Jensch Sebastiaan, van Gelder Rogier E, Florie Jasper, Thomassen-de Graaf Marloes A, Lobé Jack V, Bossuyt Patrick M M, Bipat Shandra, Nio C Yung, Stoker Jaap
Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, Noord-Holland, The Netherlands.
AJR Am J Roentgenol. 2007 Mar;188(3):W249-55. doi: 10.2214/AJR.06.0451.
The purpose of this study was to compare the accuracy of radiographers with that of radiologists in the interpretation of CT colonographic images.
Four observers (a radiologist, a radiologist in training, and two radiographers) evaluated 145 data sets using a primary 3D approach. The radiographers were part of our CT colonography work group and underwent training that consisted of 20 cases. The reference standard was optical colonoscopy with second-look colonoscopy for discrepant lesions > or = 10 mm in diameter. Mean sensitivities per patient and per polyp stratified for size (any size, > or = 6 mm, and > or = 10 mm) was determined for the radiologists and radiographers. Specificity was determined on a per-patient basis.
At colonoscopy in 86 of 145 patients, a total of 317 polyps were found (60 polyps > or = 6 mm in 26 patients and 31 polyps > or = 10 mm in 18 patients). No statistically significant differences were found in detection rates between radiologists and radiographers. Sensitivities for patients with a lesion of any size (66% for radiologists vs 65% for radiographers), > or = 6 mm (81% vs 87%), and > or = 10 mm (both 78%) were similar for all observers. On a per-polyp basis, detection rates were equivalent regardless of polyp size (47% vs 40%), for lesions > or = 6 mm (71% vs 65%), and for lesions > or = 10 mm (69% vs 66%). Mean specificities were similar among patients without lesions (31% vs 30%), patients without lesions > or = 6 mm (71% vs 67%), and patients without lesions > or = 10 mm (93% vs 93%).
Radiographers with training in CT colonographic evaluation achieved sensitivity and specificity in polyp detection comparable with that of radiologists. Radiographers can be considered reviewers in the evaluation of CT colonographic images.
本研究旨在比较放射技师与放射科医生解读CT结肠成像图像的准确性。
四名观察者（一名放射科医生、一名实习放射科医生和两名放射技师）采用主要的三维方法评估了145个数据集。放射技师是我们CT结肠成像工作组的成员，并接受了由20个病例组成的培训。参考标准是光学结肠镜检查，并对直径大于或等于10毫米的有差异病变进行二次结肠镜检查。确定了放射科医生和放射技师针对患者和按大小分层的息肉（任何大小、大于或等于6毫米、大于或等于10毫米）的平均敏感度。特异性是按患者计算的。
在145名患者中的86名患者进行结肠镜检查时，共发现317个息肉（26名患者中有60个息肉大于或等于6毫米，18名患者中有31个息肉大于或等于10毫米）。放射科医生和放射技师之间的检出率没有统计学上的显著差异。所有观察者对于任何大小病变（放射科医生为66%，放射技师为65%）、大于或等于6毫米（81%对87%）和大于或等于10毫米（均为78%）的患者的敏感度相似。基于每个息肉，无论息肉大小（47%对40%）、大于或等于6毫米的病变（71%对65%）以及大于或等于10毫米的病变（69%对66%），检出率都是相当的。在无病变患者（31%对30%）、无大于或等于6毫米病变的患者（71%对67%）以及无大于或等于10毫米病变的患者（93%对93%）中，平均特异性相似。
接受过CT结肠成像评估培训的放射技师在息肉检测方面达到了与放射科医生相当的敏感度和特异性。放射技师可被视为CT结肠成像图像评估的审阅者。
