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transducer into rectal cavity of the phantom. "Patient images" were obtained from clinical US scans. We asked 9 resident physicians (readers) to evaluate 10 US images (cases) and classify each as "patient" or "phantom" scan. No prior structured training was provided for US interpretation (other than routine clinic exposure). However, readers can review each image with and without pelvic structures labeled (to help visualize anatomy without obscuring key imaging characteristics). MRMC analysis (R software) was used to account for variability between cases & between readers. The null hypothesis is that phantoms scans are inferior; i.e. readers can correctly identify "patient" vs "phantom" scans at least 65% of the time (H 0 : p ! 0.65, H A : p < 0.65). We also asked readers to review 2 US videos and identify the hydrogel needle during insertion into the pelvic phantom (1 transabdominal & 1 transrectal view). Results: Readers correctly identified "patient" vs "phantom" scans 53.3% AE 6.2% of the time (p Z 0.054, t Z-1.89, df Z 6). The p-value is marginally >0.05, likely from limited sample size (power Z 0.32). Readers correctly identified the hydrogel needle in US videos 100% of the time in transabdominal and 78% in transrectal view. In terms of cost, we can recreate this life-sized pelvic phantom (3.5L) at $60 using existing 3D molds; in comparison, commercial phantoms cost $400 (for smaller models) to $3000 (for whole-pelvic models). Conclusion: This 3D printed phantom is a cost-effective solution to help trainees improve hydrogel injection skills. We have shown that this phantom can produce US images that are near comparable to patient scans, though reader experience in image interpretation could be limited without structured ultrasound training. In the future, we will explore its use in brachytherapy training.