To participate in a multicenter study of screening CTC (ACRIN 6664), radiologists had to pass a certification exam. Inexperienced radiologists participated in a formal educational course prior to testing. Our purpose is to describe our experience with a certification exam.
METHOD AND MATERIALS
Radiologists who had interpreted fewer than 500 CTC exams participated in a one day educational course, reviewing 40 CTC datasets with didactic instruction. Subsequently all radiologists took a certification exam, consisting of 20 CTC datasets. Polyps > 5 mm were characterized as easy, moderate, or difficult, according to visual conspicuity, as assessed by 2 colonographers not participating in the test. Criteria for participation in the trial was 90% sensitivity for easy and moderate polyps. Those achieving between 76 - 89% sensitivity were re-invited for additional training, consisting of 24 additional cases, picked to emphasize characteristics of missed lesions. These radiologists then took 8 cases, consisting of previously missed cases, one normal exam and 1-2 difficult exam(s).
RESULTS
Twenty radiologists took the certification exam. The exam had 13 easy, 7 moderate and 5 difficult-to-detect polyps > 5 mm in size. On average, radiologists detected 90% of the easy polyps, 72% of the moderate polyps, and 43% of the difficult polyps. Eight (3/8 experienced) achieved greater than 90% sensitivity, eight (1/8 experienced) achieved 76 – 89% sensitivity, and four had less than 75% sensitivity. The seven inexperienced radiologists achieving 76 – 89% sensitivity underwent additional training. Subsequently, all of these radiologists detected all but one or two of the easy and moderate missed polyps at re-testing.
CONCLUSION
1. Some inexperienced radiologists interpret CTC exams with high sensitivity after minimal training, but most require review of 40-80 datasets to interpret exams with a high degree of sensitivity. 2. Most current training programs do not offer sufficient training to help radiologists perform optimally. 3. Testing should be used as an adjunct to didactic instruction to help radiologists understand idiosyncratic weaknesses and develop problem-solving techniques.
DISCLOSURE
J.G.F.: Grant - Siemens Medical Solutions
Educational License - GE Healthcare
CME Instructor - E-Z EM, Inc. C.D.J.: Software License - GE Healthcare
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