Multidisciplinary team and clinical meeting data: JRF national survey of trainees 2015.

OBJECTIVE: To collect radiology trainees' views on training for clinic-multidisciplinary team meetings (MDTMs), identify aspects requiring improvement and develop a guide to aid training. This is central to quality assurance and is within the core RCR curriculum. METHODS: The Junior Radiology Forum National Training Survey 2015 was emailed to 1222 UK trainees. Questions related to role in MDTMs, training, use of the MDTM eportfolio tool and experience of leading meetings. RESULTS: 611 radiology trainees responded. 22% received teaching in MDTM preparation. 29% of trainees use the eportfolio MDT assessment tool. 76% of trainees who run MDTMs have adequate preparation time. 18% always review cases with a consultant prior to a meeting. 7% of trainees always debrief with a consultant. 9.7% have been asked to lead an MDTM which they did not feel comfortable with. Most trainees think trainees should be running MDTMs post FRCR2B. CONCLUSION: There are currently deficits in teaching and consultant supervision when trainees are learning to participate in MDTMs. Formal teaching sessions and timetabled preparation/debrief time with a consultant should be available. Trainees should not be asked to lead meetings without adequate support. This also ensures a safe MDTM environment for the patient. The eportfolio assessment tool can be used to sign off competence levels before independently leading an MDTM. Advances in knowledge: These results suggest shortfalls in the current model for preparing radiology trainees for their central role in clinico-MDT meetings. Using this data, a guide for trainees has been written to address these deficits.

Appearances of screen-detected versus symptomatic colorectal cancers at CT colonography.

OBJECTIVES: The aim of this study was to compare the morphology, radiological stage, conspicuity, and computer-assisted detection (CAD) characteristics of colorectal cancers (CRC) detected by computed tomographic colonography (CTC) in screening and symptomatic populations. METHODS: Two radiologists independently analyzed CTC images from 133 patients diagnosed with CRC in (a) two randomized trials of symptomatic patients (35 patients with 36 tumours) and (b) a screening program using fecal occult blood testing (FOBt; 98 patients with 100 tumours), measuring tumour length, volume, morphology, radiological stage, and subjective conspicuity. A commercial CAD package was applied to both datasets. We compared CTC characteristics between screening and symptomatic populations with multivariable regression. RESULTS: Screen-detected CRC were significantly smaller (mean 3.0 vs 4.3 cm, p < 0.001), of lower volume (median 9.1 vs 23.2 cm3, p < 0.001) and more frequently polypoid (34/100, 34 % vs. 5/36, 13.9 %, p = 0.02) than symptomatic CRC. They were of earlier stage than symptomatic tumours (OR = 0.17, 95 %CI 0.07-0.41, p < 0.001), and were judged as significantly less conspicuous (mean conspicuity 54.1/100 vs. 72.8/100, p < 0.001). CAD detection was significantly lower for screen-detected (77.4 %; 95 %CI 67.9-84.7 %) than symptomatic CRC (96.9 %; 95 %CI 83.8-99.4 %, p = 0.02). CONCLUSIONS: Screen-detected CRC are significantly smaller, more frequently polypoid, subjectively less conspicuous, and less likely to be identified by CAD than those in symptomatic patients. KEY POINTS: • Screen-detected colorectal cancers (CRC) are significantly smaller than symptomatic CRC. • Screening cases are significantly less conspicuous to radiologists than symptomatic tumours. • Screen-detected CRC have different morphology compared to symptomatic tumours (more polypoid, fewer annular). • A commercial computer-aided detection (CAD) system was significantly less likely to note screen-detected CRC.