Effect of investigator experience in CT colonography
Effect of investigator experience in CT colonography
复制标题
CT结肠成像中研究者经验的影响
作者：
T. Gluecker;J. Meuwly;P. Pescatore;P. Schnyder;J. Delarive;P. Jornod;R. Meuli;G. Dorta
抽象的。本研究的目的是确定学习曲线对CT结肠成像诊断性能的影响。两个设盲的小组，每个小组有一名放射科医生和胃肠病学家，前瞻性地检查了50名患者，使用螺旋CT扫描，然后进行结肠镜检查。在24个数据集（第1组）后进行中间数据评价，并与26名后续患者（第2组）的数据进行比较。评价的参数包括敏感性、特异性、假阳性和假阴性结果、数据采集和解释的时间。使用结肠镜检查作为金标准，对于第1组患者，两组的CT结肠成像对于>5 mm病变的灵敏度为63%;对于第2组患者，第1组的灵敏度为45%，第2组为64%。患者组1的特异性为42%（组1）和58%（组2）;患者组2的特异性为79%（组1 p=0.04;组2 p=0.2）。第1组与第2组相比，假阳性结果的数量显著减少（p=0.02）。此外，数据评价的平均时间从45分钟减少到17分钟（p=0.002），数据采集的平均时间从19分钟减少到17分钟。随着经验的增加，特异性和数据解释所需的时间得到改善，假阳性减少。敏感性、假阴性结果和数据采集时间无显著变化。CT结肠成像的数据解释需要读片者的最低经验。
Abstract. The aim of this study was to determine the impact of the learning curve on the diagnostic performances of CT colonography. Two blinded teams, each having a radiologist and gastroenterologist, prospectively examined 50 patients using helical CT scan followed by colonoscopy. Intermediate data evaluation was performed after 24 data sets (group 1) and compared with data from 26 subsequent patients (group 2). Parameters evaluated included sensitivity, specificity, false-positive and false-negative findings, time of data acquisition and interpretation. Using colonoscopy as the gold standard, sensitivity for CT colonography was for lesions >5 mm 63% for both teams for group 1 patients; for group 2 patients sensitivity was 45% for team 1 and 64% for team 2. Specificity per patients was for patient group 1 42% for team 1 and 58% for team 2; for patient group 2 it was 79% for both teams (p=0.04 for team 1; p=0.2 for team 2). Comparing group 1 with group 2, the number of false-positive findings decreased significantly (p=0.02). Furthermore, the mean time of data evaluation decreased from 45 to 17 min (p=0.002) and the mean time of data acquisition from 19 to 17 min. With increasing experience, specificity and the time required for data interpretation improved and false positives decreased. There was no significant change of sensitivity, false-negative findings and time of data acquisition. A minimum experience of the readers is required for data interpretation of CT colonography.
螺旋 CT 结肠镜检查（虚拟结肠镜检查）：先进技术和普遍性之间存在的挑战。
DOI：
10.2214/ajr.173.3.10470878
发表时间：
1999
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
McFarland,EG;Brink,JA
通讯作者：
Brink,JA
影响因子：
158.5
作者：
WINAWER, SJ;ZAUBER, AG;STEWART, ET
通讯作者：
STEWART, ET