Effect of investigator experience in CT colonography

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.

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