Comparison of rigid and elastic registration methods in software-based targeted prostate biopsy: a multicenter cohort...

Area of Science:

• Urology
• Medical Imaging
• Oncology

Background:

• Software-based targeted prostate biopsies (TPBs) are crucial for accurate prostate cancer diagnosis.
• Comparing rigid registration (RR) and elastic registration (ER) systems is essential for optimizing TPB accuracy.
• Understanding the diagnostic performance differences between RR and ER is key for improving patient outcomes.

Purpose of the Study:

• To compare the diagnostic success rates of RR and ER systems in TPBs.
• To evaluate the detection rates of all prostate cancers and clinically significant prostate cancer (csPC) using RR versus ER.
• To identify factors predicting clinically insignificant prostate cancer (ciPC) diagnoses.

Main Methods:

• Utilized data from 2061 patients across six centers performing software-based TPB.
• Employed Mahalanobis distance matching with propensity score caliper for patient cohort comparison.
• Conducted logistic regression analysis to identify predictive factors for ciPC and csPC diagnoses.

Main Results:

• Elastic registration (ER) demonstrated a significantly higher detection rate for all cancers (54.8% vs. 35.7%, p < 0.001) compared to rigid registration (RR).
• No significant difference was observed in clinically significant prostate cancer (csPC) detection rates between ER and RR (28.0% vs. 22.3%, p = 0.242).
• ER system use and decreased prostate volume were identified as independent predictors for ciPC diagnosis.

Conclusions:

• Elastic registration (ER) systems offer superior detection rates for overall prostate cancer and clinically insignificant prostate cancer (ciPC) in TPBs.
• Rigid registration (RR) and ER systems show comparable performance in detecting clinically significant prostate cancer (csPC).
• ER system utilization is a significant factor in improving the diagnosis of ciPC.