title: Multimodal image-guided prostate fusion biopsy based on automatic deformable registration.
abstract: OBJECTIVE
  Transrectal ultrasound (TRUS)-guided random prostate biopsy is, in spite of its low sensitivity, the gold standard for the diagnosis of prostate cancer. The recent advent of PET imaging using a novel dedicated radiotracer, [Formula: see text]-labeled prostate-specific membrane antigen (PSMA), combined with MRI provides improved pre-interventional identification of suspicious areas. This work proposes a multimodal fusion image-guided biopsy framework that combines PET-MRI images with TRUS, using automatic segmentation and registration, and offering real-time guidance.
  
  
  METHODS
  The prostate TRUS images are automatically segmented with a Hough transform-based random forest approach. The registration is based on the Coherent Point Drift algorithm to align surfaces elastically and to propagate the deformation field calculated from thin-plate splines to the whole gland.
  
  
  RESULTS
  The method, which has minimal requirements and temporal overhead in the existing clinical workflow, is evaluated in terms of surface distance and landmark registration error with respect to the clinical ground truth. Evaluations on agar-gelatin phantoms and clinical data of 13 patients confirm the validity of this approach.
  
  
  CONCLUSIONS
  The system is able to successfully map suspicious regions from PET/MRI to the interventional TRUS image.
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany. oliver.zettinig@tum.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Zettinig
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Amit
authors.initials: A
authors.lastname: Shah
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Hennersperger
authors.affiliation: Nuklearmedizinische Klinik und Poliklinik, Technische Universität München, München, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Eiber
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Kroll
authors.affiliation: Urologische Klinik und Poliklinik, Technische Universität München, München, Germany.
authors.forename: Hubert
authors.initials: H
authors.lastname: Kübler
authors.affiliation: Urologische Klinik und Poliklinik, Technische Universität München, München, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Maurer
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Fausto
authors.initials: F
authors.lastname: Milletarì
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Rackerseder
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schulte Zu Berge
authors.affiliation: Urologische Klinik und Poliklinik, Technische Universität München, München, Germany.
authors.forename: Enno
authors.initials: E
authors.lastname: Storz
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Frisch
authors.affiliation: Computer-Aided Medical Procedures, Technische Universität München, Boltzmannstr. 3, 85748, Garching, Germany.|Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Nassir
authors.initials: N
authors.lastname: Navab
mesh_terms: D000465:Algorithms; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D018084:Ultrasonography, Interventional / Q000379:methods; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000295:instrumentation / Q000379:methods*
keywords: Coherent point drift; Hough forest segmentation; Multimodal deformable registration; Prostate biopsy