A Workflow to Improve the Alignment of Prostate Imaging with Whole-mount Histopathology

Hidekazu Yamamoto, Dror Nir, Lona Vyas, Richard T Chang, Rick Popert, Declan Cahill, Benjamin Challacombe, Prokar Dasgupta, Ashish Chandra

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)

    Abstract

    Rationale and Objectives
    Evaluation of prostate imaging tests against whole-mount histology specimens requires accurate alignment between radiologic and histologic data sets. Misalignment results in false-positive and -negative zones as assessed by imaging. We describe a workflow for three-dimensional alignment of prostate imaging data against whole-mount prostatectomy reference specimens and assess its performance against a standard workflow.

    Materials and Methods
    Ethical approval was granted. Patients underwent motorized transrectal ultrasound (Prostate Histoscanning) to generate a three-dimensional image of the prostate before radical prostatectomy. The test workflow incorporated steps for axial alignment between imaging and histology, size adjustments following formalin fixation, and use of custom-made parallel cutters and digital caliper instruments. The control workflow comprised freehand cutting and assumed homogeneous block thicknesses at the same relative angles between pathology and imaging sections.

    Results
    Thirty radical prostatectomy specimens were histologically and radiologically processed, either by an alignment-optimized workflow (n = 20) or a control workflow (n = 10). The optimized workflow generated tissue blocks of heterogeneous thicknesses but with no significant drifting in the cutting plane. The control workflow resulted in significantly nonparallel blocks, accurately matching only one out of four histology blocks to their respective imaging data. The image-to-histology alignment accuracy was 20% greater in the optimized workflow (P < .0001), with higher sensitivity (85% vs. 69%) and specificity (94% vs. 73%) for margin prediction in a 5 × 5-mm grid analysis.

    Conclusions
    A significantly better alignment was observed in the optimized workflow. Evaluation of prostate imaging biomarkers using whole-mount histology references should include a test-to-reference spatial alignment workflow.
    Original languageEnglish
    Pages (from-to)1009-1019
    Number of pages11
    JournalAcademic Radiology
    Volume21
    Issue number8
    DOIs
    Publication statusPublished - Aug 2014

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