6 research outputs found
Effect of directed training on reader performance for CT colonography: multicenter study.
PURPOSE: To define the interpretative performance of radiologists experienced in computed tomographic (CT) colonography and to compare it with that of novice observers who had undergone directed training, with colonoscopy as the reference standard. MATERIALS AND METHODS: Physicians at each participating center received ethical committee approval and followed the committees' requests regarding informed consent. Nine experienced radiologists, nine trained radiologists, and 10 trained technologists from nine centers read 40 CT colonographic studies selected from a data set of 51 studies and modeled to simulate a population with positive fecal occult blood test results: Studies were obtained in eight patients with cancer, 12 patients with large polyp, four patients with medium polyp, and 27 patients without colonic lesions. Findings were verified with colonoscopy. An experienced radiologist used 50 endoscopically validated studies to train novice observers before they were allowed to participate. Observers used one software platform to read studies over 2 days. Responses were collated and compared with the known diagnostic category for each subject. The number of correctly classified subjects was determined for each observer, and differences between groups were examined with bootstrap analysis. RESULTS: Overall, 28 observers read 1084 studies and detected 121 cancers, 134 large polyps, and 33 medium polyps; 448 healthy subjects were categorized correctly. Experienced radiologists detected 116 lesions; trained radiologists and technologists detected 85 and 87 lesions, respectively. Overall accuracy of experienced observers (74.2%) was significantly better than that of trained radiologists (66.6%) and technologists (63.2%). There was no significant difference (P=.33) between overall accuracy of trained radiologists and that of technologists; however, some trainees reached the mean performance achieved by experienced observers. CONCLUSION: Experienced observers interpreted CT colonographic images significantly better than did novices trained with 50 studies. On average, no difference between trained radiologists and trained technologists was found; however, individual performance was variable and some trainees outperformed some experienced observers
Recommendations for additional imaging of abdominal imaging examinations: frequency, benefit, and cost
Comparison of the diagnostic performance of CT colonography interpreted by radiologists and radiographers
Magnetic resonance imaging and magnetic resonance arthrography of the shoulder: dependence on the level of training of the performing radiologist for diagnostic accuracy
PURPOSE: Discrepancies were identified between magnetic resonance (MR) imaging and clinical findings in patients who had MR imaging examinations evaluated by community-based general radiologists. The purpose of this study was to evaluate the diagnostic performance of MR imaging examinations of the shoulder with regard to the training level of the performing radiologist. METHODS: A review of patient charts identified 238 patients (male/female, 175/63; mean age, 40.4 years) in whom 250 arthroscopies were performed and who underwent MR imaging or direct MR arthrography in either a community-based or hospital-based institution prior to surgery. All MR imaging and surgical reports were reviewed and the diagnostic performance for the detection of labral, rotator cuff, biceps, and Hill-Sachs lesions was determined. Kappa and Student's t test analyses were performed in a subset of cases in which initial community-based MR images were re-evaluated by hospital-based musculoskeletal radiologists, to determine the interobserver agreement and any differences in image interpretation. RESULTS: The diagnostic performance of community-based general radiologists was lower than that of hospital-based sub-specialized musculoskeletal radiologists. A sub-analysis of re-evaluated cases showed that musculoskeletal radiologists performed better. kappa values were 0.208, 0.396, 0.376, and 0.788 for labral, rotator cuff, biceps, and Hill-Sachs lesions (t test statistics: p = <0.001, 0.004, 0.019, and 0.235). CONCLUSIONS: Our results indicate that the diagnostic performance of MR imaging and MR arthrography of the shoulder depends on the training level of the performing radiologist, with sub-specialized musculoskeletal radiologists having a better diagnostic performance than general radiologists