title: CT screening for lung cancer: value of expert review of initial baseline screenings.
abstract: OBJECTIVE. Appropriate radiologic interpretation of screening CT can minimize unnecessary workup and intervention. This is particularly challenging in the baseline round. We report on the quality assurance process we developed for the International Early Lung Cancer Action Program. MATERIALS AND METHODS. After initial training at the coordinating center, radiologists at 10 participating institutions and at the center independently interpreted the first 100 baseline screenings. The radiologist at the institutions had access to the center interpretations before issuing the final reports. After the first 100 screenings, the interpretations were jointly discussed. This report summarizes the results of the initial 100 dual interpretations at the 10 institutions. RESULTS. The final institution interpretations agreed with the center in 895 of the 1000 interpretations. Compared with the center, the frequency of positive results was higher at eight of the 10 institutions. The most frequent reason of discrepant interpretations was not following the protocol (n = 55) and the least frequent was not identifying a nodule (n = 3). CONCLUSION. The quality assurance process helped focus educational programs and provided an excellent vehicle for review of the protocol with participating physicians. It also suggests that the rate of positive results can be reduced by such measures.
authors.affiliation: 1 Department of Radiology, Mount Sinai School of Medicine, One Gustave L. Levy Pl, Box 1234, New York, NY 10029.
authors.forename: Dong Ming
authors.initials: DM
authors.lastname: Xu
authors.forename: In Jae
authors.initials: IJ
authors.lastname: Lee
authors.forename: Shijun
authors.initials: S
authors.lastname: Zhao
authors.forename: Yip
authors.initials: Y
authors.lastname: Rowena
authors.forename: Ali
authors.initials: A
authors.lastname: Farooqi
authors.forename: Edson H
authors.initials: EH
authors.lastname: Cheung
authors.forename: Cliff P
authors.initials: CP
authors.lastname: Connery
authors.forename: Carmine
authors.initials: C
authors.lastname: Frumiento
authors.forename: Robert M
authors.initials: RM
authors.lastname: Glassberg
authors.forename: Gary
authors.initials: G
authors.lastname: Herzog
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Peeke
authors.forename: Paul
authors.initials: P
authors.lastname: Scheinberg
authors.forename: Palmi
authors.initials: P
authors.lastname: Shah
authors.forename: Jana
authors.initials: J
authors.lastname: Taylor
authors.forename: Laura
authors.initials: L
authors.lastname: Welch
authors.forename: Mark
authors.initials: M
authors.lastname: Widmann
authors.forename: Mark
authors.initials: M
authors.lastname: Yoder
authors.forename: David F
authors.initials: DF
authors.lastname: Yankelevitz
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Henschke
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D014057:Tomography, X-Ray Computed
keywords: CT screening; lung cancer; positive result; quality assurance; specialized radiology training