ACRIN CT colonography trial: Does reader's preference for primary two-dimensional versus primary three-dimensional interpretation affect performance?

Amy K. Hara, Meridith Blevins, Mei Hsiu Chen, Abraham H. Dachman, Mark D. Kuo, Christine O. Menias, Bettina Siewert, Jugesh I. Cheema, Richard G. Obregon, Jeff L. Fidler, Peter Zimmerman, Karen M. Horton, Kevin J. Coakley, Revathy B. Iyer, Robert A. Halvorsen, Giovanna Casola, Judy Yee, Benjamin A. Herman, C. Daniel Johnson

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Purpose: To determine whether the reader's preference for a primary two-dimensional (2D) or three-dimensional (3D) computed tomographic (CT) colonographic interpretation method affects performance when using each technique. Materials and Methods:In this institutional review board-approved, HIPAAcompliant study, images fromm2531 CT colonographic examinations were interpreted by 15 trained radiologists by using colonoscopy as a reference standard. Through a survey at study start, study end, and 6-month intervals, readers were asked whether their interpretive preference in clinical practice was to perform a primary 2D, primary 3D, or both 2D and 3D interpretation. Readers were randomly assigned a primary interpretation method (2D or 3D) for each CT colonographic examination. Sensitivity and specifi city of each method (primary 2D or 3D), for detecting polyps of 10 mm or larger and 6 mm or larger, based on interpretive preference were estimated by using resampling methods. Results: Little change was observed in readers' preferences when comparing them at study start and study end, respectively, as follows: primary 2D (eight and seven readers), primary 3D (one and two readers), and both 2D and 3D (six and six readers). Sensitivity and specifi city, respectively, for identifying examinations with polyps of 10 mm or larger for readers with a primary 2D preference ( n = 1128 examinations) were 0.84 and 0.86, which was not signifi cantly different from 0.84 and 0.83 for readers who preferred 2D and 3D ( n = 1025 examinations) or from 0.76 and 0.82 for readers with a primary 3D preference ( n = 378 examinations). When performance by using the assigned 2D or 3D method was evaluated on the basis of 2D or 3D preference, there was no difference among those readers by using their preferred versus not preferred method of interpretation. Similarly, no signifi cant difference among readers or preferences was seen when performance was evaluated for detection of polyps of 6 mm or larger.

Original languageEnglish (US)
Pages (from-to)435-441
Number of pages7
Issue number2
StatePublished - May 2011
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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