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Modern medical image registration approaches predict deformations using deep networks. These approaches achieve state-of-the-art (SOTA) registration accuracy and are generally fast. However, deep learning (DL) approaches are, in contrast to conventional non-deep-learning-based approaches, anatomy-specific. Recently, a universal deep registration approach, uniGradICON, has been proposed. However, uniGradICON focuses on monomodal image registration. In this work, we therefore develop multiGradICON as a first step towards universal *multimodal* medical image registration. Specifically, we show that 1) we can train a DL registration model that is suitable for monomodal *and* multimodal registration; 2) loss function randomization can increase multimodal registration accuracy; and 3) training a model with multimodal data helps multimodal generalization. Our code and the multiGradICON model are available at https://github.com/uncbiag/uniGradICON.

Conventional medical image registration approaches directly optimize over the parameters of a transformation model. These approaches have been highly successful and are used generically for registrations of different anatomical regions. Recent deep registration networks are incredibly fast and accurate but are only trained for specific tasks. Hence, they are no longer generic registration approaches. We therefore propose uniGradICON, a first step toward a foundation model for registration providing 1) great performance \emph{across} multiple datasets which is not feasible for current learning-based registration methods, 2) zero-shot capabilities for new registration tasks suitable for different acquisitions, anatomical regions, and modalities compared to the training dataset, and 3) a strong initialization for finetuning on out-of-distribution registration tasks. UniGradICON unifies the speed and accuracy benefits of learning-based registration algorithms with the generic applicability of conventional non-deep-learning approaches. We extensively trained and evaluated uniGradICON on twelve different public datasets. Our code and the uniGradICON model are available at https://github.com/uncbiag/uniGradICON.

Inverse consistency is a desirable property for image registration. We propose a simple technique to make a neural registration network inverse consistent by construction, as a consequence of its structure, as long as it parameterizes its output transform by a Lie group. We extend this technique to multi-step neural registration by composing many such networks in a way that preserves inverse consistency. This multi-step approach also allows for inverse-consistent coarse to fine registration. We evaluate our technique on synthetic 2-D data and four 3-D medical image registration tasks and obtain excellent registration accuracy while assuring inverse consistency.

We present an approach to learning regular spatial transformations between image pairs in the context of medical image registration. Contrary to optimization-based registration techniques and many modern learning-based methods, we do not directly penalize transformation irregularities but instead promote transformation regularity via an inverse consistency penalty. We use a neural network to predict a map between a source and a target image as well as the map when swapping the source and target images. Different from existing approaches, we compose these two resulting maps and regularize deviations of the $\bf{Jacobian}$ of this composition from the identity matrix. This regularizer -- $\texttt{GradICON}$ -- results in much better convergence when training registration models compared to promoting inverse consistency of the composition of maps directly while retaining the desirable implicit regularization effects of the latter. We achieve state-of-the-art registration performance on a variety of real-world medical image datasets using a single set of hyperparameters and a single non-dataset-specific training protocol., Comment: 29 pages, 16 figures, CVPR 2023