Prostate magnetic resonance imaging (MRI) allows the detection and treatment planning of clinically significant cancers. However, indolent cancers, e.g., those with Gleason scores 3+3, are not readily distinguishable on MRI. Thus an image-guided biopsy is still required before proceeding with a radical treatment for aggressive tumors or considering active surveillance for indolent disease. The excision of the prostate as part of radical prostatectomy 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 disease can be mapped on MRI which allows one to investigate MRI-derived features that might be able to distinguish aggressive from indolent cancers. Here, we introduce a framework for the 3D spatial integration of radiology and pathology images in the prostate. Our approach, first, uses groupwise-registration methods to reconstruct the histology specimen prior to sectioning, and incorporates the MRI as a spatial constraint, and, then, performs a multi-modal 3D affine and deformable alignment between the reconstructed histology specimen and the MRI. We tested our approach on 15 studies and found a Dice similarity coefficient of 0.94±0.02 and a urethra deviation of 1.11±0.34 mm between the histology reconstruction and the MRI. Our robust framework successfully mapped the extent of disease from histology slices on MRI and created ground truth labels for characterizing aggressive and indolent disease on MRI.
Mirabela Rusu, Christian Kunder, Richard Fan, Pejman Ghanouni M.D., Robert West, Geoffrey Sonn, and James Brooks M.D., "Framework for the co-registration of MRI and histology images in prostate cancer patients with radical prostatectomy," Proc. SPIE 10949, Medical Imaging 2019: Image Processing, 109491P (Presented at SPIE Medical Imaging: February 22, 2019; Published: 15 March 2019); https://doi.org/10.1117/12.2513099.
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