Diagnostic accuracy of radiographer reporting of computed tomography colonography examinations: a systematic review

Computed tomography colonography (CTC) is the primary radiological test for the detection of colorectal tumours and precancerous polyps. Radiographer reporting of CTC examinations could help to improve the provision of this expanding service. We undertook a systematic review to assess the accuracy with which radiographers can provide formal written reports on intraluminal disease entities of CTC examinations compared to a reference standard. Data sources searched included online databases, peer-reviewed journals, grey literature, and reference and citation tracking. Eligible studies were assessed for bias, and data were extracted on study characteristics. Pooled estimates of sensitivities and specificities and chi-square tests of heterogeneity were calculated. Eight studies were eligible for inclusion with some risk to bias. Pooled estimates from three studies showed per patient sensitivity and specificity of reporting radiographers was 76% (95% CI: 70-80%) and 74% (95% CI: (67-80%), respectively. From seven studies, per lesion sensitivity for the detection of lesions >5 and >10 mm was 68% (95% CI: 65-71%) and 75% (95% CI: 72-79%) respectively. Pooled sensitivity for detection of lesions >5 mm in studies for which radiographers reported 50 or less training cases was 57% (95% CI: 52-61%) and more than 50 cases was 78% (95% CI: 74-81%). The current evidence does not support radiographers in a role involving the single formal written reporting of CTC examinations. Radiographers' performance, however, did appear to improve significantly with the number read. Therefore, when provided with adequate training and experience, there may be a potential role for radiographers in the reporting of CTC examinations.