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Deep learning for prostate intervention: Recent advances in non-rigid magnetic resonance imaging–transrectal ultrasound image registration

Peiyu Chen, Xudong Guo


School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200093, China.


Address correspondence to: Xudong Guo, School of Health Science and Engineering, University of Shanghai for Science and Technology, No. 516 Jungong Road, Yangpu District, Shanghai 200093, China. E-mail: guoxd@usst.edu.cn.


DOI: https://doi.org/10.61189/692164snwggk


Received December 29, 2025; Accepted March 6, 2026; Published June 26, 2026


Highlights

● This review systematically reviews the evolution of deep learning-based non-rigid prostate magnetic resonance imaging–transrectal ultrasound registration.

● This review analyzes dominant paradigms: hybrid convolutional neural networks, generative adversarial networks/diffusion models, and transformers.

● This review explores integrating anatomical priors and physical constraints to address label scarcity.

● This review critically evaluates the generalization gap between state-of-the-art benchmarks and clinical workflows.

● This review proposes future directions in physics-aware artificial intelligence and intelligent robotic interventions.

Abstract

The treatment of prostate cancer (PCa) is shifting towards the use of highly accurate image-guided procedures in order to achieve better oncologic results. A common strategy consists of using both pre-operative multiparametric magnetic resonance imaging and intra-operative transrectal ultrasound during a prostate biopsy or focal ablation procedure, thus offering enhanced localisation information through high spatial resolution and dynamic response, respectively. However, reliable non-rigid registration is still technically challenging owing to differences in cross-modal imaging physics as well as large deformations between the two modalities caused by rectal probe compression; this paper reviews how deep learning has evolved, focusing on convolutional neural networks, generative models, including generative adversarial networks and diffusion models, and transformer-based architectures. We discuss the extent to which they utilise biomechanical priors to inform the solution of registration problems, against standardized challenges such as µ-RegPro. State-of-the-art approaches achieve sub-millimetre target registration errors with real-time inference times for intra-operative deployment. Addressing outstanding challenges related to interpretation and generalization, this review provides an outlook of the road map to develop "physics-aware" smart interventional systems. All these developments represent important steps toward a fully automated, precise, and minimally invasive PCa management pipeline.

Keywords: Deep learning, Image registration, Non-rigid, Transrectal ultrasound, Magnetic resonance imaging

Cite

Chen PY, Guo XD. Deep learning for prostate intervention: Recent advances in non-rigid magnetic resonance imaging–transrectal ultrasound image registration. Prog Med Devices. 2026 Jun; 4 (2): 165-177. doi:10.61189/692164snwggk

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