Low-Cost homemade Agar-Based phantoms for Ultrasound-Guided procedure Training: A randomized educational trial

Manuel Gargiulo; Cécile Di-Rocco; Julien Doche; Laure Boyer; Jérôme Soussan; Julien Frandon; Pauline Brige; Vincent Vidal; Farouk Tradi

doi:10.1016/j.ejrad.2026.112934

Low-Cost homemade Agar-Based phantoms for Ultrasound-Guided procedure Training: A randomized educational trial

Eur J Radiol. 2026 May 13:202:112934. doi: 10.1016/j.ejrad.2026.112934. Online ahead of print.

Authors

Manuel Gargiulo¹, Cécile Di-Rocco², Julien Doche³, Laure Boyer⁴, Jérôme Soussan⁵, Julien Frandon⁶, Pauline Brige², Vincent Vidal⁷, Farouk Tradi⁷

Affiliations

¹ Aix Marseille Univ, LIIE, UR4264 Marseille, France; Aix Marseille Univ, CNRS, CERIMED, UAR2012 Marseille, France. Electronic address: carbon_uptick.4c@icloud.com.
² Aix Marseille Univ, LIIE, UR4264 Marseille, France; Aix Marseille Univ, CNRS, CERIMED, UAR2012 Marseille, France.
³ Fédération ENAC ISAE-SUPAERO ONERA, Université de Toulouse, 31400, France.
⁴ Institut de Médecine et Physiologie Spatiale (MEDES) - SpaceshipFR, BP 74404, 31405, Toulouse CEDEX 4, France.
⁵ Radiology Department, Nord Hospital, APHM, Marseille, France.
⁶ Department of Medical Imaging, IPI Plateform, Nîmes University Hospital, Medical Imaging Group Nîmes, IMAGINE, University of Montpellier, 30029 Nîmes, France.
⁷ Aix Marseille Univ, LIIE, UR4264 Marseille, France; Aix Marseille Univ, CNRS, CERIMED, UAR2012 Marseille, France; Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, 13005 Marseille, France.

PMID: 42144013
DOI: 10.1016/j.ejrad.2026.112934

Abstract

Objectives: To assess the non-inferiority of low-cost homemade agar-based phantoms compared to commercial models regarding students' self-reported confidence and performance in basic ultrasound-guided procedures.

Materials and methods: This randomized controlled study was conducted at a single university in June 2025, during interventional radiology (IR) resident training sessions. Participants were all consecutive students randomized 2:1 to either agar-based or commercial phantoms. Phantoms were designed to simulate deep collection puncture and vascular access. Participants completed technical assessments and questionnaires before and after the training.

Results: Twenty-three residents (8 male [35%]; median residency semester [IQR], 2 [2-4]) were included and randomized to the agar-based group (n = 15) or the commercial phantom group (n = 8). Students increased their self-reported confidence in basic procedures from 3.7 ± 2.4 to 6.2 ± 1.7 out of 10 (+ 2.5 points; p < 0.01), with non-inferiority of agar-based models confirmed (p = 0.04). Procedure time improved by 135 ± 174 s (p < 0.01), with non-inferiority demonstrated for deep collection puncture test (p = 0.04). The number of punctures decreased by 0.6 ± 0.7 (p = 0.04) for this test, again with non-inferiority confirmed for agar phantoms (p = 0.02). Overall interest in IR was high (7.1 ± 2.2 /10), particularly for Level-1 procedures (8.6 ± 1.3/10). Students trained with agar models expressed high satisfaction, rating their support for using such models in educational settings at 8.9 ± 1.3/10.

Conclusion: Low-cost homemade agar-based phantoms appeared to be non-inferior to commercial models for confidence improvement, but not for all performance outcomes in this small sample. However, they significantly improved trainees' performance during ultrasound-guided intervention training.

Keywords: Agar; Education,Medical,Graduate; Phantoms,Imaging; Radiology, Interventional; SimulationTraining.