Literature DB >> 19401570

Learning curve for coronary CT angiography: what constitutes sufficient training?

Francesca Pugliese1, M G Myriam Hunink, Katarzyna Gruszczynska, Filippo Alberghina, Roberto Malagó, Niels van Pelt, Nico R Mollet, Filippo Cademartiri, Annick C Weustink, Willem B Meijboom, Cilia L M Witteman, Pim J de Feyter, Gabriel P Krestin.   

Abstract

PURPOSE: To prospectively evaluate the effect of experience with coronary computed tomographic (CT) angiography on the capability to detect coronary stenoses of 50% or more.
MATERIALS AND METHODS: The institutional review board approved the study protocol. All patients gave consent to undergo CT angiography before conventional coronary angiography after being informed of the additional radiation dose. They also consented to the use of their data for future research. Three radiologists and one cardiologist inexperienced with coronary CT angiography attended this institution's cardiac CT unit for a 1-year fellowship. Fellows were involved in the acquisition and reading of 12-15 coronary CT angiograms per week (about 600 per year). To assess the progression in diagnostic performance, fellows (readers) independently read 50 CT angiographic test cases in patients who also underwent conventional coronary angiography. Cases were repeatedly assigned in random order at baseline and at 4, 8, 26, and 52 weeks. The same cases were examined by two experts in consensus. Sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated and compared with conventional coronary angiography as the reference standard.
RESULTS: Respective reader ranges for sensitivity, specificity, and DOR were 33%-72%, 70%-94%, and 3.8-8.1 at baseline; 43%-80%, 71%-88%, and 8.8-15.2 after 6 months; and 66%-75%, 87%-92%, and 14.7-25.8 after 1 year. For expert physicians, respective results were 95%, 93%, and 255.9. Between baseline and 6 months, readers 1-3 showed nonsignificantly improved sensitivities, while specificities remained similar. Reader 4 showed significantly improved specificity, while sensitivity remained similar; all readers nonsignificantly improved DORs. Between baseline and 1 year: readers 1 and 2 significantly improved sensitivity but not specificity; reader 4 significantly improved specificity but not sensitivity; readers 1, 2, and 4 improved DOR significantly; reader 3 nonsignificantly improved sensitivity, specificity, and DOR.
CONCLUSION: Increasing experience with coronary CT angiography improved the diagnostic performance of inexperienced physicians. However, acquiring expertise in coronary CT angiography was slow and may take more than 1 year.

Entities:  

Mesh:

Year:  2009        PMID: 19401570     DOI: 10.1148/radiol.2512080384

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  28 in total

1.  Canadian Cardiovascular Society/Canadian Association of Radiologists consensus training standards for cardiac computed tomography.

Authors:  Alan Brydie; Benjamin J Chow; Carole Dennie; Eric Larose; Jonathan A Leipsic; Tej Sheth
Journal:  Can J Cardiol       Date:  2010-04       Impact factor: 5.223

2.  Effect of reader experience on variability, evaluation time and accuracy of coronary plaque detection with computed tomography coronary angiography.

Authors:  Stefan C Saur; Hatem Alkadhi; Paul Stolzmann; Stephan Baumüller; Sebastian Leschka; Hans Scheffel; Lotus Desbiolles; Thomas J Fuchs; Gábor Székely; Philippe C Cattin
Journal:  Eur Radiol       Date:  2010-01-30       Impact factor: 5.315

Review 3.  Low dose CT of the heart: a quantum leap into a new era of cardiovascular imaging.

Authors:  E Maffei; C Martini; S De Crescenzo; T Arcadi; A Clemente; E Capuano; A Rossi; R Malagò; N Mollet; A Weustink; C Tedeschi; L La Grutta; S Seitun; A Igoren Guaricci; F Cademartiri
Journal:  Radiol Med       Date:  2010-06-23       Impact factor: 3.469

4.  [Cardiac SPECT/CT: correlation between atherosclerosis, significant coronary artery stenoses and myocardial perfusion parameters in patients with known coronary artery disease].

Authors:  C Ubleis; C Rist; I Griesshammer; A Becker; C Becker; M Hacker
Journal:  Radiologe       Date:  2010-04       Impact factor: 0.635

5.  Learning curve in multidetector CT coronary angiography (MDCT-CA).

Authors:  Roberto Malagò; Andrea Pezzato; Camilla Barbiani; Michela Tezza; Giuseppe Sala; Ugolino Alfonsi; Roberto Pozzi Mucelli
Journal:  Radiol Med       Date:  2013-05-27       Impact factor: 3.469

6.  Automatic segmentation, detection and quantification of coronary artery stenoses on CTA.

Authors:  Rahil Shahzad; Hortense Kirişli; Coert Metz; Hui Tang; Michiel Schaap; Lucas van Vliet; Wiro Niessen; Theo van Walsum
Journal:  Int J Cardiovasc Imaging       Date:  2013-08-08       Impact factor: 2.357

7.  Structured learning algorithm for detection of nonobstructive and obstructive coronary plaque lesions from computed tomography angiography.

Authors:  Dongwoo Kang; Damini Dey; Piotr J Slomka; Reza Arsanjani; Ryo Nakazato; Hyunsuk Ko; Daniel S Berman; Debiao Li; C-C Jay Kuo
Journal:  J Med Imaging (Bellingham)       Date:  2015-03-06

8.  Low-dose coronary-CT angiography using step and shoot at any heart rate: comparison of image quality at systole for high heart rate and diastole for low heart rate with a 128-slice dual-source machine.

Authors:  Jean-François Paul; Aude Amato; Adela Rohnean
Journal:  Int J Cardiovasc Imaging       Date:  2012-08-24       Impact factor: 2.357

9.  Central Core Laboratory versus Site Interpretation of Coronary CT Angiography: Agreement and Association with Cardiovascular Events in the PROMISE Trial.

Authors:  Michael T Lu; Nandini M Meyersohn; Thomas Mayrhofer; Daniel O Bittner; Hamed Emami; Stefan B Puchner; Borek Foldyna; Martin E Mueller; Steven Hearne; Clifford Yang; Stephan Achenbach; Quynh A Truong; Brian B Ghoshhajra; Manesh R Patel; Maros Ferencik; Pamela S Douglas; Udo Hoffmann
Journal:  Radiology       Date:  2017-11-27       Impact factor: 11.105

10.  Diagnostic accuracy of 64-slice computed tomography coronary angiography in a large population of patients without revascularisation: registry data and review of multicentre trials.

Authors:  E Maffei; A Palumbo; C Martini; W Meijboom; C Tedeschi; P Spagnolo; A Zuccarelli; A Weustink; T Torri; N Mollet; S Seitun; G P Krestin; F Cademartiri
Journal:  Radiol Med       Date:  2009-12-16       Impact factor: 3.469

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