Cause determination of missed lung nodules and impact of reader training and education: Simulation study with nodule insertion software
Autor: | Mannudeep K. Kalra, Sishir Rao, Subba R. Digumarthy, Alexi Otrakji, Marie-Helene Levesque, Roberto Lo Gullo, Karl Sayegh, Scott B. Raymond |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Nodule detection Lung Neoplasms Chest ct Computed tomography 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Simulation Training Early Detection of Cancer Aged Aged 80 and over Lung medicine.diagnostic_test business.industry Blind spot Mediastinum Solitary Pulmonary Nodule Nodule (medicine) General Medicine Middle Aged 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Multiple Pulmonary Nodules Radiographic Image Interpretation Computer-Assisted Female Radiology medicine.symptom Tomography X-Ray Computed Training program business Precancerous Conditions Algorithms Software Posterior mediastinum |
Zdroj: | Journal of Cancer Research and Therapeutics. 16:780 |
ISSN: | 0973-1482 |
Popis: | Background There are "blind spots" on chest computed tomography (CT) where pulmonary nodules can easily be overlooked. The number of missed pulmonary nodules can be minimized by instituting a training program with particular focus on the depiction of nodules at blind spots. Purpose The purpose of this study was to assess the variation in lung nodule detection in chest CT based on location, attenuation characteristics, and reader experience. Materials and Methods We selected 18 noncalcified lung nodules (6-8 mm) suspicious of primary and metastatic lung cancer with solid (n = 7), pure ground-glass (6), and part-solid ground-glass (5) attenuation from 12 chest CT scans. These nodules were randomly inserted in chest CT of 34 patients in lung hila, 1st costochondral junction, branching vessels, paramediastinal lungs, lung apices, juxta-diaphragm, and middle and outer thirds of the lungs. Two residents and two chest imaging clinical fellows evaluated the CT images twice, over a 4-month interval. Before the second reading session, the readers were trained and made aware of the potential blind spots. Chi-square test was used to assess statistical significance. Results Pretraining session: Fellows detected significantly more part-solid ground-glass nodules compared to residents (P = 0.008). A substantial number of nodules adjacent to branching vessels and posterior mediastinum were missed. Posttraining session: There was a significant increase in detectability independent of attenuation and location of nodules for all readers (P < 0.0008). Conclusion Dedicated chest CT training improves detection of lung nodules, especially the part-solid ground-glass nodules. Detection of nodules adjacent to branching vessels and the posterior mediastinal lungs is difficult even for fellowship-trained radiologists. |
Databáze: | OpenAIRE |
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