Variation in diagnostic performance among radiologists at screening CT colonography

Area of Science:

• Medical Imaging
• Gastroenterology
• Radiology

Background:

• Computed tomographic (CT) colonography is a screening tool for colorectal cancer.
• Assessing inter-reader variability in diagnostic performance is crucial for quality assurance.

Purpose of the Study:

• To evaluate the variation in diagnostic performance among radiologists interpreting screening CT colonography.
• To compare key performance measures, including adenoma and advanced neoplasia detection rates, across multiple radiologists.

Main Methods:

• A retrospective analysis of 6866 asymptomatic adults undergoing first-time CT colonography screening.
• Data from eight board-certified abdominal radiologists with varying experience levels were analyzed.
• Diagnostic performance metrics were compared, including neoplasia detection and examination quality.

Main Results:

• Prevalence of advanced neoplasia and the proportion of polyps with advanced neoplasia did not differ significantly among radiologists.
• Per-polyp endoscopic confirmation rates and the percentage of nondiagnostic examinations were consistent across readers.
• No significant variation in diagnostic performance was observed, even when excluding an outlier reader.

Conclusions:

• Radiologists demonstrated consistent performance in detecting adenomas and advanced neoplasia during CT colonography screening.
• Key clinical endpoints, including neoplasia detection and examination quality, were reliably achieved across interpreting radiologists.
• The findings support the reliability of CT colonography as a screening tool with consistent diagnostic performance among experienced readers.