

Abstract

During orthopaedic surgery, preoperative CT scans can be aligned to the patient to assist the guidance of surgical instruments and the placement of implants. Registration (i.e. alignment) can be accomplished in many ways: by registering implanted fiducial markers, by touching a probe to the bone surface, or by aligning intraoperative two dimensional flouro images with the the three dimensional CT data. These approaches have problems: They require exposure of the bone, subject the patient and surgeons to ionizing radiation, or do both. Ultrasound can also be used to register a preoperative CT scan to the patient. The ultrasound probe is tracked as it passes over the patient and the ultrasound images are aligned to the CT data. This method eliminates the problems of bone exposure and ionizing radiation, but is computationally more difficult because the ultrasound images contain incomplete and unclear bone surfaces. In this work, we compare three methods to register a set of ultrasound images to a CT scan: Iterated Closest Point, Mutual Information and a novel method Points-to-Image. The average Target Registration Error and speed of each method is presented along with a brief summary of their strengths and weaknesses.