A learning curve assessment of real-time sonoelastography of the prostate

To examine how much practice is essential to properly perform real-time sonoelastography (RTE) in the detection of PC.

RTE of the prostate was performed in 60 PC patients prior to radical prostatectomy (RP). All patients were examined by a novice and an expert observer in a blinded fashion. The novice's results were validated with the results of the expert. Kappa indexes, sensitivities, specificities as well as the duration of the examination were assessed. Learning curves (LC) were obtained by assessment of 16 (LC A) and eight (LC B) prostate sectors. Cochrane-Armitage trend test, Chi(2) test and t test for paired samples were used.

For the 16-sector method (LC A), overall sensitivity and specificity were 58.2 and 77.7 % and, for the 8-sector method, 68.3 and 64.5 %, respectively. For LC A, sensitivity rose over the whole study period (p = 0.0055). As a result, no learning plateau was reached. In contrast, a learning plateau with no constant rise in sensitivity (p = 0.4667) was reached for LC B after 30 examined patients. The mean examination time for both observers was 7.9 min (±3.7).

When being trained by an expert examiner, skills in RTE of the prostate can be obtained quickly. Performed by a trained examiner, the examination itself is little time-consuming. Thus, RTE represents a user- and patient-friendly tool that can easily be integrated into the day-to-day practice of urologists.