Objective: To assess the effect of interactive dedicated training on radiology fellows' accuracy in assessing prostate cancer on MRI.
Methods: Eleven radiology fellows, blinded to clinical and pathological data, independently interpreted preoperative prostate MRI studies, scoring the likelihood of tumour in the peripheral and transition zones and extracapsular extension. Each fellow interpreted 15 studies before dedicated training (to supply baseline interpretation accuracy) and 200 studies (10/week) after attending didactic lectures. Expert radiologists led weekly interactive tutorials comparing fellows' interpretations to pathological tumour maps. To assess interpretation accuracy, receiver operating characteristic (ROC) analysis was conducted, using pathological findings as the reference standard.
Results: In identifying peripheral zone tumour, fellows' average area under the ROC curve (AUC) increased from 0.52 to 0.66 (after didactic lectures; p<0.0001) and remained at 0.66 (end of training; p<0.0001); in the transition zone, their average AUC increased from 0.49 to 0.64 (after didactic lectures; p=0.01) and to 0.68 (end of training; p=0.001). In detecting extracapsular extension, their average AUC increased from 0.50 to 0.67 (after didactic lectures; p=0.003) and to 0.81 (end of training; p<0.0001).
Conclusion: Interactive dedicated training significantly improved accuracy in tumour localization and especially in detecting extracapsular extension on prostate MRI.