Hierarchical Image Registration for Improved Sampling During 3T MRI-Guided Transperineal Targeted Prostate Biopsy

Andriy Fedorov¹, Kemal Tuncali¹, Fiona Fennessy¹, Junichi Tokuda¹, Nobuhiko Hata¹, William M. Wells¹, Ron Kikinis¹, Clare M. C. Tempany¹

Prostate imaging with multi-parametric MRI (mpMRI) (e.g., T2w in combination with DWI and DCE) leads to improved detection of prostate cancer (PCa). Application of mpMRI for targeting during transperineal MR-guided PCa biopsy requires image registration to compensate for the differences in prostate configuration between the pre- and intra-procedural acquisitions. We develop a novel application-specific registration technology to perform hierarchical registration with minimum operator intervention. Our evaluation shows that the computation can be accomplished within the time constraints of the clinical workflow and results in good overlap of the manually segmented gland and individual zones between the registered and intra-procedural MRI.