Fig 1.
Swedish national prostate biopsy and MRI report template.
1) Side (sagittal) view of the prostate, 2) ventral (coronal) view of the prostate, 3) transverse (axial) sections A-C of pictures 1) and 2). The study participants used this diagram without the colour lines to plot the prostate tumor location. The correctly plotted tumor location of case 3 is shown in the diagram (pink areas). For the scoring system picture 1) was divided in an anterior and posterior half (green line), picture 2) in a right and left half (red line) and picture 3 A-C in quadrants (blue, orange, yellow, turquoise). (MRI) magnetic resonance imaging; (SV) seminal vesicle; (a) anterior; (p) posterior; broken lines in picture 1) mark the urethra.
Fig 2.
3D printed prostate models (case 1–3) used in the study.
The models were manufactured by 3D Systems, Inc. 5381 South Alkire Circle, Littleton, Colorado 80127 USA. Each prostate model contained a single prostate cancer lesion (pink colour). Tumor characteristics for case 1 were cT2, PI-RADS 5 (size 15x9x21 mm), mriT3, pT3a, Gleason 4+3 (tertiary grade 5); for case 2 cT2-3, PI-RADS 5 (size 19x12x17 mm), mriT3, pT2c, Gleason 4+3; and for case 3 T1c, PI-RADS 5 (size 27x11x21 mm), mriT3, pT2c, Gleason 3+3 (tertiary grade 4).
Fig 3.
Prostate cancer lesion of case 3 according to 3D printed prostate model, MRI and prostate template.
In (1) corresponding side (sagittal) views and (2) according to ventral (coronal) views in 3D printed prostate model and prostate template and different sequences of the corresponding axial view in MRI (corresponds to broken line in section B). (SV) seminal vesicle, (a) anterior, (p) posterior. Arrows indicate prostate cancer in MRI.
Table 1.
Overall total score (median with IQR) and the scores sub-classified for information tool A (written MRI report), information tool B (3D printed model) and information tool C (MRI presentation in MDT) in group 1 (expert urologists) and group 2 (medical students).
Table 2.
Scoring results (median with IQR) for group 1 (expert urologists) and group 2 (medical students), sub-classified for pictures 1–3 of the prostate template (side (sagittal) view, ventral (coronal) view, overall transverse (axial) view (ABC)) (s. Fig 1) in information tool A (written MRI report), information tool B (3D printed model) and information tool C (MRI presentation in MDT).
Table 3.
Summarized rates (%) of (A) major mistakes (s. Table 4A1) and (B) rates (%) of complete major accuracy (0% major mistakes) (s. Table 4A2) in group 1 (expert urologists) and group 2 (medical students) subdivided for information tools A-C.
Table 4.
(A1) rates (%) of major mistakes (total loss of 10 points) in 135 judgments (9 participants x 3 PCA cases x 5 views to judge/case = 135) sub-classified for the five different views in pictures 1–3 of the prostate template (Fig 1) and subdivided for group 1 (Expert urologist) and group 2 (Medical students), and (A2) rates of complete major accuracy (0% major mistakes) out of 27 judgments (9 participants x 3 PCA cases) in the experts and medical students group subdivided for information tool A (Written MRI report), information tool B (3D printed model) and information tool C (MRI presentation in MDT) respectively. (B) minus points (median with IQR) for minor mistakes in the experts und medical students group, sub-classified by (B1) type of minor mistake and by (B2) different views in pictures 1–3 of the prostate template (side (sagittal) view, ventral (coronal) view, transverse (axial) views (ABC)) in information tool A (Written MRI report), information tool B (3D printed model) and information tool C (MRI presentation in MDT).