title: Variation in diagnostic performance among radiologists at screening CT colonography.
abstract: OBJECTIVE
  To assess the variation in diagnostic performance among radiologists at screening computed tomographic (CT) colonography.
  
  
  METHODS
  In this HIPAA-compliant, institutional review board-approved study, 6866 asymptomatic adults underwent first-time CT colonographic screening at a single center between January 2005 and November 2011. Results of examinations were interpreted by one of eight board-certified abdominal radiologists (mean number of CT colonographic studies per reader, 858; range, 131-2202). Findings at CT colonography and subsequent colonoscopy were recorded, and key measures of diagnostic performance, including adenoma and advanced neoplasia detection rate, were compared among the radiologists.
  
  
  RESULTS
  The overall prevalence of histopathologically confirmed advanced neoplasia was 3.6% and did not differ significantly among radiologists (range, 2.4%-4.4%; P = .067; P = .395 when one outlier was excluded). Overall, 19.5% of polyps detected at CT colonography proved to be advanced neoplasia and did not differ significantly among radiologists (range, 14.4%-23.2%; P = .223). The overall per-polyp endoscopic confirmation rate was 93.5%, ranging from 80.0% to 97.6% among radiologists (P = .585). The overall percentage of nondiagnostic CT colonographic examinations was 0.7% and was consistent among radiologists (range, 0.3%-1.1%; P = .509).
  
  
  CONCLUSIONS
  Consistent performance for adenoma and advanced neoplasia detection, as well as other clinically relevant end points, were observed among radiologists at CT colonographic screening.
authors: Department of Radiology, University of Wisconsin School of Medicine and Public Health, E3/311 Clinical Science Center, 600 Highland Ave, Madison, WI 53792-3252, USA.
authors: B Dustin
authors: BD
authors: Pooler
authors: David H
authors: DH
authors: Kim
authors: Cesare
authors: C
authors: Hassan
authors: Antonio
authors: A
authors: Rinaldi
authors: Elizabeth S
authors: ES
authors: Burnside
authors: Perry J
authors: PJ
authors: Pickhardt
mesh_terms: D016009:Chi-Square Distribution; D002983:Clinical Competence; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D014922:Wisconsin / Q000453:epidemiology
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine