Effect of reader experience on variability, evaluation time and accuracy of coronary plaque detection with computed tomography coronary angiography

Saur, Stefan ; Alkadhi, Hatem ; Stolzmann, Paul ; Baumüller, Stephan ; Leschka, Sebastian ; Scheffel, Hans ; Desbiolles, Lotus ; Fuchs, Thomas ; Székely, Gábor ; Cattin, Philippe

In: European Radiology, 2010, vol. 20, no. 7, p. 1599-1606

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    Summary
    Objective: To assess the effect of reader experience on variability, evaluation time and accuracy in the detection of coronary artery plaques with computed tomography coronary angiography (CTCA). Methods: Three independent, blinded readers with three different experience levels twice labelled 50 retrospectively electrocardiography (ECG)-gated contrast-enhanced dual-source CTCA data sets (15 female, age 67.3 ± 10.4years, range 46-86years) indicating the presence or absence of coronary plaques. The evaluation times for the readings were recorded. Intra- and interobserver variability expressed as κ statistics and sensitivity, specificity, and negative and positive predictive values were calculated for plaque detection, with a consensus reading of the three readers taken as the standard of reference. A bootstrap method was applied in the statistical analysis to account for clustering. Results: Significant correlations were found between reader experience and, respectively, evaluation times (r = −0.59, p < 0.05) and intraobserver variability (r = 0.73, p < 0.05). The evaluation time significantly differed among the readers (p < 0.05). The observer variability for plaque detection, compared with the consensus, varied between κ = 0.582 and κ = 0.802. Variability of plaque detection was significantly smaller (p < 0.05) and more accurate (p < 0.05) for the most experienced reader. Conclusion: Reader experience significantly correlated with observer variability, evaluation time and accuracy of coronary plaque detection at CTCA