Framework for the co-registration of MRI and Histology Images in Prostate Cancer Patients with Radical Prostatectomy

摘要

Prostate magnetic resonance imaging (MRI) allows the detection and treatment planning of clinically significantcancers. However, indolent cancers, e.g., those with Gleason scores 3+3, are not readily distinguishable onMRI. Thus an image-guided biopsy is still required before proceeding with a radical treatment for aggressivetumors or considering active surveillance for indolent disease. The excision of the prostate as part of radicalprostatectomy treatments provides a unique opportunity to correlate whole-mount histology slices with MRI.Through a careful spatial alignment of histology slices and MRI, the extent of aggressive and indolent diseasecan be mapped on MRI which allows one to investigate MRI-derived features that might be able to distinguishaggressive from indolent cancers. Here, we introduce a framework for the 3D spatial integration of radiology andpathology images in the prostate. Our approach, first, uses groupwise-registration methods to reconstruct thehistology specimen prior to sectioning, and incorporates the MRI as a spatial constraint, and, then, performs amulti-modal 3D affine and deformable alignment between the reconstructed histology specimen and the MRI. Wetested our approach on 15 studies and found a Dice similarity coefficient of 0.94±0.02 and a urethra deviation of1.11±0.34 mm between the histology reconstruction and the MRI. Our robust framework successfully mappedthe extent of disease from histology slices on MRI and created ground truth labels for characterizing aggressiveand indolent disease on MRI.