Long-Term Performance of Readers Trained in Grading Crohn Disease Activity Using MRI

Publication date: Available online 21 September 2016
Source:Academic Radiology
Author(s): Carl A.J. Puylaert, Jeroen A.W. Tielbeek, Shandra Bipat, Thierry N. Boellaard, C. Yung Nio, Jaap Stoker
Rationale and ObjectivesWe aim to evaluate the long-term performance of readers who had participated in previous magnetic resonance imaging (MRI) reader training in grading Crohn disease activity.Materials and MethodsFourteen readers (8 women; 12 radiologists, 2 residents; mean age 40; range 31–59), who had participated in a previous MRI reader training, participated in a follow-up evaluation after a mean interval of 29 months (range 25–34 months). Follow-up evaluation comprised 25 MRI cases of suspected or known Crohn disease patients with direct feedback; cases were identical to the evaluation set used in the initial reader training (of which readers were unaware). Grading accuracy, overstaging, and understaging were compared between training and follow-up using a consensus score by two experienced abdominal radiologists as the reference standard.ResultsIn the follow-up evaluation, overall grading accuracy was 73% (95% confidence interval [CI]: 62%–81%), which was comparable to reader training grading accuracy (72%, 95% CI: 61%–80%) (P = .66). Overstaging decreased significantly from 19% (95% CI: 12%–27%) to 13% (95% CI: 8%–21%) between training and follow-up (P = .03), whereas understaging increased significantly from 9% (95% CI: 4%–21%) to 14% (95% CI: 7%–26%) (P < .01).ConclusionsReaders have consistent long-term accuracy for grading Crohn disease activity after case-based reader training with direct feedback.



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