Isocentric fixed angle irradiation-based DRR: a novel approach to enhance x-ray and CT image registration.

OBJECTIVE:Digitally Reconstructed Radiography (DRR) plays an important role in the registration of intraoperative X-ray and preoperative CT images. However, existing DRR algorithms often neglect the critical Isocentric Fixed Angle Irradiation (IFAI) principle in C-arm imaging, resulting in inaccurate simulation of X-ray images. This limitation degrades registration algorithms relying on DRR image libraries or employing DRR images (DRRs) to train neural network models. To address this issue, we propose a novel IFAI-based DRR method that accurately captures the true projection transformation during X-ray imaging of the human body. Approach. By strictly adhering to the IFAI principle and utilizing known parameters from intraoperative X-ray images paired with CT scans, our method successfully simulates the real projection transformation and generates DRRs that closely resemble actual X-ray images. Main result. Experimental results validate the effectiveness of our IFAI-based DRR method by successfully registering intraoperative X-ray images with preoperative CT images from multiple patients who underwent thoracic endovascular aortic procedures. Significance. The proposed IFAI-based DRR method enhances the quality of DRR images, significantly accelerates the construction of DRR image libraries, and thereby improves the performance of X-ray and CT image registration. Additionally, the method has the generality of registering CT and X-ray images generated by large C-arm devices. .