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6 programma abstracts & abstracts Sessie 6 Abdominale radiologie 2 Vrijdag 30 september, 10.45 - 12.15 uur O6.1 EVALUATION OF A STANDARDIZED CT COLONOGRAPHY TRAINING PROGRAM IN NOVICE READER M.H. Liedenbaum 1 , S. Bipat 1 , P.M.M. Bossuyt 1 , R.S. Dwarkasing 2 , M.C. de Haan 1 , R.J. Jansen 1 , D. Kauffman 1 , C. van der Leij 1 , M.S. de Lijster 1 , C.C. Lute 1 , M.P. van der Paardt 1 , M.G. Thomeer 2 , I.J.A. Zijlstra 1 , J. Stoker 1 1 Academisch Medisch Centrum, Amsterdam 2 Erasmus Medisch Centrum, Rotterdam Purpose: To determine how many CT colonography (CTC) training examinations have to be evaluated by novice readers to obtain an adequate level of competence in polyp detection. Methods: Informed consent was obtained from all participants. Six physicians (one radiologist, three radiology residents, two researchers) and three technicians completed a CTC training program. 200 CTC’s with colonoscopic verification were selected from a research database, with 100 CTC’s with at least one polyp ≥6mm. After a lecture session and an individual hands-on training, CTC reading was done individually with immediate feedback of the colonoscopy outcome. The increase in per-polyp sensitivity was calculated for four sets of 50 CTC’s for lesions ≥6mm. Using logistic regression analyses, the number of CTC’s to reach 90% sensitivity for lesions ≥6mm was estimated. Reading times were registered. Results: The average per-polyp sensitivity for lesions ≥6mm was 76% (207/270) in the first set of 50 CTC’s, 77% (262/342) in the second set (p=0.96 vs. first set), 80% (310/387) in the third set (p=0.67 vs. first set) and 91% (261/288) in the fourth set (p=0.018). The estimated number of CTC’s to be evaluated to reach a sufficient sensitivity for lesions ≥6mm was 164. Six of the nine readers reached this level of competence within 175 CTC’s. Reading times decreased significantly from the first 50 CTC’s to the second 50 CTC’s for 6 readers. Conclusions: Novice CT colonography readers obtained a sensitivity equal to that of experienced readers after practicing on average 164 CTC studies. O6.2 THE FEASIBILITY OF TRAINING RADIOLOGIC TECHNOLOGISTS IN TRIAGING CT-COLONOGRAPHY FOR EXTRACOLONIC FINDINGS T.N. Boellaard, C.Y. Nio, P.M. Bossuyt, J. Stoker Academisch Medisch Centrum, Amsterdam Purpose: Cost-effectiveness is important for the implementation of CT-colonography as a screening tool for colorectal cancer. Radiologists’ reading time contributes substantially to CT-colonography costs. Therefore we evaluate the feasibility of radiologic technologists in triaging screening CT-colonography for extracolonic findings. Method and materials: Eight technologists participated in a training program and subsequently reported extracolonic findings in 280 CT-colonography exams. The dataset contained 86 possibly (E3) and 30 probably important (E4) findings (C-RADS). The first and last 40 cases were identical examination cases. Feedback was given after each case from reference standard (the consensus read by two radiologists), except for the examination cases. Technologists reported lesion location and characteristics, C-RADS classification, need for a radiologist’s read and reading time. We constructed learning curves for correct scan and lesion triaging using a moving average technique. Results: For the final exam 70% of scans with E3 or E4 findings were correctly triaged, while 30.5% of scans without E3 or E4 findings were incorrectly triaged. For the final exam technologists correctly identified and classified 64.4%(67/104) of E3 and 67.5%(27/40) of E4 findings. This is an improvement, compared to the first exam, of 33.6%(p0.05). The learning curve for E3 and E4 findings combined did not reach a plateau after 280 cases. The technologists’ average reading time decreased from 11:51 to 4:13 minutes(p
Abdominale radiologie 2 6 Conclusion: A training program for radiologic technologists leads to an increased capability of triaging extracolonic findings at CT-colonography. The number of cases was too low to reach a sufficient competence. O6.3 A RANDOMIZED CONTROLLED TRIAL COMPARING PARTICIPATION AND DIAGNOSTIC YIELD IN COLONOSCOPY AND CT-COLONOGRAPHY FOR POPULATION BASED COLORECTAL CANCER SCREENING (COCOS TRIAL) M.C. de Haan 1 , E. Stoop 2 , T.R. de Wijkerslooth 1 , P.M. Bossuyt 1 , M. van Ballegooijen 2 , Y. Nio 1 , M.J. van de Vijver 1 , K. Biermann 2 , M. Thomeer 2 , M.E. van Leerdam 2 , P. Fockens 1 , J. Stoker 1 , E.J. Kuipers 2 , E. Dekker 1 1 Academisch Medisch Centrum, Amsterdam 2 Erasmus Medisch Centrum, Rotterdam Purpose: To compare participation rate and diagnostic yield of colonoscopy and CT-colonography screening in a RCT trial. Methods: A random selection of the Dutch population, aged 50-75 years, was 2:1 randomized to colonoscopy or CTC for primary CRC screening. Participation rate was defined as number of invitees undergoing the examination divided by the total number of invitees. Colonoscopy was positive when advanced neoplasia (adenomas with a diameter ≥10 mm, a ≥25% villous component, or high grade dysplasia or CRC) was detected; CTC when a lesion >5mm was found. Individuals with ≥1 lesions 6-9mm at CTC were offered surveillance CTC and colonoscopy was offered for lesions ≥10mm. Diagnostic yield was calculated as number of advanced neoplasia per 100 invitees. Results: 1,276 of 5,923 colonoscopy invitees participated (22%) compared to 982 of 2,919 CTC invitees (34%) (p
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