Learning curve on prostate fusion biopsies: key insights.

Abstract

Purpose: MRI-guided prostate biopsies offering improved accuracy in detecting clinically significant cancer. Image fusion (IF) techniques have shown promise, but their adoption requires overcoming a learning curve. This study evaluates the impact of operator experience on prostate biopsy outcomes using the HITACHI ultrasound system.

Methods: This study was conducted from September 2016 to March 2020, including 148 patients undergoing mpMRI and targeted biopsies. The patients were grouped into Early (first 50 cases), Intermediate (cases 51-100), and Late (cases 101-148) phases, based on operator experience. Biopsy outcomes, including cancer detection rates, procedure times, and false-negative rates, were analyzed across these phases.

Results: A significant learning curve was observed. In the Early phase, the detection rate for clinically significant cancers was 12%, increasing to 18% in the Intermediate phase and 25% in the Late phase. The overall positivity rate rose from 30 to 45%, while procedure times decreased from 45 to 30 min. Sensitivity for detecting clinically significant cancer improved from 60 to 85%, showing enhanced accuracy with operator experience.

Conclusion: Operator experience plays a crucial role in improving prostate biopsy outcomes using IF techniques. As proficiency increased, both cancer detection rates and procedural efficiency improved. These findings emphasize the need for adequate training and experience to optimize results and ensure the full benefits of fusion biopsy technologies in prostate cancer diagnosis.