Yamamoto Hidekazu, Nir Dror, Vyas Lona, Chang Richard T, Popert Rick, Cahill Declan, Challacombe Ben, Dasgupta Prokar, Chandra Ashish
Acad Radiol. 2014 Aug;21(8):1009-19. doi: 10.1016/j.acra.2014.04.015.
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.
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.
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.
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.
针对前列腺全切片组织学标本评估前列腺成像检查，需要放射学和组织学数据集之间精确对齐。未对齐会导致成像评估出现假阳性和假阴性区域。我们描述了一种用于将前列腺成像数据与前列腺全切除参考标本进行三维对齐的工作流程，并将其性能与标准工作流程进行评估。
已获得伦理批准。患者在根治性前列腺切除术前行电动经直肠超声检查（前列腺组织扫描）以生成前列腺三维图像。测试工作流程包括成像与组织学之间轴向对齐的步骤、福尔马林固定后的尺寸调整，以及使用定制的平行切割器和数字卡尺仪器。对照工作流程包括徒手切割，并假设病理切片和成像切片之间在相同相对角度下组织块厚度均匀。
对30个根治性前列腺切除标本进行了组织学和放射学处理，其中20个采用优化对齐工作流程，10个采用对照工作流程。优化后的工作流程产生的组织块厚度不均，但切割平面无明显漂移。对照工作流程导致组织块明显不平行，四个组织学块中只有一个能与各自的成像数据准确匹配。在优化后的工作流程中，图像与组织学的对齐准确率提高了20%（P <.0001），在5×5毫米网格分析中，切缘预测的敏感性更高（85%对69%），特异性更高（94%对73%）。
优化后的工作流程观察到明显更好的对齐效果。使用前列腺全切片组织学参考评估前列腺成像生物标志物应包括测试与参考的空间对齐工作流程。
