title: Using computed tomography enterography to evaluate patients with Crohn's disease: what impact does examiner experience have on the reproducibility of the method?
abstract: OBJECTIVE
  To assess the impact that examiner experience has on the reproducibility and accuracy of computed tomography (CT) enterography in the detection of radiological signs in patients with Crohn's disease.
  
  
  METHODS
  This was a retrospective, cross-sectional observational study involving the analysis of CT enterography scans of 20 patients with Crohn's disease. The exams were analyzed independently by two radiologists in their last year of residence (duo I) and by two abdominal imaging specialists (duo II). The interobserver agreement of each pair of examiners in identifying the main radiological signs was calculated with the kappa test. The accuracy of the examiners with less experience was quantified by using the consensus among three experienced examiners as a reference.
  
  
  RESULTS
  Duo I and duo II obtained a similar interobserver agreement, with a moderate to good correlation, for mural hyperenhancement, parietal thickening, mural stratification, fat densification, and comb sign (kappa: 0.45-0.64). The less experienced examiners showed an accuracy > 80% for all signs, except for lymph nodes and fistula, for which it ranged from 60% to 75%.
  
  
  CONCLUSIONS
  Less experienced examiners have a tendency to present a level of interobserver agreement similar to that of experienced examiners in evaluating Crohn's disease through CT enterography, as well as showing satisfactory accuracy in identifying most radiological signs of the disease.
authors.affiliation: MD, Radiologist in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Stênio
authors.initials: S
authors.lastname: Burlin
authors.affiliation: MD, Radiologist, Specialist in Abdominal Imaging in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Larissa Rossini
authors.initials: LR
authors.lastname: Favaro
authors.affiliation: MD, Radiologist, Graduate Student in Abdominal Imaging in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Elisa Almeida Sathler
authors.initials: EA
authors.lastname: Bretas
authors.affiliation: MD, Radiologist, Specialist in Abdominal Imaging in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Lincoln Seiji
authors.initials: LS
authors.lastname: Taniguchi
authors.affiliation: Pharmacist, Graduate Student in Preventive Medicine at the Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Loch
authors.affiliation: MD, Graduate Student in Clinical Gastroenterology, Discipline of Clinical Medicine, Department of Medicine of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Marjorie Costa
authors.initials: MC
authors.lastname: Argollo
authors.affiliation: PhD, Affiliate Professor, Discipline of Clinical Medicine, Department of Medicine of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Orlando
authors.initials: O
authors.lastname: Ambrogini Junior
authors.affiliation: Tenured Adjunct Professor in the Department of Diagnostic Imaging of the Escola Paulista de Medicina da Universidade Federal de São Paulo (EPM-Unifesp), São Paulo, SP, Brazil.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Ippolito
keywords: Crohn disease; Reproducibility of results; Tomography, X-ray computed