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AJNR - American Journal of Neuroradiology

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Registration of Three-Dimensional MR and CT Studies of the Cervical Spine

Ashok Panigrahy^a, Shelton D. Caruthers^a, Jaroslaw Krejza^a, Patrick D. Barnes^a, Sami G. Faddoul^a, Lynn A. Sleeper^a and Elias R. Melhem^,a

^a From the Department of Radiology, Boston Medical Center, Boston, MA (A.P., S.D.C., J.K., S.G.F., E.R.M.); the Department of Radiology, Children's Hospital, Boston, MA (A.P., P.D.B.); Philips Medical Systems, N.A., Shelton, CT (S.D.C.); and New England Research Institutes, Watertown, MA (L.A.S.).

View larger version (112K): [in a new window]   FIG 1. Location of external fiducials on orthogonal CT scans and MR images at a comparable level of the cervical spine. The external fiducial landmark (arrows) is first located on the axial view of the individual imaging studies and then compared with the location on the reformatted sagittal and coronal sections through the image volume

View larger version (11K): [in a new window]   FIG 2. Diagram of the registration process

View larger version (35K): [in a new window]   FIG 3. A, Bar graph shows that the RMSE value of the fiducial registration in all eight subjects is less than that of the anatomic registration (error bars represent SEM). B, Comparative profile of anatomic and fiducial RMSE values for each subject. Subject 2 has identical RMSE values for both the anatomic and fiducial registrations.

View larger version (68K): [in a new window]   FIG 4. Multiple axial images from one subject (subject 2 from fig 3B) include corresponding MR image (left), CT scan (middle), and registered image (right) of the cervical spine at the level of the neural foramina (two levels). This was the format used by the three neuroradiologists to compare the clarity of conventional images (MR and CT studies side by side) with that of the registered images. The relationships between the margins of the neural foramina (solid arrow) and spinal canal (open arrow) and their contents, respectively, are more conspicuously delineated on the fused image. The images were registered using external fiducial landmarks

View larger version (53K): [in a new window]   FIG 5. Magnified view of the axial images of the cervical spine at a comparable level (CT scan, left; MR image, center; registered image, right). The relationship between the margins of the neural foramina (solid arrow) and spinal canal (open arrow) and their contents is more conspicuously delineated on the registered image. The images were registered using external fiducial landmarks. Subject 5 from figure 3B is represented

View larger version (60K): [in a new window]   FIG 6. Corresponding midsagittal CT (left), MR (middle), and registered (right) images of the cervical spine show proper alignment and the relationship between the margin of the spinal canal (solid arrow) and its contents. The images were registered using external fiducial landmarks. Subject 4 from figure 3B is represented