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Heetman JG, Lavalaye J, Polm PD, Soeterik TFW, Wever L, Paulino Pereira LJ, van der Hoeven EJRJ, van Melick HHE, van den Bergh RCN. Gallium-68 Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Active Surveillance for Prostate Cancer Trial (PASPoRT). Eur Urol Oncol 2024; 7:204-210. [PMID: 37296065 DOI: 10.1016/j.euo.2023.05.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/24/2023] [Accepted: 05/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The use of clinical parameters, including prebiopsy magnetic resonance imaging (MRI), to decide between active surveillance (AS) and active therapy for prostate cancer (PCa) leads to imperfect selection. Additional prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) imaging may improve risk stratification. OBJECTIVE To study risk stratification and patient selection for AS with the addition of PSMA PET/CT to standard practice. DESIGN, SETTING, AND PARTICIPANTS A single-centre prospective cohort study (NL69880.100.19) enrolled patients recently diagnosed with PCa who started AS. At diagnosis, all participants had undergone prebiopsy MRI and targeted biopsy for visualised lesions. Patients underwent an additional [68Ga]-PSMA PET/CT and targeted biopsy of all PSMA lesions with a maximum standardised uptake value (SUVmax) of ≥4 not covered by previous biopsies. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was the number needed to scan (NNS) to detect one patient with upgrading. The study was powered to detect an NNS of 10. Regarding secondary outcomes, univariate logistic regressions analyses were performed on all patients and on the patients who received additional PSMA targeted biopsies on the likelihood of upgrading. RESULTS AND LIMITATIONS A total of 141 patients were included. Additional PSMA targeted biopsies were performed in 45 (32%) patients. In 13 (9%) patients, upgrading was detected: nine grade group (GG) 2, two GG 3, one GG 4, and one GG 5. The NNS was 11 (95% confidence interval 6-18). Of all participants, PSMA PET/CT and targeted biopsies yielded upgrading most frequently in patients with negative MRI (Prostate Imaging Reporting and Data System [PI-RADS] 1-2). Of patients who received additional PSMA targeted biopsies, upgrading was most frequently found in those with higher prostate-specific antigen density and negative MRI. Limitations included the lack of comparison with standard repeat biopsy, no central review of MRI, and possibility of biopsy sampling error. CONCLUSIONS PSMA PET/CT can further improve PCa risk stratification and selection for AS patients diagnosed after MRI and targeted biopsies. PATIENT SUMMARY Prostate-specific membrane antigen positron emission tomography/computed tomography and additional targeted prostate biopsies can identify more aggressive prostate cancer cases previously missed in patients recently started with expectant management for favourable-risk prostate cancer.
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Affiliation(s)
- Joris G Heetman
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands.
| | - Jules Lavalaye
- Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Pepijn D Polm
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Timo F W Soeterik
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Lieke Wever
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | | | | | - Harm H E van Melick
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
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Heetman JG, van der Hoeven EJRJ, Rajwa P, Zattoni F, Kesch C, Shariat S, Dal Moro F, Novara G, La Bombara G, Sattin F, von Ostau N, Pötsch N, Baltzer PAT, Wever L, Van Basten JPA, Van Melick HHE, Van den Bergh RCN, Gandaglia G, Soeterik TFW. External validation of nomograms including MRI features for the prediction of side-specific extraprostatic extension. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00738-3. [PMID: 37932522 DOI: 10.1038/s41391-023-00738-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/14/2023] [Accepted: 10/05/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Prediction of side-specific extraprostatic extension (EPE) is crucial in selecting patients for nerve-sparing radical prostatectomy (RP). Multiple nomograms, which include magnetic resonance imaging (MRI) information, are available predict side-specific EPE. It is crucial that the accuracy of these nomograms is assessed with external validation to ensure they can be used in clinical practice to support medical decision-making. METHODS Data of prostate cancer (PCa) patients that underwent robot-assisted RP (RARP) from 2017 to 2021 at four European tertiary referral centers were collected retrospectively. Four previously developed nomograms for the prediction of side-specific EPE were identified and externally validated. Discrimination (area under the curve [AUC]), calibration and net benefit of four nomograms were assessed. To assess the strongest predictor among the MRI features included in all nomograms, we evaluated their association with side-specific EPE using multivariate regression analysis and Akaike Information Criterion (AIC). RESULTS This study involved 773 patients with a total of 1546 prostate lobes. EPE was found in 338 (22%) lobes. The AUCs of the models predicting EPE ranged from 72.2% (95% CI 69.1-72.3%) (Wibmer) to 75.5% (95% CI 72.5-78.5%) (Nyarangi-Dix). The nomogram with the highest AUC varied across the cohorts. The Soeterik, Nyarangi-Dix, and Martini nomograms demonstrated fair to good calibration for clinically most relevant thresholds between 5 and 30%. In contrast, the Wibmer nomogram showed substantial overestimation of EPE risk for thresholds above 25%. The Nyarangi-Dix nomogram demonstrated a higher net benefit for risk thresholds between 20 and 30% when compared to the other three nomograms. Of all MRI features, the European Society of Urogenital Radiology score and tumor capsule contact length showed the highest AUCs and lowest AIC. CONCLUSION The Nyarangi-Dix, Martini and Soeterik nomograms resulted in accurate EPE prediction and are therefore suitable to support medical decision-making.
