[BibTex]

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Abstract: Precise voxel trajectory estimation in 4D CT images is a prerequisite for reliable dose accumulation during 4D treatment planning. 4D CT image data is, however, often affected by motion artifacts and applying standard pairwise registration to such data sets bears the risk of aligning anatomical structures to artifacts \– with physiologically unrealistic trajectories being the consequence. In this work, the potential of a novel non\-linear hybrid intensity\- and feature\-based groupwise registration method for robust motion field estimation in artifact\-affected 4D CT image data is investigated. The overall registration performance is evaluated on the DIR\-lab datasets; Its robustness if applied to artifact\-affected data sets is analyzed using clinically acquired data sets with and without artifacts. The proposed registration approach achieves an accuracy comparable to the state\-of\-the\-art (subvoxel accuracy), but smoother voxel trajectories compared to pairwise registration. Even more important: it maintained accuracy and trajectory smoothness in the presence of image artifacts \– in contrast to standard pairwise registration, which yields higher landmark\-based registration errors and a loss of trajectory smoothness when applied to artifact\-affected data sets