Application and validation of registration framework for real-time atlas guided biopsy

It is widely established that prostate cancer is a multifocal disease and cancerous lesions are not uniformly distributed within the gland. Current imaging methods cannot detect prostate cancer with sufficient sensitivity and specificity, especially localized cancers. A cancer atlas was previously demonstrated. However the atlas must be registered with a patient's ultrasound image in a clinical procedure. Here we present the fast registration of this atlas in a clinical setting so as to map cancer likelihoods in addition to optimized biopsy locations from the atlas space to the subject to maximize cancer detection accuracy. The registration was validated on 158 subjects with cancers annotated and the detection rate was found to be 84.81% and 89.87% for optimized 7 and 12 core biopsy schemes respectively. It took less than 8 seconds for the entire registration procedure.