Can radiographers be trained to triage CT colonography for extracolonic findings?

Abstract

ObjectivesRadiographers have been shown to be capable CT colonography observers. We evaluated whether radiographers can be trained to triage screening CT colonography for extracolonic findings.MethodsEight radiographers participated in a structured training program. They subsequently evaluated extracolonic findings in 280 low-dose CT colonograms (cases). This dataset contained 66 cases with possibly important findings (E3) and 27 cases with probably important findings (E4) [classification based on the highest classified finding (C-RADS)]. The first 40 and last 40 CT colonograms were identical test cases. Immediate feedback was given after each reading, except for test cases. Radiographers triaged cases based on C-RADS classification and indicated the need for a radiologist read. We constructed learning curves for correct case triaging by calculating moving averages.ResultsIn the final test series, 84/120 (70 %) cases with E3 or E4 findings and 139/200 (70 %) without E3 or E4 findings were correctly triaged. Correct identification of cases with E3 findings improved with training from 46/88 (52 %) to 62/88 (70 %) (P < 0.0001) but not for E4 findings [both 22/32 (69 %) P = 1.00].ConclusionsRadiographers improve after training in correctly triaging extracolonic findings at CT colonography but do not reach a high enough accuracy to consider their structural involvement in screening.Key Points• Radiographers were trained to triage CT colonography for extracolonic findings.• After training, radiographers improved sensitivity for likely unimportant findings.• After training, radiographers did not improve sensitivity for possibly important findings.• Radiographers should probably not be expected to identify all extracolonic findings.

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The bowel and beyond: extracolonic findings from CT colonography

“…However, a Dutch study in 2012 invited eight radiographers to engage in a structured training programme, to triage cases based on the CT colonography reporting and data system and to flag the appropriate scans for a radiologist review. They found that correct identification of E3 findings improved from 52 to 70% after training, but identification of E4 findings was unchanged at 69% [ 18 ]. As such, radiographers should not be expected to identify all extracolonic findings.…”