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Three methods of CT-based coregistration were compared: 1. Manual coregistration (ManReg) Ex-vivo CT was manually (ManReg) coregistered to in vivo CT, using MITK software, based on a consensus of two independent observers.
Manual coregistration (ManReg).
Manual coregistration with automatic scaling factor (with mutual information).
Manual coregistration with automatic scaling factor (ScalFactReg) Manual coregistration as described in method 1, but with isotropic scaling of the ex vivo CT using a derived scaling factor to compensate for the prostate shrinking after prostatectomy.
The transformations/deformations of the coregistration steps were also applied to the VOIs defined on the ex vivo CT in step I. Manual coregistration with automatic scaling factor (ScalFactReg). Manual coregistration as described in method 1, but with isotropic scaling of the ex vivo CT using a derived scaling factor to compensate for the prostate shrinking after prostatectomy.
We recommend manual coregistration between ex and in vivo CT followed by PET-based MI coregistration as a less complex method which nevertheless appears more stable and more precise compared to (semi- automatic methodsemi- automatic
The corresponding transformation matrix was subsequently applied to the averaged late-frames PET image, and the manual coregistration was further improved.
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We recommend manual CT-based coregistration followed by a PET-based MI algorithm to overcome limitations of purely CT-based coregistrations for meaningful voxel-wise comparisons between PET and histopathology.
Although less elaborate, manual or visual coregistration seems to be more stable and less susceptible to these effects (Fig. 8).
MI based on the purely manual CT-based coregistration method ManReg showed systematically better agreement (R 2) between PET and histoPET in all patients except patient 4 where it was similar to ScalRegMI.
As suggested in literature [ 41], by using manual region-of-interest-based (ROI) analytical methods and MRI/PET coregistration methods, the temporal medial dysfunction should be highlighted.
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