Société Internationale d’Urologie Journal (Mar 2022)

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

  • Hannes Cash,
  • Sebastian Hofbauer,
  • Neal Shore,
  • Christian P. Pavlovich,
  • Stephan Bulang,
  • Martin Schostak,
  • Erik Planken,
  • Joris J. Jaspars,
  • Ferdinand Luger,
  • Laurence Klotz,
  • Georg Salomon

DOI
https://doi.org/10.48083/KKVJ7280
Journal volume & issue
Vol. 3, no. 2
pp. 62 – 68

Abstract

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ObjectiveMicro-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. MethodsA 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. ResultsThirteen 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. ConclusionThe 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.

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