Lapo Sali1, Silvia Delsanto2, Daniela Sacchetto2, Loredana Correale2, Massimo Falchini3, Andrea Ferraris4, Giovanni Gandini4, Giulia Grazzini3, Franco Iafrate5, Gabriella Iussich6, Lia Morra2, Andrea Laghi7, Mario Mascalchi3, Daniele Regge4,8. 1. Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Viale Morgani 50, 50134, Florence, Italy. lapo.sali@unifi.it. 2. im3D S.p.A., Via Livorno 60, 10153, Turin, Italy. 3. Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Viale Morgani 50, 50134, Florence, Italy. 4. Department of Surgical Science, University of Turin, 10124, Turin, Italy. 5. Radiology Unit, Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza", Viale del Policlinico 155, 00161, Rome, Italy. 6. Radiology Unit, Sant'Anna Hospital, Via Sant'Anna 1, 6924, Sorengo, Switzerland. 7. Department of Radiological Sciences, Oncology and Pathology, University of Rome "Sapienza", Sant'Andrea University Hospital, Via di Grottarossa 1035, 00189, Rome, Italy. 8. Imaging Unit, Candiolo Cancer Institute FPO-IRCCS, 10060, Candiolo, Turin, Italy.
Abstract
OBJECTIVES: To determine whether (1) computer-based self-training for CT colonography (CTC) improves interpretation performance of novice readers; (2) computer-aided detection (CAD) use during training affects learning. METHODS: Institutional review board approval and patients' informed consent were obtained for all cases included in this study. Twenty readers (17 radiology residents, 3 radiologists) with no experience in CTC interpretation were recruited in three centres. After an introductory course, readers performed a baseline assessment test (37 cases) using CAD as second reader. Then they were randomized (1:1) to perform either a computer-based self-training (150 cases verified at colonoscopy) with CAD as second reader or the same training without CAD. The same assessment test was repeated after completion of the training programs. Main outcome was per lesion sensitivity (≥ 6 mm). A generalized estimating equation model was applied to evaluate readers' performance and the impact of CAD use during training. RESULTS: After training, there was a significant improvement in average per lesion sensitivity in the unassisted phase, from 74% (356/480) to 83% (396/480) (p < 0.001), and in the CAD-assisted phase, from 83% (399/480) to 87% (417/480) (p = 0.021), but not in average per patient sensitivity, from 93% (390/420) to 94% (395/420) (p = 0.41), and specificity, from 81% (260/320) to 86% (276/320) (p = 0.15). No significant effect of CAD use during training was observed on per patient sensitivity and specificity, nor on per lesion sensitivity. CONCLUSIONS: A computer-based self-training program for CTC improves readers' per lesion sensitivity. CAD as second reader does not have a significant impact on learning if used during training. KEY POINTS: • Computer-based self-training for CT colonography improves per lesion sensitivity of novice readers. • Self-training program does not increase per patient specificity of novice readers. • CAD used during training does not have significant impact on learning.
OBJECTIVES: To determine whether (1) computer-based self-training for CT colonography (CTC) improves interpretation performance of novice readers; (2) computer-aided detection (CAD) use during training affects learning. METHODS: Institutional review board approval and patients' informed consent were obtained for all cases included in this study. Twenty readers (17 radiology residents, 3 radiologists) with no experience in CTC interpretation were recruited in three centres. After an introductory course, readers performed a baseline assessment test (37 cases) using CAD as second reader. Then they were randomized (1:1) to perform either a computer-based self-training (150 cases verified at colonoscopy) with CAD as second reader or the same training without CAD. The same assessment test was repeated after completion of the training programs. Main outcome was per lesion sensitivity (≥ 6 mm). A generalized estimating equation model was applied to evaluate readers' performance and the impact of CAD use during training. RESULTS: After training, there was a significant improvement in average per lesion sensitivity in the unassisted phase, from 74% (356/480) to 83% (396/480) (p < 0.001), and in the CAD-assisted phase, from 83% (399/480) to 87% (417/480) (p = 0.021), but not in average per patient sensitivity, from 93% (390/420) to 94% (395/420) (p = 0.41), and specificity, from 81% (260/320) to 86% (276/320) (p = 0.15). No significant effect of CAD use during training was observed on per patient sensitivity and specificity, nor on per lesion sensitivity. CONCLUSIONS: A computer-based self-training program for CTC improves readers' per lesion sensitivity. CAD as second reader does not have a significant impact on learning if used during training. KEY POINTS: • Computer-based self-training for CT colonography improves per lesion sensitivity of novice readers. • Self-training program does not increase per patient specificity of novice readers. • CAD used during training does not have significant impact on learning.
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