Interpretation of radionuclide liver images: do training and experience make a difference?

Individual observers interpreted images in order to assess their accuracy and sources of error. Seventy-six liver images were presented to nine readers for interpretation. Readers of differing experience participated in the study: four radiology residents, three fellows in nuclear medicine, and two full-time nuclear medicine physicians. A higher incidence of false-positive reading was more common in inexperienced observers (11-50%) and the most correct readings were obtained by staff physicians (88% overall percentage accuracy). Heterogeneity in radionuclide uptake was the most frequently ill-defined nature was the most common false-positive finding in normal cases. Early stages of cirrhosis, mild hepatitis, and rare diseases such as hepatic sarcoidosis were difficult to detect. Skill of interpretation improved with experience, especially in judging heterogeneity of an ill-defined nature, and the rate of accurate readings was proportional to the level of training of the observer.