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Effect of Reader Experience on Variability and Evaluation Time of Coronary Plaque Detection with Computed Tomography Coronary Angiography

Stefan C. Saur, Hatem Alkadhi, Paul Stolzmann, Stephan Baumüller, Sebastian Leschka, Hans Scheffel, Lotus Desbiolles, Thomas J. Fuchs, Gábor Székely, Philippe C. Cattin
European Radiology
2009, in press


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 labelled twice 50 retrospectively ECG-gated contrast-enhanced dual-source CTCA data sets (15 female, age 67.3±10.4 years, range 46–86years) indicating the presence or absence of coronary plaques. The evaluation times for the readings were recorded. Intra- and inter-observer variability expressed as k 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 evaluation times (r=-0.59, p<0.05) and intra-observer 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 k=0.582 and k=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.

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  author = {Stefan C. Saur and Hatem Alkadhi and Paul Stolzmann and Stephan Baum\"uller and Sebastian Leschka and Hans Scheffel and Lotus Desbiolles and Thomas J. Fuchs and Gábor Székely and Philippe C. Cattin},
  title = {Effect of Reader Experience on Variability and Evaluation Time of Coronary Plaque Detection with Computed Tomography Coronary Angiography},
  journal = {European Radiology},
  year = {2009},
  month = {},
  pages = {},
  volume = {},
  number = {},
  keywords = {},
  note = {in press}