Literature DB >> 20566804

Can radiologist training and testing ensure high performance in CT colonography? Lessons From the National CT Colonography Trial.

Joel G Fletcher1, Mei-Hsiu Chen, Benjamin A Herman, C Daniel Johnson, Alicia Toledano, Abraham H Dachman, Amy K Hara, Jeff L Fidler, Christine O Menias, Kevin J Coakley, Mark Kuo, Karen M Horton, Jugesh Cheema, Revathy Iyer, Bettina Siewert, Judy Yee, Richard Obregon, Peter Zimmerman, Robert Halvorsen, Giovanna Casola, Martina Morrin.   

Abstract

OBJECTIVE: The objective of this article is to describe the experience of the National CT Colonography Trial with radiologist training and qualification testing at CT colonography (CTC) and to correlate this experience with subsequent performance in a prospective screening study. SUBJECTS AND METHODS: Ten inexperienced radiologists participated in a 1-day educational course, during which partial CTC examinations of 27 cases with neoplasia and full CTC examinations of 15 cases were reviewed using primary 2D and 3D search. Subsequently 15 radiologists took a qualification examination composed of 20 CTC cases. Radiologists who did not pass the first qualification examination attended a second day of focused retraining of 30 cases, which was followed by a second qualification examination. The results of the initial and subsequent qualification tests were compared with reader performance in a large prospective screening trial.
RESULTS: All radiologists took and passed the qualification examinations. Seven radiologists passed the qualification examination the first time it was offered, and eight radiologists passed after focused retraining. Significantly better sensitivities were obtained on the second versus the first examination for the retrained radiologists (difference = 16%, p < 0.001). There was no significant difference in sensitivities between the groups who passed the qualification examination the first time versus those who passed the second time in the prospective study (88% vs 92%, respectively; p = 0.612). In the prospective study, the odds of correctly identifying diseased cases increased by 1.5 fold for every 50-case increase in reader experience or formal training (p < 0.025).
CONCLUSION: A significant difference in performance was observed among radiologists before formalized training, but testing and focused retraining improved radiologist performance, resulting in an overall high sensitivity across radiologists in a subsequent, prospective screening study.

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Year:  2010        PMID: 20566804      PMCID: PMC3020575          DOI: 10.2214/AJR.09.3659

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


  18 in total

1.  Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults.

Authors:  Perry J Pickhardt; J Richard Choi; Inku Hwang; James A Butler; Michael L Puckett; Hans A Hildebrandt; Roy K Wong; Pamela A Nugent; Pauline A Mysliwiec; William R Schindler
Journal:  N Engl J Med       Date:  2003-12-01       Impact factor: 91.245

2.  Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps.

Authors:  C Daniel Johnson; William S Harmsen; Lynn A Wilson; Robert L Maccarty; Timothy J Welch; Duane M Ilstrup; David A Ahlquist
Journal:  Gastroenterology       Date:  2003-08       Impact factor: 22.682

3.  Nonradiologists as second readers for intraluminal findings at CT colonography.

Authors:  Kale D Bodily; Joel G Fletcher; Trudy Engelby; Mark Percival; Jared A Christensen; Brett Young; Aaron J Krych; Douglas C Vander Kooi; Drew Rodysill; Jeff L Fidler; C Daniel Johnson
Journal:  Acad Radiol       Date:  2005-01       Impact factor: 3.173

Review 4.  CT colonography reporting and data system: a consensus proposal.

Authors:  Michael E Zalis; Matthew A Barish; J Richard Choi; Abraham H Dachman; Helen M Fenlon; Joseph T Ferrucci; Seth N Glick; Andrea Laghi; Michael Macari; Elizabeth G McFarland; Martina M Morrin; Perry J Pickhardt; Jorge Soto; Judy Yee
Journal:  Radiology       Date:  2005-07       Impact factor: 11.105

5.  Computed tomographic colonography and conventional colonoscopy for colon diseases: a prospective, blinded study.

Authors:  G Spinzi; G Belloni; A Martegani; A Sangiovanni; C Del Favero; G Minoli
Journal:  Am J Gastroenterol       Date:  2001-02       Impact factor: 10.864

6.  Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison.

Authors:  D C Rockey; E Paulson; D Niedzwiecki; W Davis; H B Bosworth; L Sanders; J Yee; J Henderson; P Hatten; S Burdick; A Sanyal; D T Rubin; M Sterling; G Akerkar; M S Bhutani; K Binmoeller; J Garvie; E J Bini; K McQuaid; W L Foster; W M Thompson; A Dachman; R Halvorsen
Journal:  Lancet       Date:  2005 Jan 22-28       Impact factor: 79.321

7.  Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia.

