An image registration system an endoscope (12) and an endoscope controller (22). In operation, the endoscope (12) generates an intra-operative endoscopic image (14) of a vessel tree within an anatomical region including a plurality of branches of the vessel tree visible within the intra-operative endoscopic image (14) as an indication of a furcation of the vessel tree invisible within the intra-operative endoscopic image (14). The endoscope controller (22) image registers the intra-operative operative endoscopic image (14) of the vessel tree to a pre-operative three-dimensional image (44) of the vessel tree. The image registration includes an image matching of a graphical representation of the furcation of the vessel tree as indicated by the branches of the vessel tree visible within the intra-operative endoscopic image (14) of the vessel tree to a graphical representation of the furcation of the vessel tree visible within the pre-operative three-dimensional image (44) of the vessel tree.
