Learning Curves of Fusion-Guided Biopsy and Prostate Segmentation in a Study of 14 Operators and 1721 Patients.

The study aimed to determine the number of procedures needed for achieving expertise in MRI-targeted prostate biopsy (MRI-TB) using image fusion with ultrasound. Data were collected from 1,721 patients over nine years, involving 31 practitioners using the Koelis system. Analysis showed that operators reached proficiency in ultrasound segmentation after about 40 cases and overall procedure efficiency after 50 cases. A CUSUM analysis indicated that 25 to 45 procedures were necessary to achieve a satisfactory detection rate for clinically significant prostate cancer (csCaP). Furthermore, pain management proficiency required experience from 20 to 100 cases, with 92% of patients reporting low pain scores (0-1). The findings suggest that performing at least 50 cases is essential for consistent clinical and technical outcomes.