Authors:  Peter B Cotton; Valerie L Durkalski; Benoit C Pineau; Yuko Y Palesch; Patrick D Mauldin; Brenda Hoffman; David J Vining; William C Small; John Affronti; Douglas Rex; Kenyon K Kopecky; Susan Ackerman; J Steven Burdick; Cecelia Brewington; Mary A Turner; Alvin Zfass; Andrew R Wright; Revathy B Iyer; Patrick Lynch; Michael V Sivak; Harold Butler
Journal:  JAMA       Date:  2004-04-14       Impact factor: 56.272

8.  ACR Colon Cancer Committee white paper: status of CT colonography 2009.

Authors:  Elizabeth G McFarland; Joel G Fletcher; Perry Pickhardt; Abraham Dachman; Judy Yee; Cynthia H McCollough; Michael Macari; Paul Knechtges; Michael Zalis; Matthew Barish; David H Kim; Kathryn J Keysor; C Daniel Johnson
Journal:  J Am Coll Radiol       Date:  2009-11       Impact factor: 5.532

9.  Understanding interpretive errors in radiologists learning computed tomography colonography.

Authors:  Jeff L Fidler; Joel G Fletcher; C Daniel Johnson; James E Huprich; John M Barlow; Franklin Earnest; Brian J Bartholmai
Journal:  Acad Radiol       Date:  2004-07       Impact factor: 3.173

10.  Characterization of lesions missed on interpretation of CT colonography using a 2D search method.

Authors:  Thomas M Gluecker; J G Fletcher; Timothy J Welch; Robert L MacCarty; William S Harmsen; Jeffrey R Harrington; Duane Ilstrup; Lynn A Wilson; Kay E Corcoran; C Daniel Johnson
Journal:  AJR Am J Roentgenol       Date:  2004-04       Impact factor: 3.959

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  13 in total

1.  Computer-based self-training for CT colonography with and without CAD.

Authors:  Lapo Sali; Silvia Delsanto; Daniela Sacchetto; Loredana Correale; Massimo Falchini; Andrea Ferraris; Giovanni Gandini; Giulia Grazzini; Franco Iafrate; Gabriella Iussich; Lia Morra; Andrea Laghi; Mario Mascalchi; Daniele Regge
Journal:  Eur Radiol       Date:  2018-05-23       Impact factor: 5.315

2.  ACRIN CT colonography trial: does reader's preference for primary two-dimensional versus primary three-dimensional interpretation affect performance?

Authors:  Amy K Hara; Meridith Blevins; Mei-Hsiu Chen; Abraham H Dachman; Mark D Kuo; Christine O Menias; Bettina Siewert; Jugesh I Cheema; Richard G Obregon; Jeff L Fidler; Peter Zimmerman; Karen M Horton; Kevin J Coakley; Revathy B Iyer; Robert A Halvorsen; Giovanna Casola; Judy Yee; Benjamin A Herman; C Daniel Johnson
Journal:  Radiology       Date:  2011-03-01       Impact factor: 11.105

Review 3.  Evidence review and status update on computed tomography colonography.

Authors:  Darren Boone; Steve Halligan; Stuart A Taylor
Journal:  Curr Gastroenterol Rep       Date:  2011-10

Review 4.  CT colonography with computer-aided detection: recognizing the causes of false-positive reader results.

Authors:  Igor Trilisky; Kristen Wroblewski; Michael W Vannier; John M Horne; Abraham H Dachman
Journal:  Radiographics       Date:  2014 Nov-Dec       Impact factor: 5.333

5.  Improved Sensitivity and Reader Confidence in CT Colonography Using Dual-Layer Spectral CT: A Phantom Study.

Authors:  Markus M Obmann; Chansik An; Amanda Schaefer; Yuxin Sun; Zhen J Wang; Judy Yee; Benjamin M Yeh
Journal:  Radiology       Date:  2020-07-28       Impact factor: 11.105

6.  Virtual colonoscopy: Utility, impact and overview.

Authors:  Dhakshina Ganeshan; Khaled M Elsayes; David Vining
Journal:  World J Radiol       Date:  2013-03-28

Review 7.  CT colonography: over two decades from discovery to practice.

Authors:  Perry J Pickhardt; Judy Yee; C Daniel Johnson
Journal:  Abdom Radiol (NY)       Date:  2018-03

8.  Evaluation of Pseudoreader Study Designs to Estimate Observer Performance Results as an Alternative to Fully Crossed, Multireader, Multicase Studies.

Authors:  Rickey E Carter; David R Holmes; Joel G Fletcher; Cynthia H McCollough
Journal:  Acad Radiol       Date:  2019-05-07       Impact factor: 3.173

9.  Does training and experience influence the accuracy of computed tomography colonography interpretation?

Authors:  Greg Rosenfeld; Yi Tzu Nancy Fu; Brendan Quiney; Hong Qian; Darin Krygier; Jacquie Brown; Patrick Vos; Pari Tiwari; Jennifer Telford; Brian Bressler; Robert Enns
Journal:  World J Gastroenterol       Date:  2014-02-14       Impact factor: 5.742

10.  CT colonography: effect of computer-aided detection of colonic polyps as a second and concurrent reader for general radiologists with moderate experience in CT colonography.

Authors:  Thomas Mang; Luca Bogoni; Vikram X Anand; Dass Chandra; Andrew J Curtin; Anna S Lev-Toaff; Gerardo Hermosillo; Ralph Noah; Vikas Raykar; Marcos Salganicoff; Robert Shaw; Susan Summerton; Rafel F R Tappouni; Helmut Ringel; Michael Weber; Matthias Wolf; Nancy A Obuchowski
Journal:  Eur Radiol       Date:  2014-05-10       Impact factor: 5.315

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