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Improved Magnetic Resonance Imaging-Pathology Correlation With Imaging-Derived, 3D-Printed, Patient-Specific
Daniel N Costa1, Yonatan Chatzinoff, Niccolo M Passoni
1From the Departments of *Radiology, †Advanced Imaging Research Center, ‡Urology, and §Pathology, University of Texas Southwestern Medical Center, Dallas, TX.
Objectives:
The aim of this study was to compare the anatomical registration of preoperative magnetic resonance imaging (MRI) and prostate whole-mount obtained with 3D-printed, patient-specific, MRI-derived molds (PSM) versus conventional whole-mount sectioning (WMS).
Materials And Methods:
Based on an a priori power analysis, this institutional review board-approved study prospectively included 50 consecutive men who underwent 3 T multiparametric prostate MRI followed by radical prostatectomy. Two blinded and independent readers (R1 and R2) outlined the contours of the prostate, tumor, peripheral, and transition zones in the MRI scans using regions of interest. These were compared with the corresponding regions of interest from the whole-mounted histopathology, the reference standard, using PSM whole-mount results obtained in the study group (n = 25) or conventional WMS in the control group (n = 25). The spatial overlap across the MRI and histology data sets was calculated using the Dice similarity coefficient (DSC) for the prostate overall (DSCprostate), tumor (DSCtumor), peripheral (DSCPZ), and transition (DSCTZ) zone. Results in the study and control groups were compared using Wilcoxon rank sum test.
Results:
The MRI histopathology anatomical registration for the prostate gland overall, tumor, peripheral, and transition zones were significantly superior with the use of PSMs (DSCs for R1: 0.95, 0.86, 0.84, and 0.89; for R2: 0.93, 0.75, 0.78, and 0.85, respectively) than with the use of standard WMS (R1: 0.85, 0.46, 0.66, and 0.69; R2: 0.85, 0.46, 0.66, and 0.69) (P < 0.0001).
Conclusions:
The use of PSMs for prostate specimen whole-mount sectioning provides significantly superior anatomical registration of in vivo multiparametric MRI and ex vivo prostate whole-mounts than conventional WMS.
Insights
3D-printed patient-specific molds (PSM) significantly improve anatomical registration between MRI and prostate whole-mounts compared to conventional sectioning. This advance enhances the accuracy of correlating imaging with pathology for better prostate cancer assessment.
Area of Science:
- Urology
- Medical Imaging
- Pathology
Background:
- Accurate anatomical registration between preoperative MRI and whole-mount prostate pathology is crucial for cancer assessment.
- Conventional whole-mount sectioning (WMS) may introduce registration inaccuracies.
- Patient-specific, MRI-derived molds (PSM) offer a novel approach for precise specimen orientation.
Purpose of the Study:
- To compare the accuracy of anatomical registration between MRI and prostate whole-mounts using PSM versus conventional WMS.
- To evaluate the impact of PSM on the spatial overlap of prostate, tumor, and zonal regions.
Main Methods:
- Prospective study of 50 men undergoing 3T multiparametric MRI and radical prostatectomy.
- Two readers outlined prostate structures on MRI and compared with histopathology.
- Registration accuracy assessed using Dice Similarity Coefficient (DSC) for PSM (n=25) and WMS (n=25) groups.
Main Results:
- PSM demonstrated significantly superior anatomical registration for the overall prostate, tumor, peripheral zone, and transition zone compared to WMS (P < 0.0001).
- Dice Similarity Coefficients for PSM were substantially higher across all evaluated regions for both readers.
- Example DSC values for PSM (Reader 1) were 0.95 (prostate), 0.86 (tumor), 0.84 (peripheral zone), and 0.89 (transition zone).
Conclusions:
- Patient-specific molds (PSM) provide significantly better anatomical registration of multiparametric MRI and prostate whole-mounts than conventional WMS.
- PSM enhance the correlation between in vivo imaging and ex vivo histopathology.
- This technique holds promise for improving the precision of prostate cancer localization and characterization.