Jihe Li, Xiang Liu, Fabian Zhang et al.
Deformable Image Registration (DIR) is essential for aligning medical images that exhibit anatomical variations, facilitating applications such as disease tracking and radiotherapy planning. While classical iterative methods and deep learning approaches have achieved success in DIR, they are often hindered by computational inefficiency or poor generalization. In this paper, we introduce GaussianDIR, a novel, case-specific optimization DIR method inspired by 3D Gaussian splatting. In general, GaussianDIR represents image deformations using a sparse set of mobile and flexible Gaussian primitives, each defined by a center position, covariance, and local rigid transformation. This compact and explicit representation reduces noise and computational overhead while improving interpretability. Furthermore, the movement of individual voxel is derived via blending the local rigid transformation of the neighboring Gaussian primitives. By this, GaussianDIR captures both global smoothness and local rigidity as well as reduces the computational burden. To address varying levels of deformation complexity, GaussianDIR also integrates an adaptive density control mechanism that dynamically adjusts the density of Gaussian primitives. Additionally, we employ multi-scale Gaussian primitives to capture both coarse and fine deformations, reducing optimization to local minima. Experimental results on brain MRI, lung CT, and cardiac MRI datasets demonstrate that GaussianDIR outperforms existing DIR methods in both accuracy and efficiency, highlighting its potential for clinical applications. Finally, as a training-free approach, it challenges the stereotype that iterative methods are inherently slow and transcend the limitations of poor generalization.