Enhancing medical image registration via appearance adjustment networks.

Deformable image registration is fundamental for many medical image analyses. A key obstacle for accurate image registration lies in image appearance variations such as the variations in texture, intensities, and noise. These variations are readily apparent in medical images, especially in brain images where registration is frequently used. Recently, deep learning-based registration methods (DLRs), using deep neural networks, have shown computational efficiency that is several orders of magnitude faster than traditional optimization-based registration methods (ORs). DLRs rely on a globally optimized network that is trained with a set of training samples to achieve faster registration. DLRs tend, however, to disregard the target-pair-specific optimization inherent in ORs and thus have degraded adaptability to variations in testing samples. This limitation is severe for registering medical images with large appearance variations, especially since few existing DLRs explicitly take into account appearance variations. In this study, we propose an Appearance Adjustment Network (AAN) to enhance the adaptability of DLRs to appearance variations. Our AAN, when integrated into a DLR, provides appearance transformations to reduce the appearance variations during registration. In addition, we propose an anatomy-constrained loss function through which our AAN generates anatomy-preserving transformations. Our AAN has been purposely designed to be readily inserted into a wide range of DLRs and can be trained cooperatively in an unsupervised and end-to-end manner. We evaluated our AAN with three state-of-the-art DLRs - Voxelmorph (VM), Diffeomorphic Voxelmorph (DifVM), and Laplacian Pyramid Image Registration Network (LapIRN) - on three well-established public datasets of 3D brain magnetic resonance imaging (MRI) - IBSR18, Mindboggle101, and LPBA40. The results show that our AAN consistently improved existing DLRs and outperformed state-of-the-art ORs on registration accuracy, while adding a fractional computational load to existing DLRs.