Prostate Cancer Detection by Novice Micro-Ultrasound Users Enrolled in a Training Program

Objective Micro-ultrasound is an imaging modality used to visualize and target prostate cancer during transrectal or transperineal biopsy. We evaluated the effectiveness of a micro-ultrasound training program and estimated the learning curve for prostate biopsy. Methods A training program registry w...

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Bibliographic Details
Published in:	Société internationale d'urologie journal Vol. 3; no. 2; pp. 62 - 68
Main Authors:	Cash, Hannes, Hofbauer, Sebastian L., Shore, Neal, Pavlovich, Christian P., Bulang, Stephan, Schostak, Martin, Planken, Erik, Jaspars, Joris J., Luger, Ferdinand, Klotz, Laurence, Salomon, Georg
Format:	Journal Article
Language:	English
Published:	The Société Internationale d’Urologie (SIU) 08-03-2022
Subjects:	29mhz learning curve micro-ultrasound pri-mus prostate cancer targeted biopsy; prostate biopsy
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Summary:	Objective Micro-ultrasound is an imaging modality used to visualize and target prostate cancer during transrectal or transperineal biopsy. We evaluated the effectiveness of a micro-ultrasound training program and estimated the learning curve for prostate biopsy. Methods A training program registry was assessed for the rate of clinically significant prostate cancer (csPCa, grade group ≥ 2), negative predictive value, and specificity at each stage of the program. Nine metrics of biopsy quality were evaluated in 4 stages for each practitioner. Non-linear fitting and logistic regression models were used to evaluate the time-course of these metrics over training. Results Thirteen practitioners from 8 institutions completed stages 1 to 3 of the program, and 9 completed all 4 stages. Over 1190 micro-ultrasound biopsy procedures were performed. Detection of csPCa increased from 40% to 57% from stage 1 to stage 4 (P < 0.01). Stage 4 “expert” level was independently associated with higher detection of csPCa when correcting for overall risk factors (OR 1.95; P = 0.03). Limitations include the retrospective analysis and variation in biopsy protocols. Conclusion The micro-ultrasound training program was effective in improving biopsy quality and rate of csPCa detection. The presented learning curve provides an initial guide for acquiring expertise with real-time micro ultrasound image-guided biopsy.
ISSN:	2563-6499 2563-6499
DOI:	10.48083/KKVJ7280