MP20-16 TRAINING AND SKILLS ASSESSMENT FOR FUSION-GUIDED PROSTATE BIOPSY: DEFINING THE LEARNING CURVE (2016)

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment II1 Apr 2016MP20-16 TRAINING AND SKILLS ASSESSMENT FOR FUSION-GUIDED PROSTATE BIOPSY: DEFINING THE LEARNING CURVE Akhil Muthigi, Arvin George, Daniel Su, Pingkun Yan, Jochen Kruecker, Harish Narayanan, Janice Thai, Meet Kadakia, Michael Kongnyuy, Amogh Iyer, Abhinav Sidana, Amichai Kilchevsky, Thomas Frye, Baris Turkbey, Peter Choyke, Bradford Wood, and Peter Pinto Akhil MuthigiAkhil Muthigi More articles by this author , Arvin GeorgeArvin George More articles by this author , Daniel SuDaniel Su More articles by this author , Pingkun YanPingkun Yan More articles by this author , Jochen KrueckerJochen Kruecker More articles by this author , Harish NarayananHarish Narayanan More articles by this author , Janice ThaiJanice Thai More articles by this author , Meet KadakiaMeet Kadakia More articles by this author , Michael KongnyuyMichael Kongnyuy More articles by this author , Amogh IyerAmogh Iyer More articles by this author , Abhinav SidanaAbhinav Sidana More articles by this author , Amichai KilchevskyAmichai Kilchevsky More articles by this author , Thomas FryeThomas Frye More articles by this author , Baris TurkbeyBaris Turkbey More articles by this author , Peter ChoykePeter Choyke More articles by this author , Bradford WoodBradford Wood More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2785AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Advances in multiparametric MRI combined with improved sampling by MR/TRUS fusion-guided prostate biopsy (FBx) have resulted in rapid adoption of this novel technology into the biopsy paradigm. FBx accuracy is dependent on a number of factors and acquired skills that vary by user experience. We aim to define the differences among users with varying levels of experience with a tracked fusion biopsy platform. METHODS 10 users within 5 different experience levels were asked to perform electromagnetically tracked FBx after completion of a standardized didactic and hands-on course. Experience levels included gold standard (>1000 FBx), Expert (50-100 FBx), urologists, radiology residents, and medical students without FBx experience. A prostate phantom model (CIRS Inc.) with 4 gold fiducial targets was segmented on T2 imaging. FBx of each target was performed using rigid registration with the UroNav system (Invivo Corp.) and then with ultrasound (US) only. Mechanical targeting error (MTE) was calculated as distance between the bullseye target and actual core location during FBx; fusion registration error (FRE) was the distance between MR target and transformed core location from the US only biopsy. Time to completion of each task during FBx was recorded. RESULTS Data from the initial trial for each user among experience levels is reported. Mean overall time to completion of FBx by the different experience level subgroups ranged from 13:14 to 37:42 [Figure 1a]. Range of mean MTE, a measure of ability to visualize and biopsy the target, was 0.79 mm-1.42 mm and did not correlate with user level (p=0.893) Mean FRE ranged from 3.03 mm in the gold standard group up to 6.12 mm in the medical student group. FRE demonstrated a linear relationship with user level and was significantly correlated (correlation coefficient 0.935, p<0.001) [Figure 1b]. CONCLUSIONS Fusion-guided biopsy is an acquired skillset with sufficient experience needed to provide an accurate sampling within a reasonable time. Characterization of the learning curve by experience level may help determine a standardized level of proficiency and core competencies for this new procedure, prior to employing it in clinical practice. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e219-e220 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Akhil Muthigi More articles by this author Arvin George More articles by this author Daniel Su More articles by this author Pingkun Yan More articles by this author Jochen Kruecker More articles by this author Harish Narayanan More articles by this author Janice Thai More articles by this author Meet Kadakia More articles by this author Michael Kongnyuy More articles by this author Amogh Iyer More articles by this author Abhinav Sidana More articles by this author Amichai Kilchevsky More articles by this author Thomas Frye More articles by this author Baris Turkbey More articles by this author Peter Choyke More articles by this author Bradford Wood More articles by this author Peter Pinto More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...