Related Experiment Video
Updated: Sep 14, 2026
Transperineal Prostate Biopsy Using a Cone-shaped Double-hole Method with Dual-plane Probe Guidance
Published on: June 6, 2025
The battleship study: An innovation towards precision in prostate biopsy and brachytherapy grid usage
Vishen Naidoo1, Duvern Ramiah2, Marlon Perera3
1School of Clinical Medicine, Department of Surgery, Division-Urology University of the Witwatersrand Johannesburg South Africa.
Objectives:
This study aimed to compare the efficiency and accuracy of a conventional prostate brachytherapy grid with a novel Zebra grid using a laboratory-based simulation model (ProGrid model).
Methods:
This prospective and comparative experimental pilot study was conducted using a nonclinical brachytherapy simulation model (ProGrid Model). One hundred medical practitioners (Registrars and Consultants in Urology, Radiation Oncology and General Surgery) were recruited by randomization. Participants performed a series of predetermined coordinate needle insertions using either the conventional grid or the Zebra grid. Time taken to identify and accurately insert each coordinate was measured. Demographic and experiential variables were collected via questionnaire. The data were analysed using descriptive statistics, bivariate correlations and multiple regression modelling.
Results:
There were no significant differences between groups in baseline characteristics, including level of training, department, brachytherapy experience, gaming experience, hand dominance and use of prescription glasses. The Zebra grid demonstrated significantly reduced insertion times across all 10 coordinates compared to the conventional grid (p < 0.001). Mean overall time was significantly lower for the Zebra grid (3.675 ± 0.9 s) compared to the conventional grid (5.034 ± 1.4 s; p < 0.001). No statistically significant differences in accuracy of insertion in the desired grid coordinate were observed between the two grids. Multivariate analysis confirmed grid type as an independent predictor of reduced procedural time.
Conclusion:
The Zebra brachytherapy grid significantly improves procedural efficiency without compromising accuracy in a simulated setting. This low-cost, easily reproducible modification has the potential to reduce operating theatre (OT) time and improve workflow in PB. Further clinical studies are recommended to validate these findings and assess their impact on patient outcomes and healthcare resource utilization.
