title: Abdominal Multidetector Computed Tomography for Suspected Small-Bowel Obstruction: Multireader Study Comparing Radiologist Performance for Predicting Surgical Outcomes.
abstract: OBJECTIVE
  To compare performance of junior (JR)/senior (SR) abdominal radiologists using multidetector computed tomography (MDCT) to predict surgical intervention, bowel resection, and presence of bowel ischemia in patients with suspected small-bowel obstruction (SBO).
  
  
  METHODS
  Retrospective, institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, blinded, independent review of MDCT studies for suspected SBO in 179 adults (mean age, 55.8 years; 86 men/93 women) was performed by 12 board-certified radiologists (6 JR, 6 SR). Readers rated likelihood of need for surgery, bowel ischemia, and resection. Correlation with clinical outcomes/pathology was performed.
  
  
  RESULTS
  Pooled receiver operating characteristic area under the curve for surgery, ischemia, and resection were 0.802, 0.736, and 0.824 and 0.773, 0.851, and 0.751 JR/SR, respectively. Sensitivity/specificity for predicting surgery was 86.7%/65.4% and 79.6%/64.4%. No differences existed between JR/SR performance overall (P = 0.451); highest/lowest performing readers between groups (P < 0.001) and within groups (P = 0.008) varied.
  
  
  CONCLUSIONS
  Junior radiologists performed as well as SR in predicting surgical outcomes on MDCT in patients with suspected SBO.
authors.affiliation: From the University of Wisconsin School of Medicine & Public Health, Madison, WI.
authors.forename: Andrew
authors.initials: A
authors.lastname: Scrima
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.forename: Scott
authors.initials: S
authors.lastname: King
authors.forename: Gregory
authors.initials: G
authors.lastname: Kennedy
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
mesh_terms: D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000601:surgery*; D007421:Intestine, Small / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011860:Radiography, Abdominal / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome