DART: DEFORMABLE ANATOMY-AWARE REGISTRATION TOOLKIT FOR LUNG CT REGISTRATION WITH KEYPOINTS SUPERVISION.

Spatially aligning two computed tomography (CT) scans of the lung using automated image registration techniques is a challenging task due to the deformable nature of the lung. However, existing deep-learning-based lung CT registration models are not trained with explicit anatomical knowledge. We propose the deformable anatomy-aware registration toolkit (DART), a masked autoencoder (MAE)-based approach, to improve the keypoint-supervised registration of lung CTs. Our method incorporates features from multiple decoders of networks trained to segment anatomical structures, including the lung, ribs, vertebrae, lobes, vessels, and airways, to ensure that the MAE learns relevant features corresponding to the anatomy of the lung. The pretrained weights of the transformer encoder and patch embeddings are then used as the initialization for the training of downstream registration. We compare DART to existing state-of-the-art registration models. Our experiments show that DART outperforms the baseline models (Voxelmorph, ViT-V-Net, and MAE-TransRNet) in terms of target registration error of both corrField-generated keypoints with 17%, 13%, and 9% relative improvement, respectively, and bounding box centers of nodules with 27%, 10%, and 4% relative improvement, respectively. Our implementation is available at https://github.com/yunzhengzhu/DART.