title: Does training and experience influence the accuracy of computed tomography colonography interpretation?
abstract: OBJECTIVE
  To evaluate the effect of experience on the accuracy rate of computed tomography colonography (CTC) interpretation and patient preferences/satisfaction for CTC and colonoscopy.
  
  
  METHODS
  A prospective, non-randomized, observational study performed in a single, tertiary care center involving 90 adults who underwent CTC followed by colonoscopy on the same day. CTC was interpreted by an abdominal imaging radiologist and then a colonoscopy was performed utilizing segmental un-blinding and re-examination as required. A radiology resident and two gastroenterology (GI) fellows blinded to the results also interpreted the CTC datasets independently. Accuracy rates and trend changes were determined for each reader to assess for a learning curve.
  
  
  RESULTS
  Among 90 patients (57% male) aged 55 ± 8.9 years, 39 polyps ≥ 6 mm were detected in 20 patients and 13 polyps > 9 mm in 10 patients. Accuracy rates were 88.9% (≥ 6 mm) and 93.3% (> 9 mm) for the GI Radiologist, 89.8% (≥ 6 mm) and 98.9% (> 9 mm) for the Radiology Resident and 86.7% and 95.6% (≥ 6 mm) and 87.8% and 94.4% (> 9 mm) for each of the GI fellows respectively. The reader's accuracy rate did not change significantly with the percentage change rate ranging between -1.7 to 0.9 (P = 0.12 to 0.56). Patients considered colonoscopy more satisfactory than CTC (30% vs 4%, P < 0.0001), they felt less anxiety during colonoscopy (36% vs 7%, P < 0.0001), they experienced less pain or discomfort during colonoscopy compared to CTC (69% vs 4%, P < 0.0001) and colonoscopy was preferred by 77% of the participants as a repeat screening test for the future.
  
  
  CONCLUSIONS
  No statistically significant learning curve was identified in CTC interpretation suggesting that further study is required to identify the necessary training to adequately interpret CTC scans.
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Rosenfeld
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Yi Tzu Nancy
authors.initials: YT
authors.lastname: Fu
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Brendan
authors.initials: B
authors.lastname: Quiney
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Hong
authors.initials: H
authors.lastname: Qian
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Darin
authors.initials: D
authors.lastname: Krygier
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Jacquie
authors.initials: J
authors.lastname: Brown
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Vos
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Pari
authors.initials: P
authors.lastname: Tiwari
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Telford
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Bressler
authors.affiliation: Greg Rosenfeld, Yi Tzu Nancy Fu, Brendan Quiney, Hong Qian, Darin Krygier, Jacquie Brown, Patrick Vos, Pari Tiwari, Jennifer Telford, Brian Bressler, Robert Enns, Division of Gastroenterology, Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Enns
mesh_terms: D000328:Adult; D000368:Aged; D023881:Colonography, Computed Tomographic; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005189:False Positive Reactions; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D057240:Patient Preference; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Colonoscopy; Colorectal cancer screening; Colorectal neoplasia; Computed tomography colonography