Mager R, Brandt M P, Borgmann H, Gust K M, Haferkamp A, Kurosch M
Department of Urology and Pediatric Urology, University Medical Center Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
Int Urol Nephrol. 2017 Sep;49(9):1537-1544. doi: 10.1007/s11255-017-1642-7. Epub 2017 Jun 23.
To investigate the learning curve of a novice in MRI/TRUS software fusion biopsy and to compare his results with the expert standard at our institution.
Overall 126 MRI/TRUS fusion-guided transrectal biopsies were performed using an electromagnetic tracking ultrasonography platform. The learning progress of the novice was evaluated comparing his initial 42 procedures (group A) with his following 42 (group B). The institution's expert standard (group C), which was compared to the novice's groups, was defined by the expert's experience of 42 MRI/TRUS fusion biopsies. Primary learning curve parameters were targeted biopsy detection quotient and biopsy time.
Overall detection of prostate cancer was 64% (27/42), 62% (26/42) and 62% (26/42) in groups A, B and C, respectively. The median target biopsy detection quotient significantly increased (p = 0.04) in group B (0.75, interquartile range (IQR) 0.25-1.0) compared to group A. (0.33, IQR 0.2-0.5). Group C revealed a median detection quotient of 0.5 (IQR 0.25-0.76) that did not differ significantly from the novice's groups (p = 0.2). Median biopsy time was significantly higher in group A (45 min, IQR 33-50 min) compared to groups B (25 min, IQR 23-29 min) and C (24 min, IQR 16-46 min) (p < 0.01).
The present study revealed the individual learning curve of a novice in MRI/TRUS fusion biopsy and demonstrated significant learning progress regarding targeted biopsy detection quotient and biopsy time.
研究新手在MRI/TRUS软件融合活检中的学习曲线，并将其结果与本机构的专家标准进行比较。
使用电磁跟踪超声平台进行了126例MRI/TRUS融合引导下的经直肠活检。通过比较新手最初的42例操作（A组）和随后的42例操作（B组）来评估其学习进展。与新手组进行比较的机构专家标准（C组）由专家进行的42例MRI/TRUS融合活检经验确定。主要学习曲线参数为靶向活检检测商数和活检时间。
A组、B组和C组前列腺癌的总体检出率分别为64%（27/42）、62%（26/42）和62%（26/42）。与A组（0.33，四分位间距（IQR）0.2 - 0.5）相比，B组（0.75，IQR 0.25 - 1.0）的中位靶向活检检测商数显著增加（p = 0.04）。C组的中位检测商数为0.5（IQR 0.25 - 0.76），与新手组无显著差异（p = 0.2）。A组的中位活检时间（45分钟，IQR 33 - 50分钟）显著高于B组（25分钟，IQR 23 - 29分钟）和C组（24分钟，IQR 16 - 46分钟）（p < 0.01）。
本研究揭示了新手在MRI/TRUS融合活检中的个体学习曲线，并在靶向活检检测商数和活检时间方面显示出显著的学习进展。