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Affiliation(s)
- J G Heetman
- Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands
| | | | - P Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - F Zattoni
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - C Kesch
- Department of Urology, University Hospital Essen, Essen, Germany
| | - S Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Special Surgery, The University of Jordan, Amman, Jordan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia
- Department of Urology, Weill Cornell Medical College, New York, USA
| | - F Dal Moro
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - G Novara
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - G La Bombara
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - F Sattin
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - N von Ostau
- Department of Urology, University Hospital Essen, Essen, Germany
| | - N Pötsch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - P A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - L Wever
- Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands
| | - J P A Van Basten
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - H H E Van Melick
- Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands
| | | | - G Gandaglia
- Unit of Urology/Division of Oncology, San Raffaele Hospital, Milan, Italy
| | - T F W Soeterik
- Department of Urology, St. Antonius Hospital, Utrecht, The Netherlands.
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
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Heetman JG, Hermsen R, Exterkate L, Küsters-Vandevelde HVN, Brouwer LJM, Somford DM, van den Bergh RCN, van Basten JPA. Immunohistochemical and histopathological validation of 18 F-PSMA-1007 PET/CT for intraprostatic cancerous lesions. Prostate 2023; 83:1332-1341. [PMID: 37455399 DOI: 10.1002/pros.24595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/02/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Prostate-specific membrane antigen (PSMA) is overexpressed in prostate cancer (PCa). In this study, we aim to immunohistochemically and histopathological validate the fluorine-18 (18 F)-PSMA-1007 positron emission tomography/computed tomography (PET/CT) for intraprostatic PCa lesions. METHODS Between February 2019 and October 2020, patients with biopsy-proven, treatment-naïve intermediate-to-high-risk PCa undergoing an 18 F-PSMA-1007 PET/CT before robot-assisted radical prostatectomy (RARP) were prospectively enrolled. For all PCa lesions found on whole-mount histopathology, location, size, International Society of Urological Pathology (ISUP) grade group (GG), and immune reactive score (IRS) were assessed after PSMA staining. ISUP GG ≥ 3 PCa was defined as clinically significant (cs) PCa. All lesions were matched on PSMA PET/CT and the maximum standardized uptake value (SUVmax) was measured. RESULTS A total of 125 lesions were analyzed in the 80 RARP specimens, of which 49 (40%) were csPCa and 76 (60%) non-csPCa. Linear multivariable regressions showed that an increase in SUVmax significantly correlated with a higher ISUP GG (p values between 0.021 and 0.001) and a higher IRS (p = 0.017). Logistic multivariable regression showed that csPCa significantly correlated with a higher SUVmax (odds ratio, OR: 1.17 [95% confidence interval, CI: 1.04-1.21, p = 0.005]), an increase in tumor length (OR: 1.05 [95% CI 1.01-1.10, p = 0.020]) and a higher IRS (OR; 1.24 [95% CI 1.07-1.47, p = 0.006]). A SUVmax threshold of 4 would have resulted in one (2%) missed lesion with csPCa. CONCLUSION This prospective study revealed that 18 F-PSMA-1007 PET/CT SUVmax is correlated with the ISUP GG and IRS, and thereby could be a tool to characterize intraprostatic PCa lesions.
