Automated CT marker segmentation for image registration in radionuclide therapy.

In this paper a novel, automated CT marker segmentation technique for image registration is described. The technique, which is based on analysing each CT slice contour individually, treats the cross sections of the external markers as protrusions of the slice contour. Knowledge-based criteria, using the shape and dimensions of the markers, are defined to enable marker identification and segmentation. Following segmentation, the three-dimensional (3D) markers' centroids are localized using an intensity-weighted algorithm. Finally, image registration is performed using a least-squares fit algorithm. The technique was applied to both simulated and patient studies. The patients were undergoing 131I-mIBG radionuclide therapy with each study comprising several 99mTc single photon emission computed tomography (SPECT) scans and one CT marker scan. The mean residual 3D registration errors (+/- 1 SD) computed for the simulated and patient studies were 1.8 +/- 0.3 mm and 4.3 +/- 0.5 mm respectively.