Abstract: It is time consuming for surface registration of medical volumetric images in high resolution.Fully automatic methods cannot handle complex situations well,for example,massive non-continuous holes in children's skull.To address this problem,we propose an interactive registration technique based on an efficient deformation algorithm.We first sample the volumetric data; combine local as-rigid-as-possible energy with non-rigid iterative closest point as an automatic registration framework and integrate real-time interactive refinement in local regions.The experiments demonstrate our technique is able to complete the registration in 13 seconds for an average 1.2 million sample points with the same accuracy by marching cubes.