Improving membranous urethral length measurements on prostate MRI: a comparison of online training methods
Year: 2026
Type: article
Abstract: OBJECTIVES: This study compared three online training methods to enhance diagnostic performance, reader confidence, and interreader agreement in membranous urethral length (MUL) measurements. MATERIALS AND METHODS: Ninety-nine study participants were asked to measure the MUL on 20 test cases at the start of the study and rated their confidence level. Participants were then divided semi-randomly into three training groups: Group A (written instructions), Group B (1-month self-study program with case feedback using a dedicated web platform), and Group C (1-day online expert-led case-based training). Groups B and C worked through an identical set of 40 cases. One week after completing training, participants evaluated the same 20 test cases. Diagnostic performance (using expert reference standard), interreader agreement (intraclass correlation coefficient, ICC), and reader confidence levels were compared before and after training. Participants completed a questionnaire evaluating their perceptions of the training. RESULTS: Eighty-one participants (82%) completed the study. All groups demonstrated significant improvements in diagnostic performance and confidence (p < 0.001), with similar outcomes across training groups. Interreader agreement improved from ICC 0.52-0.56 pre-training to 0.74-0.80 post-training. Questionnaire responses indicated most found the training appropriate; however, 17% of Group A felt it was insufficient, while 30-35% of Group C found the expert-led training too time-consuming. CONCLUSION: All training methods-ranging from minimal, with written instructions only, to more comprehensive case-based programs-effectively improved diagnostic performance, reader confidence and interreader agreement for MUL measurements on prostate MRI. Independent online training offers practical advantages over more time-demanding hands-on sessions, supporting broader clinical implementation of MUL-based individualized continence prediction. KEY POINTS: Question Which method of online training is most effective to train radiologists in measuring the membranous urethral length (MUL) on prostate MRI? Findings 81 radiologists showed significant gains in diagnostic performance, confidence and interreader agreement, with similar results after written instructions, case-based self-study, or hands-on expert-led training. Clinical relevance Enhanced accuracy and interreader consistency achieved through online training can facilitate wider clinical adoption of MUL-based continence prediction, strengthening patient counseling and shared decision making in prostate cancer management.
Source: European Radiology
Authors: Elisabeth P. Goedegebuure, Thierry N. Boellaard, Margriet C. van Dijk-de Haan, Stijn W. T. P. J. Heijmink, Marinus J. Hagens, Renaud Tissier, Joost J. M. van Griethuysen, Artem Khmelinkskii, Regina G. H. Beets-Tan, Ivo G. Schoots, Doenja M. J. Lambregts, on behalf of the Membranous Urethral Length – Training and Interpretation (MUL-TI READ) collaborative, Georgios Agrotis, Eduardo Alvarez-Hornia, Yuki Arita, Giacomo Avesani, Remco C. Baerveldt, Tristan Barrett, Giorgio Brembilla, Annemarie Bruining, Iztok Caglic, Donna Zhan Chen, Giuseppe Di Costanzo, Renato Cuocolo, Pieter De Visschere, Marta Duczkowska, Selahattin Durmaz, Hanna Falińska, Valerio Forte, Paolo Niccolò Franco, Manca Garbajs, Alejandra García-Baizán, José Carlos García-Gil García, Caterina Gaudiano, Remy W. F. Geenen, Anil Kumar Geetha Virupakshappa, Rossano Girometti, Matilde L. R. R. Gonçalves, Maureen E. Groote, Eline Hanrath-Vos, Jonathan Hernández-Mancera, Huseyin Kasap, Bas-Jeroen van Kelckhoven, Carolien Kobus, Kang-Lung Lee, Mariano Lorea, Cindy Mai, Patricia María José Manganaro, Luigi Mannacio, Benedetta Masci, Vuk Matic, Sabrina de Mello Ando, Iris Minis-Rutten, Ana Sofia L. Moreira, Joost Nederend, Jorrit Noordmans, Verena C. Obmann, Jorge Alberto Ocantos, Radin-Darius Onit, Niek van Oorschot, Thijs van Oudheusden, Andrea Ponsiglione, Hendricus P. J. Raat, Alout Ramselaar, Rinze Reinhard, Rafael Salvador Izquierdo, Lex J. Schouten, Amreen Shakur, Katarina Kaja Šifer, Miguel C. Silva, Ruth S. Smit, Evsen Polattas Solak, Arjuna Somasundaram, Inne Somers, Arnaldo Stanzione, Rogier S. A. van Stiphout, Milton Josué Tapia Proaño, Carolina Terra, Mariliis Tiidermann, Suzanne Tol, Ali Çağlar Turgut, Stephan Ursprung, Nicolae Vainak, Sandra Vennix, Eric Verhoeff, Miha Vesel, Marianne J. Voogt, Steven F. de Walle, Emilie A. M. Weimar, Paul P. van Westerveld, Bart W. K. de Wit, Samuel Withey, Marta Zerunian
Institutions: The Netherlands Cancer Institute, Maastricht University, University Medical Center Utrecht, Erasmus MC, Universidad de Deusto, Memorial Sloan Kettering Cancer Center, University of California, San Francisco, Keio University, Agostino Gemelli University Polyclinic, Spaarne Gasthuis, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, University College Hospital, University College London Hospitals NHS Foundation Trust, University of Cambridge, University College London, Hospital Universitario de La Princesa, University of Salerno, Ghent University Hospital, Ghent University, Rigshospitalet, Gaziosmanpaşa Eğitim Ve Araştırma Hastanesi, Wojskowy Instytut Medyczny, University Hospital Complex Of Vigo, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, Noordwest Ziekenhuisgroep, Bedford Hospital NHS Trust, Bedford Hospital, University of Udine, Ospedale Santa Maria della Misericordia di Udine, Azienda sanitaria universitaria Friuli Centrale, Unidade Local de Saúde do Algarve, Sint Franciscus Gasthuis, Franciscus Vlietland, Elisabeth-TweeSteden Ziekenhuis, Puigvert Foundation, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, Hospital Italiano de Buenos Aires, Antwerp University Hospital, University of Naples Federico II, Azienda Ospedaliera Sant'Andrea, Sapienza University of Rome, Universidade de São Paulo, Hospital Universitário da Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Maastricht University Medical Centre, Catharina Ziekenhuis, University of Bern, University Hospital of Bern, Zug Cantonal Hospital, Elkerliek Ziekenhuis, Laurentius Ziekenhuis, OLVG, Hospital Clínic de Barcelona, Universitat de Barcelona, Universidade do Porto, Amsterdam UMC Location University of Amsterdam, Amsterdam University Medical Centers, Griffith University, Royal Brisbane and Women's Hospital, Unidade Local de Saúde de Santo António EPE, Tartu University Hospital, Ege University, University of Tübingen, Meander Medisch Centrum, Ziekenhuis Amstelland, Reinier de Graaf Hospital, Slingeland Ziekenhuis, Royal Marsden NHS Foundation Trust, Royal Marsden Hospital
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $2,890
Funders: Memorial Sloan-Kettering Cancer Center, University of Cambridge, University College London, Keio University, Cambridge University Hospitals, Universitair Ziekenhuis Gent, Universiteit Gent, KWF Kankerbestrijding, Rigshospitalet, Università degli Studi di Salerno, Università degli Studi di Udine, Wojskowy Instytut Medyczny, Universidad de Deusto, University of California, San Francisco, National Cancer Institute, Department of Radiology and Biomedical Imaging, University of California, San Francisco
OpenAlex ID: W7143713394