Introduction: There are limited data on the learning curve of magnetic resonance imaging/transrectal ultrasound (MRI/TRUS)-fusion targeted prostate biopsies (tBx). Objective: The aim of this study was to investigate the difference in prostate cancer (PCa) detection rate between an experienced urologist and novice resident performing tBx. Methods: A total of 183 patients underwent tBx from 2012 to 2016 for a total of 518 tBx cores. Biopsies in this study were performed by an experienced urologist (investigator A) or a novice resident (investigator B). The outcome was the detection of PCa on tBx. Using a multivariable logistic regression model, we estimated odds ratios for the detection of PCa. Inverse probability treatment weighting (IPTW) was used to balance patients’ baseline characteristics and compare detection rates of PCa. Before performance of tBx, all patients underwent MRI. Results: On multivariable logistic regression analysis, investigator experience was associated with a higher odds of detection of PCa (OR = 1.003; 95% confidence interval 1.002–1.006, p = 0.037). After IPTW adjustment, there was no significant difference between the detection rate of investigator A (23%) and investigator B (32%; p = 0.457). Conclusions: Data revealed a positive association between investigator experience and the odds of PCa detection, although there was no difference in the detection rates of the investigators.

1.
Donovan
J
,
Hamdy
F
,
Neal
D
,
Peters
T
,
Oliver
S
,
Brindle
L
, et al.;
ProtecT Study Group
.
Prostate Testing for Cancer and Treatment (ProtecT) feasibility study
.
Health Technol Assess
.
2003
;
7
(
14
):
1
88
.
[PubMed]
1366-5278
2.
Kvåle
R
,
Møller
B
,
Wahlqvist
R
,
Fosså
SD
,
Berner
A
,
Busch
C
, et al.
Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study
.
BJU Int
.
2009
Jun
;
103
(
12
):
1647
54
.
[PubMed]
1464-4096
3.
Lecornet
E
,
Ahmed
HU
,
Hu
Y
,
Moore
CM
,
Nevoux
P
,
Barratt
D
, et al.
The accuracy of different biopsy strategies for the detection of clinically important prostate cancer: a computer simulation
.
J Urol
.
2012
Sep
;
188
(
3
):
974
80
.
[PubMed]
0022-5347
4.
Mottet
N
. (Chair) RCNvdB, E. Briers (Patient Representative), P. Cornford (Vice-chair), M. De Santis, S. Fanti, S. Gillessen, J. Grummet, A.M. Henry, T.B. Lam, M.D. Mason, T.H. van der Kwast, H.G. van der Poel, O. Rouvière, D. Tilki, T. Wiegel, Guidelines Associates: T. Van den Broeck MC, N. Fossati, T. Gross, M. Lardas, M. Liew, L. Moris, I.G. Schoots, P-P.M. Willemse. EAU Guidelines. Edn. presented at the EAU Annual Congress Barcelona 2019. ISBN 978-94-92671-04-2.
2019
5.
Roethke
M
,
Anastasiadis
AG
,
Lichy
M
,
Werner
M
,
Wagner
P
,
Kruck
S
, et al.
MRI-guided prostate biopsy detects clinically significant cancer: analysis of a cohort of 100 patients after previous negative TRUS biopsy
.
World J Urol
.
2012
Apr
;
30
(
2
):
213
8
.
[PubMed]
0724-4983
6.
D’Amico
AV
,
Tempany
CM
,
Cormack
R
,
Hata
N
,
Jinzaki
M
,
Tuncali
K
, et al.
Transperineal magnetic resonance image guided prostate biopsy
.
J Urol
.
2000
Aug
;
164
(
2
):
385
7
.
[PubMed]
0022-5347
7.
Sonn
GA
,
Chang
E
,
Natarajan
S
,
Margolis
DJ
,
Macairan
M
,
Lieu
P
, et al.
Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen
.
Eur Urol
.
2014
Apr
;
65
(
4
):
809
15
.
[PubMed]
0302-2838
8.
Delongchamps
NB
,
Peyromaure
M
,
Schull
A
,
Beuvon
F
,
Bouazza
N
,
Flam
T
, et al.
Prebiopsy magnetic resonance imaging and prostate cancer detection: comparison of random and targeted biopsies
.
J Urol
.
2013
Feb
;
189
(
2
):
493
9
.
[PubMed]
0022-5347
9.
Siddiqui
MM
,
Rais-Bahrami
S
,
Turkbey
B
,
George
AK
,
Rothwax
J
,
Shakir
N
, et al.
Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer
.
JAMA
.
2015
Jan
;
313
(
4
):
390
7
.
[PubMed]
0098-7484
10.
Kasivisvanathan
V
,
Rannikko
AS
,
Borghi
M
,
Panebianco
V
,
Mynderse
LA
,
Vaarala
MH
, et al.;
PRECISION Study Group Collaborators
.
MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis
.
N Engl J Med
.
2018
May
;
378
(
19
):
1767
77
.
[PubMed]
0028-4793
11.
Borkowetz
A
,
Renner
T
,
Platzek
I
,
Toma
M
,
Herout
R
,
Baunacke
M
, et al.
Evaluation of Transperineal Magnetic Resonance Imaging/Ultrasound-Fusion Biopsy Compared to Transrectal Systematic Biopsy in the Prediction of Tumour Aggressiveness in Patients with Previously Negative Biopsy
.
