Original investigationComparison of On-Call Radiology Resident and Faculty Interpretation of 4- and 16-row Multidetector CT Pulmonary Angiography with Indirect CT Venography1
Section snippets
Study Population
Patient populations consisted of both emergency room patients and inpatients. All studies were performed outside of routine work hours (weekdays 5 pm to 8 am, weekends, and holidays). The 4-row MDCT study group consisted of 122 consecutive CTPA and CTV studies performed over a 5-month period from March 2001 to July 2001. There were 75 females and 47 males with a mean age of 53 years (range 21–80). The 16-row MDCT group consisted of 125 consecutive CTPA examinations performed over a 3-month
Results
Resident and faculty CTPA and CTV interpretations agreed in 98 of 122 patients (80%) for 4-row MDCT and 118 of 125 patients (94%) using 16-row MDCT (Fig 1). The difference in concordance rates was statistically significant (P < .001 [two-sided] by Fisher’s exact test). Using the final expert panel reference standard, CTPA agreement was significantly higher with 16-row MDCT than the 4-row MDCT (94% versus 83%, P = .0046 [two-sided] by Fisher’s exact test). CTV agreement was 96% with 4-row MDCT
Discussion
Resident interpretation of emergent radiology studies is becoming increasingly significant, particularly in the university hospital environment. A prospective study by Scott et al found that radiology residents are interpreting a diverse and increasing number of emergent diagnostic examinations after hours. In their study, the most common examination performed during off hours was CT (69%) (2). The results of our study show that preliminary interpretations of CTPA and CTV examinations by
Conclusion
Interpretation of CTPA and CTV studies by second, third, and fourth year on-call radiology residents demonstrates a high level of concordance with radiology faculty interpretations, supporting the practice of resident interpretation of emergent CTPA and CTV studies performed outside of routine work hours. Concordance rates may be further improved when MDCT scanners with a greater number of detectors are used.
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Funded in part by the RSNA Research Scholar Grant. Funded in part by the GE-AUR Radiology Research Academic Fellowship.