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There is a need for identifying quantitative imaging (e.g. MRI) signatures for prostate cancer (CaP), so that
computer-aided diagnostic methods can be trained to detect disease extent in vivo. Determining CaP extent
on in vivo MRI is difficult to do; however, with the availability of ex vivo surgical whole mount histological
sections (WMHS) for CaP patients undergoing radical prostatectomy, co-registration methods can be applied to
align and map disease extent onto pre-operative MR imaging from the post-operative histology. Yet obtaining
digitized images of WHMS for co-registration with the pre-operative MRI is cumbersome since (a) most digital
slide scanners are unable to accommodate the entire section, and (b) significant technical expertise is required
for whole mount slide preparation. Consequently, most centers opt to construct quartered sections of each
histology slice. Prior to co-registration with MRI, however, these quartered sections need to be digitally stitched
together to reconstitute a digital, pseudo WMHS. Histostitcher© is an interactive software program that uses
semi-automatic registration tools to digitally stitch quartered sections into pseudo WMHS. Histostitcher© was
originally developed using the GUI tools provided by the Matlab programming interface, but the clinical use was
limited due to the inefficiency of the interface. The limitations of the Matlab based GUI include (a) an inability to
edit the fiducials, (b) the rendering being extremely slow, and (c) lack of interactive and rapid visualization tools.
In this work, Histostitcher© has been integrated into the eXtensible Imaging Platform (XIP
TM
) framework (a set
of libraries containing functionalities for analyzing and visualizing medical image data). XIP
TM
lends the stitching
tool much greater flexibility and functionality by (a) allowing interactive and seamless navigation through the
full resolution histology images, (b) the ability to easily add, edit, or remove fiducials and annotations in order
to register the quadrants and map the disease extent. In this work, we showcase examples of digital stitching of
quartered histological sections into pseudo-WHMS using Histostitcher © via the new XIP
TM
interface. This tool
will be particularly useful in clinical trials and large cohort studies where a quick, interactive way of digitally
reconstructing pseudo WMHS is required.
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