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Understanding Reader Variability: A 25-Radiologist Study on Liver Metastasis Detection at CT.
Hsieh, Scott S; Cook, David A; Inoue, Akitoshi; Gong, Hao; Sudhir Pillai, Parvathy; Johnson, Matthew P; Leng, Shuai; Yu, Lifeng; Fidler, Jeff L; Holmes, David R; Carter, Rickey E; McCollough, Cynthia H; Fletcher, Joel G.
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  • Hsieh SS; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Cook DA; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Inoue A; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Gong H; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Sudhir Pillai P; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Johnson MP; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Leng S; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Yu L; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Fidler JL; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Holmes DR; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Carter RE; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • McCollough CH; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
  • Fletcher JG; From the Departments of Radiology (S.S.H., A.I., H.G., P.S.P., S.L., L.Y., J.L.F., C.H.M., J.G.F.), General Internal Medicine (D.A.C.), Quantitative Health Services-Clinical Trials and Biostatistics (M.P.J.), and Physiology and Biomedical Engineering (D.R.H.), Mayo Clinic Rochester, 200 First St SW,
Radiology ; 306(2): e220266, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36194112
Background Substantial interreader variability exists for common tasks in CT imaging, such as detection of hepatic metastases. This variability can undermine patient care by leading to misdiagnosis. Purpose To determine the impact of interreader variability associated with (a) reader experience, (b) image navigation patterns (eg, eye movements, workstation interactions), and (c) eye gaze time at missed liver metastases on contrast-enhanced abdominal CT images. Materials and Methods In a single-center prospective observational trial at an academic institution between December 2020 and February 2021, readers were recruited to examine 40 contrast-enhanced abdominal CT studies (eight normal, 32 containing 91 liver metastases). Readers circumscribed hepatic metastases and reported confidence. The workstation tracked image navigation and eye movements. Performance was quantified by using the area under the jackknife alternative free-response receiver operator characteristic (JAFROC-1) curve and per-metastasis sensitivity and was associated with reader experience and image navigation variables. Differences in area under JAFROC curve were assessed with the Kruskal-Wallis test followed by the Dunn test, and effects of image navigation were assessed by using the Wilcoxon signed-rank test. Results Twenty-five readers (median age, 38 years; IQR, 31-45 years; 19 men) were recruited and included nine subspecialized abdominal radiologists, five nonabdominal staff radiologists, and 11 senior residents or fellows. Reader experience explained differences in area under the JAFROC curve, with abdominal radiologists demonstrating greater area under the JAFROC curve (mean, 0.77; 95% CI: 0.75, 0.79) than trainees (mean, 0.71; 95% CI: 0.69, 0.73) (P = .02) or nonabdominal subspecialists (mean, 0.69; 95% CI: 0.60, 0.78) (P = .03). Sensitivity was similar within the reader experience groups (P = .96). Image navigation variables that were associated with higher sensitivity included longer interpretation time (P = .003) and greater use of coronal images (P < .001). The eye gaze time was at least 0.5 and 2.0 seconds for 71% (266 of 377) and 40% (149 of 377) of missed metastases, respectively. Conclusion Abdominal radiologists demonstrated better discrimination for the detection of liver metastases on abdominal contrast-enhanced CT images. Missed metastases frequently received at least a brief eye gaze. Higher sensitivity was associated with longer interpretation time and greater use of liver display windows and coronal images. © RSNA, 2022 Online supplemental material is available for this article.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies Límite: Adult / Humans / Male Idioma: En Revista: Radiology Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies Límite: Adult / Humans / Male Idioma: En Revista: Radiology Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos