The impact of trained radiographers as concurrent readers on performance and reading time of experienced radiologists in the UK Lung Cancer Screening (UKLS) trial

Eur Radiol. 2018 Jan;28(1):226-234. doi: 10.1007/s00330-017-4903-z. Epub 2017 Jun 22.


Objectives: To compare radiologists' performance reading CTs independently with their performance using radiographers as concurrent readers in lung cancer screening.

Methods: 369 consecutive baseline CTs performed for the UK Lung Cancer Screening (UKLS) trial were double-read by radiologists reading either independently or concurrently with a radiographer. In concurrent reading, the radiologist reviewed radiographer-identified nodules and then detected any additional nodules. Radiologists recorded their independent and concurrent reading times. For each radiologist, sensitivity, average false-positive detections (FPs) per case and mean reading times for each method were calculated.

Results: 694 nodules in 246/369 (66.7%) studies comprised the reference standard. Radiologists' mean sensitivity and average FPs per case both increased with concurrent reading compared to independent reading (90.8 ± 5.6% vs. 77.5 ± 11.2%, and 0.60 ± 0.53 vs. 0.33 ± 0.20, respectively; p < 0.05 for 3/4 and 2/4 radiologists, respectively). The mean reading times per case decreased from 9.1 ± 2.3 min with independent reading to 7.2 ± 1.0 min with concurrent reading, decreasing significantly for 3/4 radiologists (p < 0.05).

Conclusions: The majority of radiologists demonstrated improved sensitivity, a small increase in FP detections and a statistically significantly reduced reading time using radiographers as concurrent readers.

Key points: • Radiographers as concurrent readers could improve radiologists' sensitivity in lung nodule detection. • An increase in false-positive detections with radiographer-assisted concurrent reading occurred. • The false-positive detection rate was still lower than reported for computer-aided detection. • Concurrent reading with radiographers was also faster than single reading. • The time saved per case using concurrently reading radiographers was relatively modest.

Keywords: Diagnostic imaging; Lung neoplasm; Mass screening; Multidetector computed tomography; Pulmonary nodule.

MeSH terms

  • Clinical Competence / statistics & numerical data*
  • Humans
  • Lung Neoplasms / diagnostic imaging*
  • Medical Laboratory Personnel / statistics & numerical data*
  • Radiologists / statistics & numerical data*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Time
  • Tomography, X-Ray Computed / methods*
  • United Kingdom