Prostate MRI learning curves: establishing training benchmarks for radiology and urology trainees
摘要
Evidence-based training benchmarks for prostate multiparametric MRI (mpMRI) interpretation remain undefined amid growing educational demands. We compared learning curves between radiology and urology trainees and quantified the impact of prior radiological experience.
Materials and methodsFourteen trainees (10 radiology, median 2.7 years experience; 4 urology, no imaging experience), all naïve to prostate mpMRI, prospectively interpreted 200 cases using a feedback-based platform. Performance metrics included agreement with expert consensus reference for PI-RADSv2.1 (≥ 3), PI-QUALv2 image quality, extraprostatic extension (EPE) grading, and readout time. Learning curves were modeled using generalized estimating equations; segmented regression identified inflection points; bootstrapping generated 95% CIs.
ResultsPrior radiological experience showed no significant impact on PI-RADSv2.1 (OR per year 1.06 [95% CI: 0.96, 1.16]) or PI-QUALv2 (1.05 [0.99, 1.23]), with a minor effect on EPE grading (1.11 [1.03, 1.24]). Final PI-RADSv2.1 agreement with reference was similar (urology 80.9%, radiology 77.4%; OR 1.24 [0.55, 3.10]), with sensitivity/specificity 0.84/0.80 and 0.83/0.79, and Cohen’s κ values (0.64 and 0.61) matching inter-expert κ = 0.63. Learning plateaued after 69–75 cases. Urology trainees demonstrated higher baseline PI-QUALv2/EPE agreement (OR 2.01 [1.35, 3.02] and 1.90 [1.11, 2.93]), but radiology trainees achieved similar final performance (PI-QUALv2: 88.0% vs 89.9%, OR 0.82 [0.35, 1.72]; EPE: 84.6% vs 90.0%, OR 0.61 [0.31, 1.42]). Readout times decreased markedly in both groups (final difference 53.3 s [−9.4, 95.9]).
ConclusionFeedback-based training enabled similar prostate mpMRI interpretation performance across specialties, with most learning within 75 cases. Prior radiological experience had a limited impact. These empirical benchmarks inform certification standards and early-residency curricula in radiology and urology.
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