Study examines performance of rads, residents in interpreting low-dose appendiceal CT

Radiologists require years of training and clinical experience to significantly improve at interpreting low-dose appendiceal CT, according to a recent study published by the American Journal of Roentgenology.

Hyun Kyung Yang, MD, Seoul National University Bundang Hospital in Gyeonggi-do, Korea, and colleagues asked a group of attending radiologists, senior residents, second-year residents, and first-year residents to complete a 30-case online training course in low-dose appendiceal CT.

Overall, the researchers found that individuals with more training exhibited an improved diagnostic performance. Attending radiologists scored the highest in terms of accuracy (90 percent), sensitivity (93 percent), and specificity (89 percent). In addition, senior residents finished second in all three categories, second-year residents finished third in all three categories, and finally, first-year residents finished fourth in all three categories.

The results varied from what the researchers initially expected.  

“When we designed this study, we hypothesized a significant intrareader learning curve at least for the inexperienced readers,” the authors wrote. “However, we did not observe improvements in the measured performances for readers in any of the four training levels except improvements in reading times.”

Yang et al. also wrote that they uncovered some interesting facts when taking a closer look at the training course results.

“The performances were significantly affected by the prior overall experience with appendiceal CT in general but not by the prior experience with low-dose appendiceal CT specifically,” the authors wrote. “In addition, we observed a consistent association between the reading time and performances, indicating that readers required more time for difficult cases.”

The authors noted that appendicitis is relatively common, and interpretation of appendiceal CT to diagnose or rule out the disease is often left to “nonexpert or relatively inexperienced radiologists.” Their analysis provides insight into what radiologists in training need most to improve and excel at diagnosing appendicitis: experience.

“The learning curve is likely prolonged and forms gradually over years by overall radiology training and clinical experience in general rather than by experience with low-dose appendiceal CT specifically,” the authors wrote.