Comparison of On-Call Radiology Resident and Faculty Interpretation of 4- and 16-row Multidetector CT Pulmonary Angiography with Indirect CT Venography

Rufener, Stephanie L.; Patel, Smita; Kazerooni, Ella A.; Schipper, Matthew; Kelly, Aine M.

doi:10.1016/j.acra.2007.06.030

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Volume 15, Issue 1 , Pages 71-76, January 2008

Comparison of On-Call Radiology Resident and Faculty Interpretation of 4- and 16-row Multidetector CT Pulmonary Angiography with Indirect CT Venography1

Stephanie L. Rufener, MD
- Department of Radiology, Division of Cardiothoracic Imaging, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- VA Ann Arbor Healthcare System, Ann Arbor, MI.
- Address correspondence to: S.L.R.
Smita Patel, MBBS, MRCP, FRCR
- Department of Radiology, Division of Cardiothoracic Imaging, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- VA Ann Arbor Healthcare System, Ann Arbor, MI.
Ella A. Kazerooni, MD, MS
- Department of Radiology, Division of Cardiothoracic Imaging, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- VA Ann Arbor Healthcare System, Ann Arbor, MI.
Matthew Schipper, PhD
- Department of Radiology, Division of Cardiothoracic Imaging, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109
Aine M. Kelly, MD, MS
- Department of Radiology, Division of Cardiothoracic Imaging, University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109
- VA Ann Arbor Healthcare System, Ann Arbor, MI.

Received 29 April 2007; accepted 29 June 2007.

Rationale and Objectives

On-call radiology residents frequently interpret computed tomography (CT) pulmonary angiography and CT venography studies outside of routine working hours. The purpose of this study was to compare resident and faculty interpretation concordance rates and to see if concordance rates differed depending on the number of CT detectors used.

Materials and Methods

The study population included 122 consecutive CT pulmonary angiography (CTPA) and CT venography (CTV) examinations performed on a four-row multidetector CT (MDCT) and 125 consecutive CTPA examinations performed using a 16-row MDCT scanner with CTV performed in 124 patients. Preliminary resident reports and final faculty reports were compared. Discrepant cases were independently reviewed by three cardiothoracic radiologists who were unaware of the initial interpretations. Interpretation concordance rates were calculated for both 4- and 16- row MDCT studies and compared using Fisher’s exact test.

Results

Resident and faculty CTPA and CTV interpretations were concordant in 80% of the 4-row cases and 94% of the 16-row cases. When comparing resident interpretation to the final expert reference standard, the corrected resident error rate was 11% and 2% for 4-row CTPA and CTV, respectively and 4% and 2% for 16-row CTPA and CTV, respectively. Overall CTPA and CTV concordance was significantly lower for 4-row MDCT (80% versus 94%, P < .001 [two-sided] by Fisher’s exact test).

Conclusions

Radiology resident interpretation of CTPA and CTV studies demonstrates a high level of agreement with radiology faculty interpretation. Concordance rates are significantly higher for 16-row MDCT than 4-row MDCT which may be due to improved image quality.

Key Words: Computed tomography pulmonary angiography (CTPA), computed tomography venography (CTV), on-call interpretation, radiology resident, pulmonary embolism, deep venous thrombosis, venous thromboembolism, multidetector CT (MDCT)