Abstract
AIM: The aim of this study was to compare the accuracy of spiral computed tomography (CT) performed by a specialist radiologist within a multi disciplinary team (MDT) framework with that of radiologists working outside of this framework. MATERIALS AND METHODS: One hundred and ten patients [median age 70 (35–86) yr, 71 m] underwent either a preoperative CT performed by the MDT specialist consultant radiologist ( n = 60) or a CT performed by one of 13 other consultant radiologists ( n = 50). The strength of the agreement between the CT stage and the histopathological stage was determined by the weighted Kappa statistic (Kw). RESULTS: Sensitivity for T, N and M stage were 64%, 65% and 25% for MDT specialist CT, compared with 24%, 24% and 5% for control CT. Specificity for T, N and M stage were 68%, 59% and 95% for MDT specialist CT compared with 79%, 94% and 93% for control CT. Kw for T, N and M stage were 0.314, 0.350 and 0.255 for MDT specialist CT compared with 0.088, 0.102 and −0.019 for control CT. Unsuspected metastases were found in 12 patients staged by MDT specialist CT compared with 19 patients staged by control CT (Chi 2 = 4.366, df = 1, p = 0.037). CONCLUSION: Improved patient selection for surgery should maximize use of a limited resource. Barry, J. D. et al. (2002). Clinical Radiology 57, 984–988.
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