Disagreements of non-vascular findings in computed tomography of the aorta by radiology residents

Abstract

Background

Although non-vascular findings from computed tomography angiography (CTA) of the aorta are not the primary interpretation, the significant findings can affect the patient's treatment.

Purpose

To evaluate the disagreement between radiology residents and staff regarding non-vascular findings in CTA of the aorta.

Material and Methods

We conducted a retrospective study of 419 CTA scans of the aorta between January 2014 and December 2016. The non-vascular findings from the final preliminary reports, which were interpreted by radiology residents, were recorded and compared with blind interpretations by an experienced member of the radiology staff. Disagreements were analyzed using the unweighted Kappa value.

Results

A total of 419 CTA aorta were interpreted by 38 radiology residents. The elective versus emergency CTA rate was 58% versus 42%. The emergency CTA rate related to traumatic conditions was 57.9% The thoracic system was the most common disagreement of significant non-vascular findings, with the highest disagreement rate being significant breast lesions (80.0%, Kappa = 0.33; 95% confidence interval [CI] = 0.15–0.81). Non-vascular findings detected by residents in significant and intermediated significant groups were 339/627 for elective CTAs and 241/457 for emergency CTAs. The disagreement rates for these findings were 45.9% (Kappa = 0.68; 95% CI = 0.54–0.97) in elective CTAs and 47.3% (Kappa = 0.60; 95% CI = 0.53–0.90) in emergency CTAs.

Conclusion

The most disagreement of non-vascular findings in significant and intermediated significant groups was the thoracic system. The disagreement rates of non-vascular findings between radiology residents and staff were higher in emergency CTA. These results can be used to improve radiology training.