Purpose Assessing the treated region with locoregional therapy (LT) provides valuable information for predicting hepatocellular carcinoma (HCC) recurrence. The commonly used of assessment method is inefficient because it only compares two-dimensional CT images manually. In our previous work, we automatically aligned the two CT volumes to evaluate the therapeutic efficiency using registration algorithms. The non-rigid registration is applied to capture local deformation, however, it usually destroys internal structure. Taking these into consideration, this paper proposes a novel non-rigid registration approach for evaluating LT of HCC to maintain the image integrity. Method In our registration algorithm, a global affine transformation combined with localized cubic B-spline is used to estimate the significant non-rigid motions of two livers. The proposed method extends a classical non-rigid registration based on mutual information (MI) that uses an anatomical structure term to constrain the local deformation. The energy function can be defined based on the total one associated with the anatomical structure and deformation information. Optimal transformation is obtained by finding the equilibrium state in which the total energy is minimized, indicating that the anatomical landmarks have found their correspondences. Thus, we can use the same transformation to automatically transform the ablative region to the optimal position. Results Registration accuracy is evaluated using the clinical data. Improved results are obtained with respect to all criteria in our proposed method (MI-LC) than those in the MI-based non-rigid registration. The landmark distance error (LDE) of MI-LC is decreased by an average of 3.93mm compared to the case of MI-based registration. Moreover, it could be found regardless of how many landmarks applied in our proposed method, a significant reduction in LDE values using registrations based on MI-LC compared with those based on MI is confirmed. Conclusion Our proposed approach can guarantee the continuity, the accuracy and the smoothness of structures by constraining the anatomical features. The results clearly indicate that our method can retain the local deformation of the image. In addition, it assures the anatomical structure stability. 
Non-rigid image registration with anatomical structure constraint for assessing locoregional therapy of hepatocellular carcinoma