Intra-operative multimodal non-rigid registration of the liver for navigated tumor ablation.

CT guided tumor ablation of the liver often suffers from a lack of visualization of the target tumor and surrounding critical structures. This information is available on pre-operative contrast enhanced MR images and a non-rigid registration technique is desirable. However while registration methods have been successfully tested retrospectively on patient data, very few have been incorporated into clinical procedures. A non-rigid registration technique has been evaluated, optimized and validated to be able to perform registration of the liver between MR to CT images, and between intra-operative CT images. The method requires pre-processing and segmentation of the liver, and presents an accuracy of approximately 2 mm. A clinical feasibility study has been conducted in 5 liver ablation cases. The method helps clinicians enhance interventional planning, confirm ablation probe location with respect to the tumor, and in the case of cryotherapy, evaluate tumor coverage by the ice ball.