Evaluation Principles for MRI-MRA Registration in Trigeminal Neuralgia: An ROI-Centered Neurovascular Benchmark
Authors: Xupeng Zhang, Xihang Wang, Michael Xie, Haoyuan Liang, Hau Ern Lien, Oishika Das, James Feghali, Risheng Xu, +1 more
Abstract
Preoperative evaluation of trigeminal neuralgia (TN) often requires joint interpretation of structural MRI, which depicts the trigeminal nerve and surrounding cisternal anatomy, and time-of-flight MRA, which highlights vascular structures. Although MRI-MRA fusion is clinically attractive for visualizing neurovascular compression, this task is poorly captured by conventional whole-brain registration evaluation because the clinically relevant target is a small trigeminal ROI, vessel annotations are partial and clinically focused, local TOF-MRA contrast is variable, and field-of-view mismatch can limit deformable alignment. We formulate TN MRI-MRA fusion as an ROI-centered neurovascular registration-evaluation problem and construct a benchmark from 149 patients with clinician-annotated bilateral trigeminal ROIs. Six representative registration pipelines were evaluated using local image-based metrics, segmentation-derived vessel-localization metrics, prediction-volume analysis, and contrast- and FOV-stratified comparisons. Conventional evaluation summaries were often misleading: local image similarity, vessel-background separability, and downstream vessel localization did not co-rank methods; one-sided vessel distances were strongly affected by predicted vessel extent under partial annotations; and local MRA contrast determined when vessel-separability metrics were informative. Deformable refinement provided only a small, FOV-dependent benefit over affine alignment, while reader review showed that locally favorable vessel distances could coexist with globally implausible registrations. These findings indicate that TN MRI-MRA registration should be evaluated as a local, vessel-aware, contrast-sensitive, and FOV-aware visualization task rather than as generic multimodal brain registration. Our code is publicly available at https://github.com/jhuldr/TN-Reg-Benchmark.
Multimodal CT-MRI registration is central to image-guided radiotherapy, surgical navigation, and diagnostic workflows, but most pipelines report only aggregate quality metrics without per-case reliability signals. We propose a reliability-aware framework that converts registration quality into Green/Yellow/Red risk categories using data-learned thresholds. CT images were registered to T1-weighted MRI using rigid and affine transformations on 90 paired slices from 18 patients across brain, abdominal, and neck anatomies. Reliability was assessed using Delta NMI, Delta SSIM, Dice overlap, registration stability, and inverse consistency error, combined into a single score R. Thresholds learned from training patients were applied unchanged to held-out test patients. Affine registration outperformed rigid registration on NMI and SSIM, yielding 44% Green classifications versus 33% for rigid. Reliability-filtered registrations improved the average alignment profile compared with unfiltered methods. Per-anatomy analysis showed substantial variation, with stronger reliability for abdominal registrations than brain registrations. Weight sensitivity analysis identified Dice overlap as the dominant reliability component. The proposed framework provides an interpretable quality-control layer for multimodal registration, while risk thresholds reflect statistical rather than clinical validation.
Accurate CT-MRI registration of the cervical spine is essential for preoperative planning because this region is anatomically complex,highly variable,and vulnerable to injury of the vertebral arteries and spinal cord. However,cervical CT-MRI registration remains underexplored,particularly for rigid-deformable hybrid modeling,and the lack of high-quality annotated multimodal data further limits progress. To address these challenges, we construct and release a comprehensively annotated CT-MRI dataset, R-D-Reg, and propose MSR, a rigid-deformable hybrid registration framework for complex joint structures. Specifically, MSR includes a rigid registration module for independent local rigid alignment of individual vertebrae and a deformable registration module with an MSL block that combines Mamba-based global modeling and Swin Transformer-based local modeling through adaptive gating. The rigid and deformable deformation fields are then fused to generate a hybrid field that better preserves local anatomical consistency. The code and dataset are publicly available at https://github.com/ssc1230609-spec/MSR-registration.
Deformable medical image registration aligns anatomical structures across images but remains computationally dense at 3D resolution. Spiking neural networks (SNNs) offer sparse event-driven computation, yet have not been systematically studied for deformable medical image registration. We introduce SpikeReg, a spiking U-Net for 3D brain MRI registration. SpikeReg is initialized from an analog ANN registration teacher, converted by layer-wise weight transfer and activation-percentile threshold calibration, and fine-tuned with a surrogate-gradient objective combining local cross-correlation, diffusion regularization, and spike-rate sparsity. On the OASIS Learn2Reg validation split (19 image pairs), SpikeReg reaches Dice 0.7474±0.032, with no significant paired Dice difference from the ANN teacher (0.7480±0.037, p=0.67), at a 12.8% mean spike rate and a 55.5× projected arithmetic-energy reduction under an event-sparse SynOps/MAC proxy relative to the dense-ANN baseline. We additionally report two negative findings: displacement distillation from the ANN teacher hurts performance, and ANN teachers trained with a label-Dice loss fail to transfer through rate-code conversion. Together these results show that dense geometric prediction can be performed under sparse event-driven computation, opening a path toward neuromorphic medical image registration.
Ali Mikaeili Barzili, Behzad Moshiri, Hamid Azadegan +1