# Tumor aware recurrent inter-patient deformable image registration of computed tomography scans with lung cancer

arXiv: https://arxiv.org/abs/2409.11910 · HTML: https://mlsanity.com/paper/2409.11910/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 14 of its 34 references that are in the map.
- First posted on arXiv 18 Sep 2024.

## Builds on (most cited first, 14 of 14)

- [Spatial Transformer Networks](https://mlsanity.com/paper/1506.02025/) (2015)
- [VoxelMorph: A Learning Framework for Deformable Medical Image Registration](https://mlsanity.com/paper/1809.05231/) (2018)
- [Unsupervised Learning of Probabilistic Diffeomorphic Registration for Images and Surfaces](https://mlsanity.com/paper/1903.03545/) (2019)
- [Large Deformation Diffeomorphic Image Registration with Laplacian Pyramid Networks](https://mlsanity.com/paper/2006.16148/) (2020)
- [CycleMorph: Cycle Consistent Unsupervised Deformable Image Registration](https://mlsanity.com/paper/2008.05772/) (2020)
- [DeepAtlas: Joint Semi-Supervised Learning of Image Registration and Segmentation](https://mlsanity.com/paper/1904.08465/) (2019)
- [Conditional Deformable Image Registration with Convolutional Neural Network](https://mlsanity.com/paper/2106.12673/) (2021)
- [Inverse-Consistent Deep Networks for Unsupervised Deformable Image Registration](https://mlsanity.com/paper/1809.03443/) (2018)
- [SAME: Deformable Image Registration based on Self-supervised Anatomical Embeddings](https://mlsanity.com/paper/2109.11572/) (2021)
- [GroupRegNet: A Groupwise One-shot Deep Learning-based 4D Image Registration Method](https://mlsanity.com/paper/2009.02613/) (2020)
- [Conditional Prior Networks for Optical Flow](https://mlsanity.com/paper/1807.10378/) (2018)
- [Recurrent Registration Neural Networks for Deformable Image Registration](https://mlsanity.com/paper/1906.09988/) (2019)
- [One shot PACS: Patient specific Anatomic Context and Shape prior aware recurrent registration-segmentation of longitudinal thoracic cone beam CTs](https://mlsanity.com/paper/2201.11000/) (2022)
- [Multiple resolution residual network for automatic thoracic organs-at-risk segmentation from CT](https://mlsanity.com/paper/2005.13690/) (2020)

## Built on by (most cited first, 2 of 2)

- [Med-PerSAM: One-Shot Visual Prompt Tuning for Personalized Segment Anything Model in Medical Domain](https://mlsanity.com/paper/2411.16123/) (2024)
- [Interpretable Unsupervised Deformable Image Registration via Confidence-bound Multi-Hop Visual Reasoning](https://mlsanity.com/paper/2602.00211/) (2026)

## Abstract (arXiv)

Background: Voxel-based analysis (VBA) for population level radiotherapy (RT) outcomes modeling requires topology preserving inter-patient deformable image registration (DIR) that preserves tumors on moving images while avoiding unrealistic deformations due to tumors occurring on fixed images. Purpose: We developed a tumor-aware recurrent registration (TRACER) deep learning (DL) method and evaluated its suitability for VBA. Methods: TRACER consists of encoder layers implemented with stacked 3D convolutional long short term memory network (3D-CLSTM) followed by decoder and spatial transform layers to compute dense deformation vector field (DVF). Multiple CLSTM steps are used to compute a progressive sequence of deformations. Input conditioning was applied by including tumor segmentations with 3D image pairs as input channels. Bidirectional tumor rigidity, image similarity, and deformation smoothness losses were used to optimize the network in an unsupervised manner. TRACER and multiple DL methods were trained with 204 3D CT image pairs from patients with lung cancers (LC) and evaluated using (a) Dataset I (N = 308 pairs) with DL segmented LCs, (b) Dataset II (N = 765 pairs) with manually delineated LCs, and (c) Dataset III with 42 LC patients treated with RT. Results: TRACER accurately aligned normal tissues. It best preserved tumors, blackindicated by the smallest tumor volume difference of 0.24%, 0.40%, and 0.13 % and mean square error in CT intensities of 0.005, 0.005, 0.004, computed between original and resampled moving image tumors, for Datasets I, II, and III, respectively. It resulted in the smallest planned RT tumor dose difference computed between original and resampled moving images of 0.01 Gy and 0.013 Gy when using a female and a male reference.