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Affiliation(s)
- Joris G Heetman
- Department of Urology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - Rick Hermsen
- Department of Nuclear Medicine, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Leonie Exterkate
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | | | - Lenneke J M Brouwer
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | - Diederik M Somford
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
| | | | - Jean-Paul A van Basten
- Department of Urology, Canisius-Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen/Eindhoven, The Netherlands
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Heetman JG, Versteeg R, Wever L, Pereira LJP, Soeterik TFW, Lavalaye J, de Bruin PC, van den Bergh RCN, van Melick HHE. Correction: Is cribriform pattern in prostate biopsy a risk factor for metastatic disease on 68Ga-PSMA-11 PET/CT? World J Urol 2023; 41:2877. [PMID: 37733091 DOI: 10.1007/s00345-023-04615-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Affiliation(s)
- J G Heetman
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands.
| | - R Versteeg
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - L Wever
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
- Department of Urology, Canisius Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen, The Netherlands
| | - L J Paulino Pereira
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - T F W Soeterik
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - J Lavalaye
- Department of Pathology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - P C de Bruin
- Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - R C N van den Bergh
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - H H E van Melick
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
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Heetman JG, Versteeg R, Wever L, Paulino Pereira LJ, Soeterik TFW, Lavalaye J, de Bruin PC, van den Bergh RCN, van Melick HHE. Is cribriform pattern in prostate biopsy a risk factor for metastatic disease on 68Ga-PSMA-11 PET/CT? World J Urol 2023; 41:2165-2171. [PMID: 37330440 DOI: 10.1007/s00345-023-04467-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 05/29/2023] [Indexed: 06/19/2023] Open
Abstract
INTRODUCTION Cribriform growth pattern (CP) in prostate cancer (PCa) has been associated with different unfavourable oncological outcomes. This study addresses if CP in prostate biopsies is an independent risk factor for metastatic disease on PSMA PET/CT. METHODS Treatment-naive patients with ISUP GG ≥ 2 staged with 68Ga-PSMA-11 PET/CT diagnosed from 2020 to 2021 were retrospectively enrolled. To test if CP in biopsies was an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT, regression analyses were performed. Secondary analyses were performed in different subgroups. RESULTS A total of 401 patients were included. CP was reported in 252 (63%) patients. CP in biopsies was not an independent risk factor for metastatic disease on the 68Ga-PSMA PET/CT (p = 0.14). ISUP grade group (GG) 4 (p = 0.006), GG 5 (p = 0.003), higher PSA level groups per 10 ng/ml until > 50 (p-value between 0.02 and > 0.001) and clinical EPE (p > 0.001) were all independent risk factors. In the subgroups with GG 2 (n = 99), GG 3 (n = 110), intermediate-risk group (n = 129) or the high-risk group (n = 272), CP in biopsies was also not an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT. If the EAU guideline recommendation for performing metastatic screening was applied as threshold for PSMA PET/CT imaging, in 9(2%) patients, metastatic disease was missed, and 18% fewer PSMA PET/CT would have been performed. CONCLUSION This retrospective study found that CP in biopsies was not an independent risk factor for metastatic disease on 68Ga-PSMA PET/CT.
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Affiliation(s)
- J G Heetman
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands.
| | - R Versteeg
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - L Wever
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
- Department of Urology, Canisius Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen, The Netherlands
| | - L J Paulino Pereira
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - T F W Soeterik
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
- Department of Urology, Canisius Wilhelmina Hospital, Prosper Prostate Cancer Clinics, Nijmegen, The Netherlands
- Department of Pathology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
- Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - J Lavalaye
- Department of Pathology, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - P C de Bruin
- Department of Nuclear Medicine, Sint Antonius Hospital, Utrecht-Nieuwegein, The Netherlands
| | - R C N van den Bergh
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
| | - H H E van Melick
- Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Utrecht-Nieuwegein, The Netherlands
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Paulino Pereira LJ, Heetman JG, van den Bergh RC, van Melick HH. Superfast Magnetic Resonance Imaging-based Diagnostic Pathway for Prostate Cancer. EUR UROL SUPPL 2022; 46:30-32. [PMID: 36310760 PMCID: PMC9615134 DOI: 10.1016/j.euros.2022.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
We describe a <36-h superfast diagnostic pathway for men at risk of prostate cancer (PCa) that was initiated in our centre in March 2022. Patients are scheduled to undergo a repeat prostate-specific antigen blood test, magnetic resonance imaging, a urology consultation, and, if indicated, prostate biopsies in a single morning. The histopathology report is available the next day, after which the biopsy results and treatment options are discussed via a telephone consultation. The project has included 122 patients so far. With a reduction to only one hospital visit per patient and just five appointments (4%) cancelled so far, this timely pathway seems to be efficient from a patient perspective. In addition, reducing the waiting time until histopathology diagnosis could decrease the anxiety and depression that patients may experience during the diagnostic workup for PCa. Therefore, we believe that this fast-track diagnostic pathway could be incorporated in the future European standard of care, bringing PCa care in line with other malignancies such as breast cancer. Patient summary We describe a superfast diagnostic pathway for men at risk of prostate cancer. So far, this strategy seems to be an efficient and appropriate way to shorten time to diagnosis and to reduce the number of hospital visits for patients.