Urol Int
.
2019
;
102
(
1
):
20
6
.
[PubMed]
0042-1138
12.
Kuru
TH
,
Roethke
MC
,
Seidenader
J
,
Simpfendörfer
T
,
Boxler
S
,
Alammar
K
, et al.
Critical evaluation of magnetic resonance imaging targeted, transrectal ultrasound guided transperineal fusion biopsy for detection of prostate cancer
.
J Urol
.
2013
Oct
;
190
(
4
):
1380
6
.
[PubMed]
0022-5347
13.
Calio
B
,
Sidana
A
,
Sugano
D
,
Gaur
S
,
Jain
A
,
Maruf
M
, et al.
Changes in prostate cancer detection rate of MRI-TRUS fusion vs systematic biopsy over time: evidence of a learning curve
.
Prostate Cancer Prostatic Dis
.
2017
Dec
;
20
(
4
):
436
41
.
[PubMed]
1365-7852
14.
Epstein
JI
,
Walsh
PC
,
Carmichael
M
,
Brendler
CB
.
Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer
.
JAMA
.
1994
Feb
;
271
(
5
):
368
74
.
[PubMed]
0098-7484
15.
Röthke
M
,
Blondin
D
,
Schlemmer
HP
,
Franiel
T
.
[PI-RADS classification: structured reporting for MRI of the prostate]
.
Rofo
.
2013
Mar
;
185
(
3
):
253
61
.
[PubMed]
1438-9010
16.
Mager
R
,
Brandt
MP
,
Borgmann
H
,
Gust
KM
,
Haferkamp
A
,
Kurosch
M
.
From novice to expert: analyzing the learning curve for MRI-transrectal ultrasonography fusion-guided transrectal prostate biopsy
.
Int Urol Nephrol
.
2017
Sep
;
49
(
9
):
1537
44
.
[PubMed]
0301-1623
17.
Cash
H
,
Günzel
K
,
Maxeiner
A
,
Stephan
C
,
Fischer
T
,
Durmus
T
, et al.
Prostate cancer detection on transrectal ultrasonography-guided random biopsy despite negative real-time magnetic resonance imaging/ultrasonography fusion-guided targeted biopsy: reasons for targeted biopsy failure
.
BJU Int
.
2016
Jul
;
118
(
1
):
35
43
.
[PubMed]
1464-4096
18.
Latchamsetty
KC
,
Borden
LS
 Jr
,
Porter
CR
,
Lacrampe
M
,
Vaughan
M
,
Lin
E
, et al.
Experience improves staging accuracy of endorectal magnetic resonance imaging in prostate cancer: what is the learning curve?
Can J Urol
.
2007
Feb
;
14
(
1
):
3429
34
.
[PubMed]
1195-9479
19.
Akin
O
,
Riedl
CC
,
Ishill
NM
,
Moskowitz
CS
,
Zhang
J
,
Hricak
H
.
Interactive dedicated training curriculum improves accuracy in the interpretation of MR imaging of prostate cancer
.
Eur Radiol
.
2010
Apr
;
20
(
4
):
995
1002
.
[PubMed]
0938-7994
20.
Borofsky
S
,
George
AK
,
Gaur
S
,
Bernardo
M
,
Greer
MD
,
Mertan
FV
, et al.
What Are We Missing? False-Negative Cancers at Multiparametric MR Imaging of the Prostate
.
Radiology
.
2018
Jan
;
286
(
1
):
186
95
.
[PubMed]
0033-8419
21.
Moldovan
PC
,
Van den Broeck
T
,
Sylvester
R
,
Marconi
L
,
Bellmunt
J
,
van den Bergh
RC
, et al.
What Is the Negative Predictive Value of Multiparametric Magnetic Resonance Imaging in Excluding Prostate Cancer at Biopsy? A Systematic Review and Meta-analysis from the European Association of Urology Prostate Cancer Guidelines Panel
.
Eur Urol
.
2017
Aug
;
72
(
2
):
250
66
.
[PubMed]
0302-2838
22.
Sonn
GA
,
Fan
RE
,
Ghanouni
P
,
Wang
NN
,
Brooks
JD
,
Loening
AM
, et al.
Prostate Magnetic Resonance Imaging Interpretation Varies Substantially Across Radiologists
.
Eur Urol Focus
.
2017
.
[PubMed]
2405-4569
23.
Gaziev
G
,
Wadhwa
K
,
Barrett
T
,
Koo
BC
,
Gallagher
FA
,
Serrao
E
, et al.
Defining the learning curve for multiparametric magnetic resonance imaging (MRI) of the prostate using MRI-transrectal ultrasonography (TRUS) fusion-guided transperineal prostate biopsies as a validation tool
.
BJU Int
.
2016
Jan
;
117
(
1
):
80
6
.
[PubMed]
1464-4096
24.
Toner
L
,
Weerakoon
M
,
Bolton
DM
,
Ryan
A
,
Katelaris
N
,
Lawrentschuk
N
.
Magnetic resonance imaging for prostate cancer: comparative studies including radical prostatectomy specimens and template transperineal biopsy
.
Prostate Int
.
2015
Dec
;
3
(
4
):
107
14
.
[PubMed]
2287-8882
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.