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