We aimed to separate the influence of radiologist experience from that of CT quality in the evaluation of CT examinations of patients with esophageal or gastric cardia cancer. Two radiologists from referral centers ('expert radiologists') and six radiologists from regional non-referral centers ('non-expert radiologists') performed 240 evaluations of 72 CT examinations of patients diagnosed with esophageal or gastric cardia cancer between 1994 and 2003. We used conditional logistic regression analysis to calculate odds ratios (OR) for the likelihood of a correct diagnosis. Expert radiologists made a correct diagnosis of the presence or absence of distant metastases according to the gold standard almost three times more frequently (OR 2.9; 95% CI 1.4-6.3) than non-expert radiologists. For the subgroup of CT examinations showing distant metastases, a statistically significant correlation (OR 3.5; 95% CI 1.4-9.1) was found between CT quality as judged by the radiologists and a correct diagnosis. Both radiologist experience and quality of the CT examination play a role in the detection of distant metastases in esophageal or gastric cardia cancer patients. Therefore, we suggest that staging procedures for esophageal and gastric cardia cancer should preferably be performed in centers with technically advanced equipment and experienced radiologists.

CT, Esophageal cancer, Gastric cardia cancer, Staging, article, cancer diagnosis, cancer grading, cancer staging, cardia carcinoma, computer assisted tomography, contrast medium, controlled study, diagnostic accuracy, diagnostic value, esophagus cancer, gold standard, human, image quality, intermethod comparison, job experience, laboratory personnel, metastasis, priority journal, professional competence, radiologist, risk assessment, sensitivity and specificity, trend study
dx.doi.org/10.1007/s00330-008-1052-4, hdl.handle.net/1765/14579
European Radiology: journal of the European Congress of Radiology
Erasmus MC: University Medical Center Rotterdam

van Vliet, E.P.M, Hermans, J.J, Wever, W, Eijkemans, M.J.C, Steyerberg, E.W, Faasse, C, … Siersema, P.D. (2008). Radiologist experience and CT examination quality determine metastasis detection in patients with esophageal or gastric cardia cancer. European Radiology: journal of the European Congress of Radiology, 18(11), 2475–2484. doi:10.1007/s00330-008-1052-4