Training on Reporting and Data System (RADS) for Somatostatin-Receptor Targeted Molecular Imaging Can Reduce the Test Anxiety of Inexperienced Readers

Alexander Weich,Sebastian E Serfling,Constantin Lapa,Ralph A Bundschuh,Ken Herrmann,Rudolf A Werner,Takahiro Higuchi,Thorsten Derlin,Steven P Rowe,Andreas K Buck,Martin G Pomper

doi:10.1007/s11307-022-01712-6

Abstract

PurposeFor somatostatin receptor (SSTR)-positron emission tomography/computed tomography (PET/CT), a standardized framework termed SSTR-reporting and data system (RADS) has been proposed. We aimed to elucidate the impact of a RADS-focused training on reader’s anxiety to report on SSTR-PET/CT, the motivational beliefs in learning such a system, whether it increases reader’s confidence, and its implementation in clinical routine.ProceduresA 3-day training course focusing on SSTR-RADS was conducted. Self-report questionnaires were handed out prior to the course (Pre) and thereafter (Post). The impact of the training on the following categories was evaluated: (1) test anxiety to report on SSTR-PET/CT, (2) motivational beliefs, (3) increase in reader’s confidence, and (4) clinical implementation. To assess the effect size of the course, Cohen’s d was calculated (small, d = 0.20; large effect, d = 0.80).ResultsOf 22 participants, Pre and Post were returned by 21/22 (95.5%). In total, 14/21 (66.7%) were considered inexperienced (IR, < 1 year experience in reading SSTR-PET/CTs) and 7/21 (33.3%) as experienced readers (ER, > 1 year). Applying SSTR-RADS, a large decrease in anxiety to report on SSTR-PET/CT was noted for IR (d = − 0.74, P = 0.02), but not for ER (d = 0.11, P = 0.78). For the other three categories motivational beliefs, reader’s confidence, and clinical implementation, agreement rates were already high prior to the training and persisted throughout the course (P ≥ 0.21).ConclusionsA framework-focused reader training can reduce anxiety to report on SSTR-PET/CTs, in particular for inexperienced readers. This may allow for a more widespread adoption of this system, e.g., in multicenter trials for better intra- and interindividual comparison of scan results.

Highlights

The demand for somatostatin receptor (SSTR) imaging with subsequent therapy for neuroendocrine neoplasms (NEN) has rapidly expanded in recent years [1–3], mainly due to encouraging results of the first randomized, controlled trial demonstrating the efficacy and safety of SSTR-targeted peptide receptor radionuclide therapy (PRRT) [4–6]
Analyzing Q1, Q2, and Q3, with emphasis on the change in test anxiety before and after the training, the change from pre to post on the 4-point Likert scale for all readers (AR) was − 0.21 ± 0.65, thereby indicating a small to medium effect by the course (d = − 0.32, P = 0.16; Fig. 1A)
This was driven by inexperienced readers (IRs) with a significant medium to large reduction in anxiety, while for ER, only an insignificant effect caused by the program was noted

Summary

Introduction

The demand for somatostatin receptor (SSTR) imaging with subsequent therapy for neuroendocrine neoplasms (NEN) has rapidly expanded in recent years [1–3], mainly due to encouraging results of the first randomized, controlled trial demonstrating the efficacy and safety of SSTR-targeted peptide receptor radionuclide therapy (PRRT) [4–6]. To conduct such treatment, uptake in putative sites of disease should be confirmed by a preceding SSTR-directed positron emission tomography (PET)/ computed tomography (CT) scan [7, 8], and a precise interpretation of such scans is of utmost importance to select appropriate treatment candidates or to risk-stratify patients [9, 10]. In order to minimize stress and anxiety in inexperienced readers (IRs), molecular imaging has to advance their training models and provide guiding tools that determine precisely what makes abnormalities different from normal tissue [15]

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