Gastrointestinal

European Radiology

, Volume 16, Issue 8, pp 1745-1749

CT colonography interpretation times: effect of reader experience, fatigue, and scan findings in a multi-centre setting

  • David BurlingAffiliated withIntestinal Imaging Centre, St. Marks Hospital
  • , Steve HalliganAffiliated withSpecialist Radiology, Level 2 Podium, University College Hospital Email author 
  • , Douglas G. AltmanAffiliated withCentre for Medical Statistics
  • , Wendy AtkinAffiliated withCancer Research UK, St Mark’s Hospital
  • , Clive BartramAffiliated withIntestinal Imaging Centre, St. Marks Hospital
  • , Helen FenlonAffiliated withMater Misericordiae
  • , Andrea LaghiAffiliated withLa Sapienza
  • , Jaap StokerAffiliated withAmsterdam Medical Centre
  • , Stuart TaylorAffiliated withSpecialist Radiology, Level 2 Podium, University College Hospital
    • , Roger FrostAffiliated withSalisbury District Hospital
    • , Guido DesseyAffiliated withStedelijk Ziekenhuis
    • , Melinda De VilliersAffiliated withIntestinal Imaging Centre, St. Marks Hospital
    • , Jasper FlorieAffiliated withAmsterdam Medical Centre
    • , Shane FoleyAffiliated withMater Misericordiae
    • , Lesley HoneyfieldAffiliated withIntestinal Imaging Centre, St. Marks Hospital
    • , Riccardo IannacconeAffiliated withLa Sapienza
    • , Teresa GalloAffiliated withIntestinal Imaging Centre, St. Marks HospitalCandiolo Oncologic Hospital
    • , Clive KayAffiliated withIntestinal Imaging Centre, St. Marks HospitalBradford Royal Infirmary
    • , Philippe LefereAffiliated withStedelijk Ziekenhuis
    • , Andrew LoweAffiliated withIntestinal Imaging Centre, St. Marks HospitalBradford Royal Infirmary
    • , Filipo MangiapaneAffiliated withLa Sapienza
    • , Jesse MarrannesAffiliated withStedelijk Ziekenhuis
    • , Emmanuele NeriAffiliated withIntestinal Imaging Centre, St. Marks HospitalUniversity of Pisa
    • , Giulia NiedduAffiliated withIntestinal Imaging Centre, St. Marks HospitalCandiolo Oncologic Hospital
    • , David NicholsonAffiliated withIntestinal Imaging Centre, St. Marks HospitalHope Hospital
    • , Alan O’HareAffiliated withMater Misericordiae
    • , Sante OriAffiliated withLa Sapienza
    • , Benedetta PolitiAffiliated withIntestinal Imaging Centre, St. Marks HospitalUniversity of Pisa
    • , Martin PoulusAffiliated withAmsterdam Medical Centre
    • , Daniele ReggeAffiliated withIntestinal Imaging Centre, St. Marks HospitalCandiolo Oncologic Hospital
    • , Lisa RenautAffiliated withIntestinal Imaging Centre, St. Marks HospitalHope Hospital
    • , Velauthan RudralinghamAffiliated withIntestinal Imaging Centre, St. Marks HospitalHope Hospital
    • , Saverio SignorettaAffiliated withIntestinal Imaging Centre, St. Marks HospitalCandiolo Oncologic Hospital
    • , Paola VagliAffiliated withIntestinal Imaging Centre, St. Marks HospitalUniversity of Pisa
    • , Victor Van der HulstAffiliated withAmsterdam Medical Centre
    • , Jane Williams-ButtAffiliated withIntestinal Imaging Centre, St. Marks HospitalBradford Royal Infirmary

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Abstract

Our purpose was to assess the effect of reader experience, fatigue, and scan findings on interpretation time for CT colonography. Nine radiologists (experienced in CT colonography); nine radiologists and ten technicians (both groups trained using 50 validated examinations) read 40 cases (50% abnormal) under controlled conditions. Individual interpretation times for each case were recorded, and differences between groups determined. Multi-level linear regression was used to investigate effect of scan category (normal or abnormal) and observer fatigue on interpretation times. Experienced radiologists (mean time 10.9 min, SD 5.2) reported significantly faster than less experienced radiologists and technicians; odds ratios of reporting times 1.4 (CI 1.1, 1.8) and 1.6 (1.3, 2.0), respectively (P≤0.001). Experienced and less-experienced radiologists took longer to report abnormal cases; ratio 1.2 (CI 1.1,1.4, P<0.001) and 1.2 (1.0, 1.3, P=0.03), respectively. All groups took 70% as long to report the final five cases as they did with an initial five; ratio 0.7 (CI 0.6 to 0.8), P<0.001. For technicians only, accuracy increased with longer reporting times (P=0.04). Experienced radiologists report faster than do less-experienced observers and proportionally spend less time interpreting normal cases. Technicians who report more slowly are more accurate. All groups reported faster as the study period progressed.

Keywords

CT Colon Virtual colonoscopy Computerised tomography