  Purpose: The fusion of transrectal ultrasound (TRUS) and magnetic resonance
(MR) images for guiding targeted prostate biopsy has significantly improved the
biopsy yield of aggressive cancers. A key component of MR-TRUS fusion is image
registration. However, it is very challenging to obtain a robust automatic
MR-TRUS registration due to the large appearance difference between the two
imaging modalities. The work presented in this paper aims to tackle this
problem by addressing two challenges: (i) the definition of a suitable
similarity metric and (ii) the determination of a suitable optimization
strategy.
  Methods: This work proposes the use of a deep convolutional neural network to
learn a similarity metric for MR-TRUS registration. We also use a composite
optimization strategy that explores the solution space in order to search for a
suitable initialization for the second-order optimization of the learned
metric. Further, a multi-pass approach is used in order to smooth the metric
for optimization.
  Results: The learned similarity metric outperforms the classical mutual
information and also the state-of-the-art MIND feature based methods. The
results indicate that the overall registration framework has a large capture
range. The proposed deep similarity metric based approach obtained a mean TRE
of 3.86mm (with an initial TRE of 16mm) for this challenging problem.
  Conclusion: A similarity metric that is learned using a deep neural network
can be used to assess the quality of any given image registration and can be
used in conjunction with the aforementioned optimization framework to perform
automatic registration that is robust to poor initialization.
