Can radiographers be trained to triage CT colonography for extracolonic findings?

OBJECTIVES: Radiographers have been shown to be capable CT colonography observers. We evaluated whether radiographers can be trained to triage screening CT colonography for extracolonic findings. METHODS: Eight radiographers participated in a structured training program. They subsequently evaluated extracolonic findings in 280 low-dose CT colonograms (cases). This dataset contained 66 cases with possibly important findings (E3) and 27 cases with probably important findings (E4) [classification based on the highest classified finding (C-RADS)]. The first 40 and last 40 CT colonograms were identical test cases. Immediate feedback was given after each reading, except for test cases. Radiographers triaged cases based on C-RADS classification and indicated the need for a radiologist read. We constructed learning curves for correct case triaging by calculating moving averages. RESULTS: In the final test series, 84/120 (70 %) cases with E3 or E4 findings and 139/200 (70 %) without E3 or E4 findings were correctly triaged. Correct identification of cases with E3 findings improved with training from 46/88 (52 %) to 62/88 (70 %) (P < 0.0001) but not for E4 findings [both 22/32 (69 %) P = 1.00]. CONCLUSIONS: Radiographers improve after training in correctly triaging extracolonic findings at CT colonography but do not reach a high enough accuracy to consider their structural involvement in screening. KEY POINTS: • Radiographers were trained to triage CT colonography for extracolonic findings. • After training, radiographers improved sensitivity for likely unimportant findings. • After training, radiographers did not improve sensitivity for possibly important findings. • Radiographers should probably not be expected to identify all extracolonic findings.