Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

• Published in: Diagnostic and interventional radiology (Ankara, Turkey) Turkey), 2014-05, Vol.20 (3), p.277-284
• Main Authors: Kim, Eun Soo, Yoon, Dae Young, Lee, Ha-yeon, Ku, You Jin, Han, Ari, Yoon, Soo Jeong, Kim, Heung Cheol
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Consciousness Disorders - diagnostic imaging; Craniocerebral Trauma - diagnostic imaging; Emergency Service, Hospital; Epilepsy - diagnostic imaging; Female; Headache Disorders - diagnostic imaging; Humans; Imaging, Three-Dimensional; Internship and Residency; Male; Middle Aged; Neuroradiography; Neuroradiology; Observer Variation; Retrospective Studies; Skull - diagnostic imaging; Stroke - diagnostic imaging; Tomography, X-Ray Computed; Young Adult
• ISSN: 1305-3825; 1305-3612
• DOI: 10.5152/dir.2014.13401

Three-dimensional (3D) reformatted images provide a more inclusive representation of abnormalities than transverse images in cranial computed tomography (CT). The purpose of this study was to assess the value of 3D reformations for radiology residents in the interpretation of emergency cranial CTs. In total, 218 consecutive patients who underwent emergency cranial CT scans with 3D reformation were included in this retrospective study. Four blinded readers (three radiology residents and a neuroradiologist) interpreted the transverse and 3D images in two separate sessions. Each reader assessed 1) abnormal finding(s) and the confidence score(s) (5-point scale) for transverse and 3D images, 2) added value score of 3D images (5-point scale), and 3) interpretation time for both transverse and 3D images. We analyzed discordance between each radiology resident and the neuroradiologist on a lesion-by-lesion basis. In total, 509 lesions were detected in 218 patients. Discordance rates between the three residents and the neuroradiologist were 11.4%-20.2% (mean, 15.0%) and 8.8%-16.9% (mean, 12.1%) in the interpretation of transverse and 3D images, respectively. Confidence scores were higher for 3D images than for transverse images for all readers. The added value scores for the 3D images were relatively higher for the inexperienced residents. Interpretation times for 3D images were significantly higher than for transverse images for all readers. The 3D reformations assist radiology residents in the interpretation of emergency cranial CT examinations.