An image registration apparatus comprising: a diagnostic volume image memory which receives a 3 or higher dimension diagnostic volume image of a target area generated by a scanner; an ultrasound volume image memory which stores a 3 or higher dimension ultrasound volume image of the target region; a localizer and registration unit which determines a baseline transform (T base) that brings the 3 or higher dimension diagnostic volume image and the 3 or higher dimension ultrasound volume image of the target area into registration; an image adjustment processor which adjusts at least a selected portion of the diagnostic volume image in accordance with the baseline transform (T base); and a real-time ultrasound scanner which generates 2 or higher dimensional real-time images; wherein the localizer and registration unit further determines a motion correction transform (T motion) which brings real-time ultrasound images from the real-time ultrasound scanner and the 3 or higher dimension ultrasound volume image from the ultrasound volume image memory into registration; the image adjustment processor receiving the motion correction transform (T motion) and adjusting at least a portion of the 3 or higher dimension diagnostic volume image with the baseline transform (T base) and the motion correction transform (T motion) to bring at least a corresponding portion of the diagnostic volume image and the real-time ultrasound images into registration; characterized in that the motion correction transform (T motion) is determined for correcting motion of tissue in the target region and brings real-time ultrasound images from the real-time ultrasound scanner and the 3 or higher dimension ultrasound volume image from the ultrasound volume image memory into registration by using a similarity measure; wherein for determining the baseline transform, the localizer and registration unit includes: a processor which iteratively applies an automated registration relative to each of the 3 or higher dimensions, wherein different similarity measures are used in each iteration or in different dimensions in the same iteration; and a user interface (36, 38) by which the automated registrations are reviewed, adjusted as necessary, and approved. a diagnostic volume image memory which receives a 3 or higher dimension diagnostic volume image of a target area generated by a scanner; an ultrasound volume image memory which stores a 3 or higher dimension ultrasound volume image of the target region; a localizer and registration unit which determines a baseline transform (T base) that brings the 3 or higher dimension diagnostic volume image and the 3 or higher dimension ultrasound volume image of the target area into registration; an image adjustment processor which adjusts at least a selected portion of the diagnostic volume image in accordance with the baseline transform (T base); and a real-time ultrasound scanner which generates 2 or higher dimensional real-time images; wherein the localizer and registration unit further determines a motion correction transform (T motion) which brings real-time ultrasound images from the real-time ultrasound scanner and the 3 or higher dimension ultrasound volume image from the ultrasound volume image memory into registration; the image adjustment processor receiving the motion correction transform (T motion) and adjusting at least a portion of the 3 or higher dimension diagnostic volume image with the baseline transform (T base) and the motion correction transform (T motion) to bring at least a corresponding portion of the diagnostic volume image and the real-time ultrasound images into registration; characterized in that the motion correction transform (T motion) is determined for correcting motion of tissue in the target region and brings real-time ultrasound images from the real-time ultrasound scanner and the 3 or higher dimension ultrasound volume image from the ultrasound volume image memory into registration by using a similarity measure; wherein for determining the baseline transform, the localizer and registration unit includes: a processor which iteratively applies an automated registration relative to each of the 3 or higher dimensions, wherein different similarity measures are used in each iteration or in different dimensions in the same iteration; and a user interface (36, 38) by which the automated registrations are reviewed, adjusted as necessary, and approved. a processor which iteratively applies an automated registration relative to each of the 3 or higher dimensions, wherein different similarity measures are used in each iteration or in different dimensions in the same iteration; and a user interface (36, 38) by which the automated registrations are reviewed, adjusted as necessary, and approved.