Automatic registration and alignment on a template of cardiac stress and rest reoriented SPECT images

Single photon emission computed tomography (SPECT) imaging with ²⁰¹Tl or ^99mTc agent is used to assess the location or the extent of myocardial infarction or ischemia. A method is proposed to decrease the effect of operator variability in the visual or quantitative interpretation of scintigraphic myocardial perfusion studies. To effect this, the patient´s myocardial images (target cases) are registered automatically over a template image, utilizing a nonrigid transformation. The intermediate steps are: 1) Extraction of feature points in both stress and rest three-dimensional (3-D) images. The images are resampled in a polar geometry to detect edge points, which in turn are filtered by the use of a priori constraints. The remaining feature points are assumed to be points on the edges of the left ventricular myocardium. 2) Registration of stress and rest images with a global affine transformation. The matching method is an adaptation of the iterative closest point algorithm. 3) Registration and morphological matching of both stress and rest images on a template using a nonrigid local spline transformation following a global affine transformation. 4) Resampling of both stress and rest images in the geometry of the template. Optimization of the method was performed on a database of 40 pairs of stress and rest images selected to obtain a wide variation of images and abnormalities. Further testing was performed on 250 cases selected from the same database on the basis of the availability of angiographic results and patient stratification.