To present and evaluate a method for registration of whole-mount prostate digital histology images to ex vivo magnetic resonance (MR) images. Nine radical prostatectomy specimens were marked with 10 strand-shaped fiducial markers per specimen, imaged with T1- and T2-weighted 3T MRI protocols, sliced at 4.4-mm intervals, processed for whole-mount histology, and the resulting histological sections (3-5 per specimen, 34 in total) were digitized. The correspondence between fiducial markers on histology and MR images yielded an initial registration, which was refined by a local optimization technique, yielding the least-squares best-fit affine transformation between corresponding fiducial points on histology and MR images. Accuracy was quantified as the postregistration 3D distance between landmarks (3-7 per section, 184 in total) on histology and MR images, and compared to a previous state-of-the-art registration method. The proposed method and previous method had mean (SD) target registration errors of 0.71 (0.38) mm and 1.21 (0.74) mm, respectively, requiring 3 and 11 hours of processing time, respectively. The proposed method registers digital histology to prostate MR images, yielding 70% reduced processing time and mean accuracy sufficient to achieve 85% overlap on histology and ex vivo MR images for a 0.2 cc spherical tumor.
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