Abdominal Multidetector Computed Tomography for Suspected Small-Bowel Obstruction: Multireader Study Comparing...

Area of Science:

• Radiology
• Gastroenterology
• Abdominal Imaging

Background:

• Small-bowel obstruction (SBO) is a common surgical emergency.
• Accurate prediction of surgical intervention, bowel resection, and ischemia is crucial for patient management.
• Multidetector computed tomography (MDCT) is a key imaging modality for evaluating SBO.

Purpose of the Study:

• To compare the diagnostic performance of junior (JR) and senior (SR) abdominal radiologists.
• To evaluate their ability to predict surgical intervention, bowel resection, and bowel ischemia using MDCT in patients with suspected SBO.

Main Methods:

• Retrospective review of MDCT studies in 179 adult patients with suspected SBO.
• Independent, blinded review by 12 board-certified radiologists (6 JR, 6 SR).
• Readers assessed likelihood of surgery, ischemia, and resection; correlation with clinical outcomes and pathology.

Main Results:

• Pooled receiver operating characteristic (ROC) areas under the curve for surgery, ischemia, and resection were comparable between JR and SR.
• No statistically significant differences in overall performance between JR and SR (P = 0.451).
• Variability in highest/lowest performing readers existed both between and within JR/SR groups (P < 0.001, P = 0.008).

Conclusions:

• Junior radiologists achieved performance levels similar to senior radiologists in predicting surgical outcomes for SBO on MDCT.
• Experience level alone did not confer a significant advantage in interpreting MDCT for SBO-related surgical outcomes.
• MDCT interpretation for SBO management can be effectively performed by both junior and senior radiologists.