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Computed tomographic colonography: how many and how fast should radiologists report?
Anu E Obaro1,2, Andrew A Plumb3, Michael P North2
1Centre for Medical Imaging, Podium Level 2, University College London Hospital, Euston Rd, London, NW1 2BU, UK.
European Radiology
|April 10, 2019
Summary
Radiologists interpreting too many computed tomographic colonography (CTC) scans daily or too quickly detect fewer polyps. Limiting daily CTC workload and ensuring adequate interpretation time can improve polyp detection rates.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Computed tomographic colonography (CTC) is a key tool for colorectal cancer screening.
- Optimizing radiologist performance in CTC interpretation is crucial for maximizing its effectiveness.
- Factors influencing polyp detection rates in CTC require further investigation.
Purpose of the Study:
- To investigate the association between the number of daily CTC examinations interpreted by a radiologist and polyp detection rates.
- To determine if the time spent scrutinizing CTC scans impacts polyp detection.
- To identify potential workflow or performance factors affecting CTC accuracy.
Main Methods:
- Retrospective observational study analyzing CTC data from two hospitals (Jan 2012-Dec 2015).
- Data extracted included the number of prior CTCs interpreted daily and interpretation time per scan.
- Multilevel logistic regression used to assess relationships between workload, interpretation time, and polyp detection metrics (referral rate, PPV, PDR).
Main Results:
- A total of 5,191 CTC scans were analyzed, with 17.2% reported positive and 10.3% confirmed polyp detection.
- Increased daily CTC workload and faster interpretation times were significantly associated with reduced polyp detection rates (PDR).
- Each additional CTC interpreted per day decreased PDR by 7%; a 16% increase in interpretation time correlated with a 1% PDR increase.
Conclusions:
- High daily CTC interpretation volume and rapid scan scrutiny are linked to decreased polyp detection.
- Recommendations include protecting radiologists from excessive workloads and establishing minimum interpretation times.
- Quality markers for CTC interpretation, such as minimum time per case, should be considered by professional bodies.
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