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Affiliation(s)
- Leonor Jane Paulino Pereira
- Corresponding author. Department of Urology, Sint Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands. Tel. +31 6 4712 6781.
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Heetman JG, Wever L, Paulino Pereira LJ, van den Bergh RC. Clinically Significant Prostate Cancer Diagnosis Without Histological Proof: A Possibility in the Prostate-specific Membrane Antigen Era? EUR UROL SUPPL 2022; 44:30-32. [PMID: 36046616 PMCID: PMC9421196 DOI: 10.1016/j.euros.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/18/2022] Open
Abstract
Magnetic resonance imaging (MRI) has resulted in a reduction in the number of patients indicated for prostate biopsy. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has recently shown additional value in detecting clinically significant prostate cancer (csPCa). Combining these imaging modalities allows such specific prediction of the presence of csPCa that the need for histological confirmation may be obsolete. We retrospectively analyzed PSMA PET/CT scans performed in the primary staging of PCa in the past 2 yr in our center (n = 451). All 74 patients with a PSMA ligand maximum standardized uptake value (SUVmax) of ≥16 had csPCa (grade group ≥2). Of the 185 patients with a combination of a Prostate Imaging-Reporting and Data System score ≥4 and SUVmax ≥8, 98% had csPCa. A nomogram combining predictive factors should be developed to identify patients in whom biopsy could theoretically be avoided. Nevertheless, biopsy will remain indispensable in patients with indefinite risk of csPCa and can provide important additional information. Patient summary Using patient data from our center, we found that addition of a special type of scan based on prostate-specific membrane antigen could help in the diagnosis of clinically significant prostate cancer without the need for prostate biopsy. Direct therapy without biopsy confirmation of cancer might be possible for a highly select group of patients.
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van Grevenstein WMU, van der Linde EM, Heetman JG, Lange JF, Ten Cate TJ, Wauben LSGL, Dekker-van Doorn CM. Crew Resource Management Training for Surgical Teams, A Fragmented Landscape. J Surg Educ 2021; 78:2102-2109. [PMID: 34134934 DOI: 10.1016/j.jsurg.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/20/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Medical Crew Resource Management (CRM) training courses are designed to increase patient safety by reducing the effects of human errors. These training courses are most popular in surgery and a wide range of medical CRM training courses for surgical teams is now available. However, the effects of these CRM training courses on patient outcomes are inconclusive. Although surgical teams feel the need to be trained in team collaboration skills, they are often puzzled about what criteria to apply when choosing a medical CRM training course. This study aimed to compare CRM training courses on didactic components and simulation-exercises to explore if these courses are interchangeable. METHODS In this qualitative study, semi-structured interviews were conducted among 10 main CRM training providers of surgical teams in the Netherlands. RESULTS Although a large variety was found in the content of CRM training courses, the most substantial differences were found in the simulation-exercises. Nine out of 10 trainers stated that standard simulation-exercises would be a step forward to ensure quality in CRM trainings. According to the trainers, the implementation of medical CRM can reduce human errors and as a result, preventable patient complications. They suggested a quality standard for CRM trainers in the medical field to ensure the quality of medical team training as a way to reach this. CONCLUSIONS Medical CRM training courses are diverse and noninterchangeable. Trainers expect that if CRM becomes part of surgical training and is embedded in operating theatre culture, it could be of great value for patients and professionals.
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Affiliation(s)
| | - E M van der Linde
- Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands; Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
| | - J G Heetman
- Department of Surgery, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Th J Ten Cate
- Centre for Research and Development of Education, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - L S G L Wauben
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - C M Dekker-van Doorn
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
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Heetman JG, Lavalaye J, van Selm S, van der Hoeven EJ, van Melick HH, van den Bergh RC. Is there any additional value to 68Ga-PSMA PET/CT in patients with suspicion of prostate cancer despite negative MRI and systematic biopsy? MINERVA UROL NEFROL 2020; 72:511-513. [PMID: 32284529 DOI: 10.23736/s0393-2249.20.03722-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Joris G Heetman
- Department of Urology, St. Antonius Hospital, Nieuwegein, the Netherlands -
| | - Jules Lavalaye
- Department of Nuclear Medicine, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Sandrine van Selm
- Department of Urology, St. Antonius Hospital, Nieuwegein, the Netherlands
| | | | - Harm H van Melick
- Department of Urology, St. Antonius Hospital, Nieuwegein, the Netherlands
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