Effect of directed training on reader performance for CT colonography: Multicenter study

Steve Halligan, David Burling, Wendy Atkin, Clive Bartram, Helen Fenlon, Andrea Laghi, Jaap Stoker, Douglas G. Altman, Paul Bassett, Roger Frost, Stuart Taylor, Lesley Honeyfield, Melinda De Villiers, David Nicholson, Velauthan Rudralingham, Lisa Renaut, Clive Kay, Andy Lowe, Jane Williams-Butt, Jasper FlorieMartin Poulus, Victor Van Der Hulst, Philippe Lefere, Jesse Marrannes, Guido Dessey, Alan O'Hare, Shane Foley, Emmanuele Neri, Paola Vagli, Benedetta Politi, Riccardo Iannaccone, Filipo Mangiapane, Sante Ori, Teresa Gallo, Giulia Nieddu, Saverio Signoretta, Daniele Regge

Research output: Contribution to journalArticlepeer-review


Purpose: To define the interpretative performance of radiologists experience in computed tomographic (CT) colonography and to compare it with that of novice observers who had undergone directed training, with colonoscopy as the reference standard. Materials and Methods: Physicians at each participating center received ethical committee approval and followed the committees' requests regarding informed consent. Nine experienced radiologists, nine trained radiologists, and 10 trained technologists from nine centers read 40 CT colonographic studies selected from a data set of 51 studies and modeled to simulate a population with positive fecal occult blood test results: Studies were obtained in eight patients with cancer, 12 patients with large polyp, four patients with medium polyp, and 27 patients without colonic lesions. Findings were verified with colonoscopy. An experienced radiologist used 50 endoscopically validated studies to train novice observers before they were allowed to participate. Observers used one software platform to read studies over 2 days. Responses were collated and compared with the known diagnostic category for each subject. The number of correctly classified subjects was determined for each observer, and differences between groups were examined with bootstrap analysis. Results: Overall, 28 observers read 1084 studies and detected 121 cancers, 134 large polyps, and 33 medium polyps; 448 healthy subjects were categorized correctly. Experienced radiologists detected 116 lesions; trained radiologists and technologists detected 85 and 87 lesions, respectively. Overall accuracy of experienced observers (74.2%) was significantly better than that of trained radiologists (66.6%) and technologists (63.2%). There was no significant difference (P = .33) between overall accuracy of trained radiologists and that of technologists; however, some trainees reached the mean performance achieved by experienced observers. Conclusions: Experienced observers interpreted CT colonographic images significantly better than did novices trained with 50 studies. On average, no difference between trained radiologists and trained technologists was found; however, individual performance was variable and some trainees out-performed some experienced observers.

Original languageEnglish
Pages (from-to)152-161
Number of pages10
Issue number1
Publication statusPublished - Jan 2007

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology


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