title: Evaluation of the efficacy of the guideline on reading CT images of malignant pleural mesothelioma with reference CT films for improving the proficiency of radiologists.
abstract: OBJECTIVE
  To assess the efficacy of the developed guideline on reading CT images of malignant pleural mesothelioma for improving radiologists' reading proficiency.
  
  
  METHODS
  Three radiologists independently read the CT films of 22 cases including definite mesothelioma and non-mesothelioma cases at two times before and after studying the malignant pleural mesothelioma CT Guideline. The sensitivity and specificity for mesothelioma were calculated and compared between the 1st and 2nd trials. The kappa statistics was examined for agreement with experts for mesothelioma probability and for mesothelioma features recorded by three radiologists.
  
  
  RESULTS
  After studying the mesothelioma CT Guideline, the sensitivity for mesothelioma shown by the three radiologists at the 2nd trial was 100%, 100% and 80%, which were higher than 80%, 85% and 60% at the 1st trial, respectively. The average kappa for agreement between radiologists and experts on dichotomized mesothelioma probability were 0.69 (good) at the 2nd trial vs. 0.38 (fair) at the 1st trial. The average kappa for the agreement with experts for each of 7 features by three radiologists were 0.52-0.80 at the 2nd trial, which were significantly higher than 0.34-0.58 at the 1st trial (Wilcoxon Signed Rank Test: P<0.01), and as to five features "unilateral pleural effusion", "nodular pleural thickening", "tumoral encasement of lung", "mediastinal pleural thickening", and "diminished lung", they achieved good agreement with average kappa of 0.61-0.80.
  
  
  CONCLUSIONS
  The developed mesothelioma CT Guideline was suggested to have substantial effect in improving the radiologists' proficiency for reading CT images of mesothelioma, and may contribute to accurate diagnosis of mesothelioma.
authors.affiliation: Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture 910-1193, Japan. zhouhua@u-fukui.ac.jp
authors.forename: Huashi
authors.initials: H
authors.lastname: Zhou
authors.forename: Taro
authors.initials: T
authors.lastname: Tamura
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Kusaka
authors.forename: Narufumi
authors.initials: N
authors.lastname: Suganuma
authors.forename: Ponglada
authors.initials: P
authors.lastname: Subhannachart
authors.forename: Chomphunut
authors.initials: C
authors.lastname: Vijitsanguan
authors.forename: Weeraya
authors.initials: W
authors.lastname: Noisiri
authors.forename: Kurt G
authors.initials: KG
authors.lastname: Hering
authors.forename: Masanori
authors.initials: M
authors.lastname: Akira
authors.forename: Harumi
authors.initials: H
authors.lastname: Itoh
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Arakawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Kumagai
authors.forename: Norio
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000368:Aged; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D038622:Internationality; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008654:Mesothelioma / Q000000981:diagnostic imaging*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D015588:Observer Variation; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D011361:Professional Competence / Q000592:standards*; D013902:Radiography, Thoracic / Q000592:standards; D011871:Radiology / Q000592:standards*; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards*; D014962:X-Ray Film / Q000592:standards*