Abstract
Background: The Japanese Society of Gastrointestinal Cancer Screening has published the guideline for gastric cancer screening using radiographic examination. The guideline defines the screening procedures and recommends supplemental images, if necessary, in addition to the routine examination. Additional radiographs are shot when a radiology technologist considers them necessary for the routine examination; however, their impact on improving diagnostic accuracy has not yet been assessed. Therefore, this study aimed to evaluate the utility of additional radiographs in obtaining accurate diagnoses.
Materials and Methods: Twelve gastroenterologists were categorized into either the beginner or senior group, according to their clinical experience. Gastrointestinal (GI) series images from 40 patients who had undergone gastroendoscopy and acquired pathological diagnosis, if necessary, were obtained. Of these patients, 20 were diagnosed with gastric cancer, and the other 20 had benign lesions. The GI series radiographs were then randomly arranged and presented to the gastroenterologists. Sensitivities for gastric cancer were compared between the two gastroenterologist groups, and the supplemental images' contributions to accurate diagnoses were also assessed.
Results: Median sensitivities for all gastroenterologists were 76.5% (mean: 71.6%) when supplemental images were given and 30.0% (mean: 41.7%) during routine examinations only, indicating a significant difference (P<0.05). In the senior group, median sensitivities with supplemental radiographs were 93.0% (mean: 92.0%), and median sensitivities with routine examination alone were 80.0% (mean: 80%), indicating no statistical significance. In the beginner group, median sensitivities with supplemental radiographs were 47.0% (mean: 57.1%), and median sensitivities with routine examination alone were 20.0% (mean: 14.3%), indicating a statistically significant difference (P<0.05).
Conclusions: In the senior group, sensitivity enhancement with the implementation of supplemental images was not observed. However, the beginner group showed an increase in sensitivity with the application of supplemental images.
