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Objectives <p>This study compared three online training methods to enhance diagnostic performance, reader confidence, and interreader agreement in membranous urethral length (MUL) measurements.</p> Materials and methods <p>Ninety-nine study participants were asked to measure the MUL on 20 test cases at the start of the study and rated their confidence level. Participants were then divided semi-randomly into three training groups: Group A (written instructions), Group B (1-month self-study program with case feedback using a dedicated web platform), and Group C (1-day online expert-led case-based training). Groups B and C worked through an identical set of 40 cases. One week after completing training, participants evaluated the same 20 test cases. Diagnostic performance (using expert reference standard), interreader agreement (intraclass correlation coefficient, ICC), and reader confidence levels were compared before and after training. Participants completed a questionnaire evaluating their perceptions of the training.</p> Results <p>Eighty-one participants (82%) completed the study. All groups demonstrated significant improvements in diagnostic performance and confidence (<i>p</i> &lt; 0.001), with similar outcomes across training groups. Interreader agreement improved from ICC 0.52–0.56 pre-training to 0.74–0.80 post-training. Questionnaire responses indicated most found the training appropriate; however, 17% of Group A felt it was insufficient, while 30–35% of Group C found the expert-led training too time-consuming.</p> Conclusion <p>All training methods—ranging from minimal, with written instructions only, to more comprehensive case-based programs—effectively improved diagnostic performance, reader confidence and interreader agreement for MUL measurements on prostate MRI. Independent online training offers practical advantages over more time-demanding hands-on sessions, supporting broader clinical implementation of MUL-based individualized continence prediction.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>Which method of online training is most effective to train radiologists in measuring the membranous urethral length (MUL) on prostate MRI?</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>81 radiologists showed significant gains in diagnostic performance, confidence and interreader agreement, with similar results after written instructions, case-based self-study, or hands-on expert-led training</i>.</p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>Enhanced accuracy and interreader consistency achieved through online training can facilitate wider clinical adoption of MUL-based continence prediction, strengthening patient counseling and shared decision making in prostate cancer management</i>.</p> Graphical Abstract <p></p>

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Improving membranous urethral length measurements on prostate MRI: a comparison of online training methods

  • 期刊论文

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  • 发表日期：

    2026年3月31日

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  • Elisabeth P. Goedegebuure,
  • Thierry N. Boellaard,
  • Margriet C. van Dijk-de Haan,
  • Stijn W. T. P. J. Heijmink,
  • Marinus J. Hagens,
  • Renaud Tissier,
  • Joost J. M. van Griethuysen,
  • Artem Khmelinkskii,
  • Regina G. H. Beets-Tan,
  • Ivo G. Schoots,
  • Doenja M. J. Lambregts,
  • Georgios Agrotis,
  • Eduardo Alvarez-Hornia,
  • Yuki Arita,
  • Giacomo Avesani,
  • Remco C. Baerveldt,
  • Tristan Barrett,
  • Giorgio Brembilla,
  • Annemarie Bruining,
  • Iztok Caglic,
  • Donna Zhan Chen,
  • Giuseppe Di Costanzo,
  • Renato Cuocolo,
  • Pieter De Visschere,
  • Marta Duczkowska,
  • Selahattin Durmaz,
  • Hanna Falińska,
  • Valerio Forte,
  • Paolo Niccolò Franco,
  • Manca Garbajs,
  • Alejandra García-Baizán,
  • José Carlos García-Gil García,
  • Caterina Gaudiano,
  • Remy W. F. Geenen,
  • Anil Kumar Geetha Virupakshappa,
  • Rossano Girometti,
  • Matilde L. R. R. Gonçalves,
  • Maureen E. Groote,
  • Eline Hanrath-Vos,
  • Jonathan Hernández-Mancera,
  • Huseyin Kasap,
  • Bas-Jeroen van Kelckhoven,
  • Carolien Kobus,
  • Kang-Lung Lee,
  • Mariano Lorea,
  • Cindy Mai,
  • Patricia María José Manganaro,
  • Luigi Mannacio,
  • Benedetta Masci,
  • Vuk Matic,
  • Sabrina de Mello Ando,
  • Iris Minis-Rutten,
  • Ana Sofia L. Moreira,
  • Joost Nederend,
  • Jorrit Noordmans,
  • Verena C. Obmann,
  • Jorge Alberto Ocantos,
  • Radin-Darius Onit,
  • Niek van Oorschot,
  • Thijs van Oudheusden,
  • Andrea Ponsiglione,
  • Hendricus P. J. Raat,
  • Alout Ramselaar,
  • Rinze Reinhard,
  • Rafael Salvador Izquierdo,
  • Lex J. Schouten,
  • Amreen Shakur,
  • Katarina Kaja Šifer,
  • Miguel C. Silva,
  • Ruth S. Smit,
  • Evsen Polattas Solak,
  • Arjuna Somasundaram,
  • Inne Somers,
  • Arnaldo Stanzione,
  • Rogier S. A. van Stiphout,
  • Milton Josué Tapia Proaño,
  • Carolina Terra,
  • Mariliis Tiidermann,
  • Suzanne Tol,
  • Ali Çağlar Turgut,
  • Stephan Ursprung,
  • Nicolae Vainak,
  • Sandra Vennix,
  • Eric Verhoeff,
  • Miha Vesel,
  • Marianne J. Voogt,
  • Steven F. de Walle,
  • Emilie A. M. Weimar,
  • Paul P. van Westerveld,
  • Bart W. K. de Wit,
  • Samuel Withey,
  • Marta Zerunian

摘要

Objectives

This study compared three online training methods to enhance diagnostic performance, reader confidence, and interreader agreement in membranous urethral length (MUL) measurements.

Materials and methods

Ninety-nine study participants were asked to measure the MUL on 20 test cases at the start of the study and rated their confidence level. Participants were then divided semi-randomly into three training groups: Group A (written instructions), Group B (1-month self-study program with case feedback using a dedicated web platform), and Group C (1-day online expert-led case-based training). Groups B and C worked through an identical set of 40 cases. One week after completing training, participants evaluated the same 20 test cases. Diagnostic performance (using expert reference standard), interreader agreement (intraclass correlation coefficient, ICC), and reader confidence levels were compared before and after training. Participants completed a questionnaire evaluating their perceptions of the training.

Results

Eighty-one participants (82%) completed the study. All groups demonstrated significant improvements in diagnostic performance and confidence (p < 0.001), with similar outcomes across training groups. Interreader agreement improved from ICC 0.52–0.56 pre-training to 0.74–0.80 post-training. Questionnaire responses indicated most found the training appropriate; however, 17% of Group A felt it was insufficient, while 30–35% of Group C found the expert-led training too time-consuming.

Conclusion

All training methods—ranging from minimal, with written instructions only, to more comprehensive case-based programs—effectively improved diagnostic performance, reader confidence and interreader agreement for MUL measurements on prostate MRI. Independent online training offers practical advantages over more time-demanding hands-on sessions, supporting broader clinical implementation of MUL-based individualized continence prediction.

Key Points

Question Which method of online training is most effective to train radiologists in measuring the membranous urethral length (MUL) on prostate MRI?

Findings 81 radiologists showed significant gains in diagnostic performance, confidence and interreader agreement, with similar results after written instructions, case-based self-study, or hands-on expert-led training.

Clinical relevance Enhanced accuracy and interreader consistency achieved through online training can facilitate wider clinical adoption of MUL-based continence prediction, strengthening patient counseling and shared decision making in prostate cancer management.

Graphical Abstract