Rationale and Objectives
The objective of this study was to compare reader accuracy and time efficiency between coronal reformats of abdominopelvic computed tomography (CT) and axial images, by means of a visual search task.
Materials and methods
In this experimental crossover study, a novel visual search task, containing targets placed on actual CT images, was constructed to assess reader performance on both planes. Six trials were shown to participants in each plane, at a fixed time of 0.5 seconds per slice. The task was presented to 43 junior doctors. On each trial, participants were assessed for accuracy and confidence in finding the target on a five-point scale. Statistical analysis was performed using the Wilcoxon signed rank test, and Fleiss kappa.
Results
Coronal images took 40% less time to view overall. No significant difference was found in reader accuracy or reader confidence between the two planes. Interrater agreement was observed as fair, across a very large number of raters (43).
Conclusions
Target identification in the coronal plane is extremely similar to the axial plane on abdominopelvic CT in this study and offers a substantial time benefit. A perceptual limit to visual processing of CT images may contribute to this similarity. Greater use of coronal reformats in day-to-day practice could substantially improve radiologist workflow.
The amount of computed tomography (CT) scans performed in Australia increases at a rate of around 12% per year . Increasing CT examinations translates into an increased radiologist workload, in a throughput-driven work environment.
Scan volumes have been further increased by improvements in CT technology, particularly multidetector-row CT (MDCT). MDCT can acquire several thin slices in one rotation of the x-ray tube, resulting in speed of acquisition, high spatial resolution, and anatomic detail. Sixty-four (or greater)–slice MDCT can generate images with a spatial resolution of less than 1 mm . Use of MDCT has created a much larger volume of images to be viewed in the axial plane, mainly because of the generation of thin slices . This influx of images to the radiology workstation can create workflow problems for radiologists as a result of “image overload” .
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Materials and methods
Participants
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Technique
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Statistical Analysis
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Results
Speed
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Accuracy
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Reader Confidence
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Table 1
Distribution of Confidence Scores for 43 Participants Across 12 Trials
Confidence Score Coronal Plane Axial Plane Target Present No Target Target Present No Target 1 29 12 28 13 2 42 17 34 23 3 25 29 40 24 4 42 22 33 20 5 34 6 37 6
No differences found to be significant (all P > .05).
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Interrater Agreement
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Discussion
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Study Limitations
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Implications
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Conclusions
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Acknowledgments
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