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Electromagnetic tracking (EMT) shows great potential for automating implantreconstruction in brachytherapy. One of the challenges of this technology isthat it does not intrinsically share the same reference frame as the patient'smedical imaging. The purpose of this work is to register the reference framesof an EMT-enabled afterloader and a CT scan image of a rigid phantom forquality control of EMT-based implant reconstruction. The geometry of twelve 6Fcatheters and a tandem and ring gynecological applicator were reconstructedusing an EMT sensor attached to an afterloader's check cable. All EMTreconstructions were done in three different environments: disturbance free,CT-on-rails brachytherapy suite and MRI brachytherapy suite. Implants werereconstructed using two acquisition methods: step-and-record and continuousmotion. A CT scan of the phantom was obtained and manually reconstructed in thetreatment planning system, with the help of the solid model of the applicator.Rigid registration algorithms were used to register EMT and CT scan referenceframes using corresponding points from the EMT and CT based reconstructions ofthe phantom, following three approaches: one gynecological applicator, fourcatheters inside four calibration plates having and S-shaped path, and fourceramic marbles within the calibration plates. The absolute median deviationfrom the expected value for EMT measurements in all three environmentssignificantly lie below the sensor's expected accuracy of 0.70 mm (p < 0.001),suggesting that the environment did not have a significant impact on themeasurements, given that care is taken in the immediate surroundings. In allthree environments, the two acquisition and three registration approaches havea mean and median registration errors (perpendicular distance) that lie at orbelow 1 mm, which is lower than the clinical acceptable threshold of 2 mm.

Image registration of an electromagnetic tracking enabled afterloader and CT using a phantom for the quality control of implant reconstruction