Prostate tumour volumes: Evaluation of the agreement between magnetic resonance imaging and histology using novel co-registration software

Julien Le Nobin, Clément Orczyk, Fang Ming Deng, Jonathan Melamed, Henry Rusinek, Samir S. Taneja, Andrew B. Rosenkrantz

Research output: Contribution to journalArticlepeer-review


Objective To evaluate the agreement between prostate tumour volume determined using multiparametric magnetic resonance imaging (MRI) and that determined by histological assessment, using detailed software-assisted co-registration. Materials and Methods A total of 37 patients who underwent 3T multiparametric MRI (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC], dynamic contrast-enhanced [DCE] imaging) were included. A radiologist traced the borders of suspicious lesions on T2WI and ADC and assigned a suspicion score of between 2 and 5, while a uropathologist traced the borders of tumours on histopathological photographs. Software was used to co-register MRI and three-dimensional digital reconstructions of radical prostatectomy specimens and to compute imaging and histopathological volumes. Agreement in volumes between MRI and histology was assessed using Bland-Altman plots and stratified by tumour characteristics.

Results Among 50 tumours, the mean differences (95% limits of agreement) in MRI relative to histology were -32% (-128 to +65%) on T2WI and -47% (-143 to +49%) on ADC. For all tumour subsets, volume underestimation was more marked on ADC maps (mean difference ranging from -57 to -16%) than on T2WI (mean difference ranging from -45 to +2%). The 95% limits of agreement were wide for all comparisons, with the lower 95% limit ranging between -77 and -143% across assessments. Volume underestimation was more marked for tumours with a Gleason score ≥7 or a MRI suspicion score 4 or 5. Conclusion Volume estimates of prostate cancer using MRI tended to substantially underestimate histopathological volumes, with a wide variability in extent of underestimation across cases. These findings have implications for efforts to use MRI to guide risk assessment.

Original languageEnglish (US)
Pages (from-to)E105-E112
JournalBJU International
Issue number6
StatePublished - Dec 1 2014


  • computer-assisted
  • diffusion-weighted MRI
  • histology
  • image processing
  • prostate cancer
  • tumour volume

ASJC Scopus subject areas

  • Urology


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