Limits...
Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists

View Article: PubMed Central - PubMed

ABSTRACT

Background: Low-dose computed tomography (LDCT) techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed.

Objectives: To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT) and contrast-enhanced standard dose CT (CE-SDCT) for acute appendicitis among attending and resident radiologists.

Patients and methods: This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC) curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI) subgroups and noise using independent T test.

Results: Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05) for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically significant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018) on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not significantly related to BMI or noise.

Conclusion: Attending radiologists could diagnose acute appendicitis accurately on NE-LDCT. Performance of senior residents on NE-LDCT is better than junior residents and comparable to attending radiologists.

No MeSH data available.


Related in: MedlinePlus

Bar charts of AUC values for the diagnosis of acute appendicitis on NE-LDCT and CE-SDCT of six readers. Statistically significant inter-observer comparisons (P < 0.05) of AUC values on both NE-LDCT (solid line) and CE-SDCT (dash line) are denoted by * (CE-SDCT, contrast enhanced standard dose computed tomography; NE-LDCT, non-enhanced low dose computed tomography; AUC, area under the curve).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037579&req=5

fig26118: Bar charts of AUC values for the diagnosis of acute appendicitis on NE-LDCT and CE-SDCT of six readers. Statistically significant inter-observer comparisons (P < 0.05) of AUC values on both NE-LDCT (solid line) and CE-SDCT (dash line) are denoted by * (CE-SDCT, contrast enhanced standard dose computed tomography; NE-LDCT, non-enhanced low dose computed tomography; AUC, area under the curve).

Mentions: Inter-observer comparisons of AUC values among the six readers on NE-LDCT and CE-SDCT for the diagnosis of acute appendicitis are tabulated and compared in Figure 4. The AUC values on both NE-LDCT and CE-SDCT of the three attending radiologists (readers 1, 2, and 3) were comparable. A similar comparison between the three attending radiologists and the senior resident radiologist (reader 4) also showed no difference. A statistically significant difference in AUC values on NE-LDCT (P = 0.001 - 0.018) was observed when they were compared between attending radiologists and junior resident radiologists (readers 5 and 6). Similar comparisons of AUC values on CE-SDCT showed significant differences (P = 0.008 - 0.041) only between the attending radiologists (readers 1, 2 and 3) and one junior resident radiologist (reader 6).


Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists
Bar charts of AUC values for the diagnosis of acute appendicitis on NE-LDCT and CE-SDCT of six readers. Statistically significant inter-observer comparisons (P < 0.05) of AUC values on both NE-LDCT (solid line) and CE-SDCT (dash line) are denoted by * (CE-SDCT, contrast enhanced standard dose computed tomography; NE-LDCT, non-enhanced low dose computed tomography; AUC, area under the curve).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037579&req=5

fig26118: Bar charts of AUC values for the diagnosis of acute appendicitis on NE-LDCT and CE-SDCT of six readers. Statistically significant inter-observer comparisons (P < 0.05) of AUC values on both NE-LDCT (solid line) and CE-SDCT (dash line) are denoted by * (CE-SDCT, contrast enhanced standard dose computed tomography; NE-LDCT, non-enhanced low dose computed tomography; AUC, area under the curve).
Mentions: Inter-observer comparisons of AUC values among the six readers on NE-LDCT and CE-SDCT for the diagnosis of acute appendicitis are tabulated and compared in Figure 4. The AUC values on both NE-LDCT and CE-SDCT of the three attending radiologists (readers 1, 2, and 3) were comparable. A similar comparison between the three attending radiologists and the senior resident radiologist (reader 4) also showed no difference. A statistically significant difference in AUC values on NE-LDCT (P = 0.001 - 0.018) was observed when they were compared between attending radiologists and junior resident radiologists (readers 5 and 6). Similar comparisons of AUC values on CE-SDCT showed significant differences (P = 0.008 - 0.041) only between the attending radiologists (readers 1, 2 and 3) and one junior resident radiologist (reader 6).

View Article: PubMed Central - PubMed

ABSTRACT

Background: Low-dose computed tomography (LDCT) techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed.

Objectives: To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT) and contrast-enhanced standard dose CT (CE-SDCT) for acute appendicitis among attending and resident radiologists.

Patients and methods: This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC) curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI) subgroups and noise using independent T test.

Results: Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05) for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically signi&#64257;cant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018) on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not significantly related to BMI or noise.

Conclusion: Attending radiologists could diagnose acute appendicitis accurately on NE-LDCT. Performance of senior residents on NE-LDCT is better than junior residents and comparable to attending radiologists.

No MeSH data available.


Related in: MedlinePlus