{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:15Z","timestamp":1788847635898,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005941","name":"Dietmar Hopp Stiftung","doi-asserted-by":"publisher","award":["1DH2311194"],"award-info":[{"award-number":["1DH2311194"]}],"id":[{"id":"10.13039\/501100005941","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether a structured 2\u2010day micro\u2010ultrasonography (microUS) training curriculum improves diagnostic performance and management decisions for clinically significant prostate cancer (csPCa) detection in novice readers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>A total of 20 participants with limited microUS experience completed the Mannheim Micro\u2010Ultrasound Curriculum, comprising didactic modules, supervised case interpretation, and 85 reference cases. Pre\u2010 and post\u2010training performance was assessed on a fixed, biopsy confirmed test set of 100 cases (50 csPCa confirmed on radical prostatectomy, 50 biopsy negative). Each participant interpreted 10 randomised cases per timepoint, with no case assessed twice per reader and each case being assessed once before and after training in each training session. The primary endpoint was change in cohort\u2010level accuracy for csPCa detection; secondary endpoints included sensitivity, specificity, predictive values, area under the receiver operating characteristic curve (AUC), Prostate Risk Identification using microUS (PRI\u2010MUS) performance, and management recommendations. Mixed\u2010effects models were applied as a robustness analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Training significantly improved pooled cohort level accuracy from 50.5% (95% confidence interval [CI] 43.4\u201357.6%) to 64.5% (95% CI 57.4\u201371.1%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), sensitivity from 70.0% (95% CI 60.0\u201378.8%) to 92.0% (95% CI 84.8\u201396.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), and negative predictive value from 50.8% (95% CI 37.7\u201363.9%) to 82.2% (95% CI 67.9\u201392.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), whereas specificity did not increase significantly (31.0% vs 37.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.46). The AUC for the overall subjective risk score rose from 0.53 (95% CI 0.45\u20130.61) to 0.70 (95% CI 0.63\u20130.77;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002). Mixed\u2010effects modelling confirmed a significant training effect (odds ratio 2.13, 95% CI 1.20\u20133.79;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01), reproducible across two independent sessions. PRI\u2010MUS scoring improvements were not statistically significant. Overall decision correctness improved from 67% to 83% (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), with poor\u2010quality decisions decreasing from 33% to 17%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Structured image\u2010based microUS training significantly improved cohort\u2010level diagnostic performance and management decisions in novice readers in a controlled reader\u2010study. These findings support structured training and quality assurance before independent clinical implementation of microUS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.70360","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:29:48Z","timestamp":1781843388000},"page":"630-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Structured micro\u2010ultrasonography training improves prostate cancer detection and management decisions"],"prefix":"10.1111","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8885-7505","authenticated-orcid":false,"given":"Maximilian Philip","family":"Wessendorf","sequence":"first","affiliation":[{"name":"German Cancer Research Centre (Deutsches Krebsforschungszentrum [DKFZ]) Heidelberg Intelligent Systems and Robotics in Urology  Heidelberg Germany"},{"name":"DKFZ Hector Cancer Institute at the University Medical Centre Mannheim  Heidelberg Germany"},{"name":"Department of Urology Mannheim University Medical Centre  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5594-0083","authenticated-orcid":false,"given":"Maurin Helen","family":"Mangold","sequence":"additional","affiliation":[{"name":"German Cancer Research Centre (Deutsches Krebsforschungszentrum [DKFZ]) Heidelberg Intelligent Systems and Robotics in Urology  Heidelberg Germany"},{"name":"DKFZ Hector Cancer Institute at the University Medical Centre Mannheim  Heidelberg Germany"},{"name":"Department of Urology Mannheim University Medical Centre  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8607-1179","authenticated-orcid":false,"given":"Gloria","family":"Baumann","sequence":"additional","affiliation":[{"name":"German Cancer Research Centre (Deutsches Krebsforschungszentrum [DKFZ]) Heidelberg Intelligent Systems and 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