Medical imaging plays an increasingly important role in modern healthcare. In medical imaging, it is often relevant to relate different images to each other, something which can prove challenging, since there rarely exists a pre-defined mapping between the pixels in different images. Hence, there is a need to find such a mapping/transformation, a procedure known as image registration. Over the years, image registration has been proved useful in a number of clinical situations. Despite this, current use of image registration in clinical practice is rather limited, typically only used for image fusion. The limited use is, to a large extent, caused by excessive computation times, lack of established validation methods/metrics and a general skepticism toward the trustworthiness of the estimated transformations in deformable image registration.

This thesis aims to overcome some of the issues limiting the use of image registration, by proposing a set of technical contributions and two clinical applications targeted at improved clinical efficiency. The contributions are made in the context of a generic framework for non-parametric image registration and using an image registration method known as the Morphon. 

In image registration, regularization of the estimated transformation forms an integral part in controlling the registration process, and in this thesis, two regularizers are proposed and their applicability demonstrated. Although the regularizers are similar in that they rely on local structure analysis, they differ in regard to implementation, where one is implemented as applying a set of filter kernels, and where the other is implemented as solving a global optimization problem. Furthermore, it is proposed to use a set of quadrature filters with parallel scales when estimating the phase-difference, driving the registration. A proposal that brings both accuracy and robustness to the registration process, as shown on a set of challenging image sequences. Computational complexity, in general, is addressed by porting the employed Morphon algorithm to the GPU, by which a performance improvement of 38-44x is achieved, when compared to a single-threaded CPU implementation.

The suggested clinical applications are based upon the concept paint on priors, which was formulated in conjunction with the initial presentation of the Morphon, and which denotes the notion of assigning a model a set of properties (local operators), guiding the registration process. In this thesis, this is taken one step further, in which properties of a model are assigned to the patient data after completed registration. Based upon this, an application using the concept of anatomical transfer functions is presented, in which different organs can be visualized with separate transfer functions. This has been implemented for both 2D slice visualization and 3D volume rendering. A second application is proposed, in which landmarks, relevant for determining various measures describing the anatomy, are transferred to the patient data. In particular, this is applied to idiopathic scoliosis and used to obtain various measures relevant for assessing spinal deformity. In addition, a data analysis scheme is proposed, useful for quantifying the linear dependence between the different measures used to describe spinal deformities.