Registration Accuracy of Patient-Specific, Three-Dimensional-Printed Prostate Molds for Correlating Pathology With Magnetic Resonance Imaging

<italic>Objective:</italic> This investigation was performed to evaluate the registration accuracy between magnetic resonance imaging (MRI) and pathology using three-dimensional (3-D) printed molds. <italic>Methods:</italic> Tissue-mimicking prostate phantoms were manufactured with embedded fiducials. The fiducials were used to measure and compare target registration error (TRE) between phantoms that were sliced by hand versus phantoms that were sliced within 3-D-printed molds. Subsequently, ten radical prostatectomy specimens were placed inside molds, scanned with MRI, and then sliced. The <italic>ex vivo</italic> scan was used to assess the true location of whole mount (WM) slides relative to <italic>in vivo</italic> MRI. The TRE between WM and <italic>in vivo</italic> MRI was measured using anatomic landmarks. <italic>Results:</italic> Manually sliced phantoms had a 4.1-mm mean TRE, whereas mold-sliced phantoms had a 1.9-mm mean TRE. Similarly, mold-assisted slicing reduced mean angular misalignment around the left-right (LR) anatomic axis from 10.7° to 4.5°. However, <italic>ex vivo</italic> MRI revealed that excised prostates were misaligned within molds, including a mean 14° rotation about the LR axis. The mean in-plane TRE was 3.3 mm using molds alone and 2.2 mm after registration was corrected with <italic>ex vivo</italic> MRI. <italic>Conclusion:</italic> Patient-specific molds improved accuracy relative to manual slicing techniques in a phantom model. However, the registration accuracy of surgically resected specimens was limited by their imperfect fit within molds. This limitation can be overcome with the addition of <italic>ex vivo</italic> imaging. <italic>Significance:</italic> The accuracy of 3-D-printed molds was characterized, quantifying their utility for facilitating MRI-pathology registration.

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