Virtual reality-based training for the diagnosis of prostate cancer

Prostate malignancies are the second leading cause of cancer deaths among m en. The most common method of detecting this disease is digital rectal exam ination (DRE). Current DRE training is inadequate, since the number of pati ents that students can practice on is limited. Furthermore, allied care per sonnel do not train in screening for prostate cancer. Finally, there is no objective may to follow the improvement in DRE skills for medical personnel . This paper presents a virtual reality-based simulator that addresses the above problems. The prototype consists of a PHANToM haptic interface which provides feedback to the trainee's index finger, a motion restricting board , and an SGI workstation, which renders the patient's anatomy. Four types o f prostates mere modeled-normal, enlarged with no tumor, incipient malignan cy (single tumor), and advanced malignancy (tumor cluster). Human factors s tudies mere conducted on both nonmedical students and urology residents in order to quantify the system usefulness. After only five minutes of trainin g, nonmedical students had a 67% correct diagnosis rate of malignant versus nonmalignant cases. This compared with 56% for urology residents in the sa me trials. Subjective evaluation by the residents pointed out the heed to i mprove the virtual prostate model realism. A control group formed of urolog y residents performed the same trials on a modified Merck Procar simulator. The control group scored significantly better (96% correct diagnosis of ma lignancies). We conclude that the virtual prostate palpation simulator, whi le promising, needs significant improvement in both model realism and hapti c interface hardware.