Document Detail

64-Slice Multidetector-row Computed Tomography in the Diagnosis of Coronary Artery Disease: Interobserver Agreement Among Radiologists With Varied Levels of Experience on a Per-patient and Per-segment Basis.
MedLine Citation:
PMID:  21102356     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: To assess the interobserver variability of 4 radiologists with different levels of experience in the evaluation of 64-slice coronary computed tomographic angiography (cCTA).
MATERIALS AND METHODS: Two board-certified radiologists with 10 and 8 years of experience in reading cCTA and 2 radiology residents, 1 with 3 years of experience in reading cCTA and 1 with experience in reading general computed tomographic scans but without dedicated cCTA training, participated in the study. All the observers independently analyzed 50 cCTA studies for signs of coronary artery disease (stenosis of 0%, ≤49%, 50% to 74%, 75% to 99%, or 100%). Diagnostic accuracy of the 4 readers for stenosis detection on cCTA was compared with that of conventional angiography on a per-segment and per-patient basis. No patients, vessels, or segments were excluded from analysis.
RESULTS: On a per-segment basis, correlation between cCTA and invasive coronary angiography was good for readers with more than 10 (r=0.75), more than 8 (r=0.75), and more than 3 (r=0.73) years of cCTA experience. The correlation coefficient was poor (r=0.39) for the untrained reader. Sensitivity was not significantly (P=0.56) different between observers with more than 8 and more than 10 years of experience but was significantly (P>0.05) lower for the reader with less than 3 years experience and for the untrained reader. However, we found no significant difference in overall diagnostic accuracy on a per-patient (P=0.86) and on a per-segment level (P=0.72) among the 4 readers.
CONCLUSION: The level of experience significantly influences the sensitivity of coronary artery stenosis detection at cCTA, and thus highlights the need for dedicated training in cCTA interpretation.
Josef Matthias Kerl; U Joseph Schoepf; Ralf W Bauer; Tuna Tekin; Philip Costello; Thomas J Vogl; Christopher Herzog
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thoracic imaging     Volume:  27     ISSN:  1536-0237     ISO Abbreviation:  J Thorac Imaging     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2011-12-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606160     Medline TA:  J Thorac Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-35     Citation Subset:  IM    
*Department of Radiology and Radiological Science ‡Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC †Department of Diagnostic and Interventional Radiology, University of Frankfurt, Frankfurt, Germany.
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