An assessment of the potential for interpretation of CT images by radiological technologists

The increasing number of CT images to be interpreted in mass screening requires radiologists to interpret a huge number of CT images, and the capacity for screening has therefore been limited by the capacity to process images. To remedy this situation we considered paramedical staff, especially radiological technologists, as "potential screeners," and investigated their capacity to detect abnormalities in CT images of lung cancer screening with and without the assistance of a computer-aided diagnosis (CAD) system. We then compared their performances with those of physicians. A set of 100 slices of thoracic CT images from 100 cases ( 73 abnormal and 27 normal), one slice per case, was interpreted by 43 paramedical college students. A second interpretation by the students was performed after they had been instructed on how to interpret CT images, and a third interpretation was assisted by a virtual CAD system. We calculated the areas under the ROC curve (Az values) for both students and physicians. For the first set of interpretations, the Az values of 40% out of students placed the Az values within the range of Az values of the physicians, which varied from 0.870 to 0.964. For the second set of interpretations after the students had been instructed on CT image interpretation, the students' rate was 86%, and for the third set of virtual CAD-assisted interpretations it was 95%. The performance of paramedical college students in detecting abnormalities from thoracic CT images proved to be sufficient to qualify them as "potential screeners."