Evaluation of intersession 3D-TRUS to 3D-TRUS image registration for repeat prostate biopsies.

PURPOSE 3D-TRUS-guided prostate biopsy permits a 3D record of biopsy cores, supporting the planning of targets to resample or avoid during repeat biopsy sessions. Image registration is required in order to map biopsy targets planned on a previous session's 3D-TRUS image into the context of the current session. The authors evaluated the performance of surface- and intensity-based rigid and nonrigid registration algorithms for this task using a clinically motivated success criterion of a maximum 2.5 mm target registration error (TRE). METHODS The authors collected two 3D-TRUS images for each of 13 patients, where each image was collected in a separate biopsy session, and the sessions were 1 week apart. The authors tested the iterative closest point and thin-plate spline surface-based registration methods, and the block matching and B-spline intensity-based methods. Manually marked intrinsic fiducials (calcifications) were used to calculate a TRE for each of the tested methods. In addition, error ellipsoids, anisotropy, and variability due to image segmentation were analyzed. All analysis was performed separately for the peripheral zone since this area harbors up to 80% of all prostate cancer. RESULTS Only the intensity-based nonrigid registration method met the success criterion for both the whole gland and the peripheral zone. Segmentation was a substantial contributor to registration error variability for the surface-based methods, and the surface-based methods resulted in greater error volumes and anisotropy. CONCLUSIONS Intensity-based rigid registration is clinically sufficient to register regions outside the peripheral zone, but nonrigid registration is required in order to register the peripheral zone with clinically needed accuracy. The clinical advantage of using nonrigid registration is questionable since the difference between the RMS TREs for rigid and nonrigid intensity-based registration could be considered to be small (0.3 mm) and is statistically significant. If the added clinical value in performing a nonrigid registration is insufficient given the additional time required for this computation, rigid registration alone may be suitable.

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