Abstract:Effective representation of Regions of Interest (ROI) and independent alignment of these ROIs can significantly enhance the performance of deformable medical image registration (DMIR). However, current learning-based DMIR methods have limitations. Unsupervised techniques disregard ROI representation and proceed directly with aligning pairs of images, while weakly-supervised methods heavily depend on label constraints to facilitate registration. To address these issues, we introduce a novel ROI-based registration approach named EASR-DCN. Our method represents medical images through effective ROIs and achieves independent alignment of these ROIs without requiring labels. Specifically, we first used a Gaussian mixture model for intensity analysis to represent images using multiple effective ROIs with distinct intensities. Furthermore, we propose a novel Divide-and-Conquer Network (DCN) to process these ROIs through separate channels to learn feature alignments for each ROI. The resultant correspondences are seamlessly integrated to generate a comprehensive displacement vector field. Extensive experiments were performed on three MRI and one CT datasets to showcase the superior accuracy and deformation reduction efficacy of our EASR-DCN. Compared to VoxelMorph, our EASR-DCN achieved improvements of 10.31\% in the Dice score for brain MRI, 13.01\% for cardiac MRI, and 5.75\% for hippocampus MRI, highlighting its promising potential for clinical applications. The code for this work will be released upon acceptance of the paper.