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

摘要

AIM: To evaluate the effect of experience on the accuracy rate of computed tomography colonography(CTC) interpretation and patient preferences/satisfaction for CTC and colonoscopy. METHODS: A prospective, non-randomized, observational study performed in a single, tertiary care center involving 90 adults who underwent CTC followed by colonoscopy on the same day. CTC was interpreted by an abdominal imaging radiologist and then a colonoscopy was performed utilizing segmental un-blinding and re-examination as required. A radiology resident and two gastroenterology(GI) fellows blinded to the results also interpreted the CTC datasets independently. Accuracy rates and trend changes were determined for each reader to assess for a learning curve. RESULTS: Among 90 patients(57% male) aged 55 ± 8.9 years, 39 polyps ≥ 6 mm were detected in 20 patients and 13 polyps > 9 mm in 10 patients. Accuracy rates were 88.9%(≥ 6 mm) and 93.3%(> 9 mm) for the GI Radiologist, 89.8%(≥ 6 mm) and 98.9%(> 9 mm) for the Radiology Resident and 86.7% and 95.6%(≥ 6 mm) and 87.8% and 94.4%(> 9 mm) for each of the GI fellows respectively. The reader's accuracy rate did not change significantly with the percentage change rate ranging between-1.7 to 0.9(P = 0.12 to 0.56). Patients considered colonoscopy more satisfactory than CTC(30% vs 4%, P < 0.0001), they felt less anxiety during colonoscopy(36% vs 7%, P < 0.0001), they experienced less pain or discomfort during colonoscopy compared to CTC(69% vs 4%, P < 0.0001) and colonoscopy was preferred by 77% of the participants as a repeat screening test for the future. CONCLUSION: No statistically significant learning curve was identified in CTC interpretation suggesting that further study is required to identify the necessary training to adequately interpret CTC scans.