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David Burling

Publications and source records attributed to David Burling.

3 recordsLinked to original sources

Virtual colonoscopy.

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Colonography, Computed Tomographic↗

CT colonography: effect of experience and training on reader performance.

The purpose of this paper was to investigate the effect of radiologist experience and increasing exposure to CT colonography on reader performance. Three radiologists of differing general experience (consultant, research fellow, trainee) independently analysed 100 CT colonographic datasets. Readers had no prior experience of CT colonography and received feedback and training after the first 50 cases from an independent experienced radiologist. Diagnostic performance and reporting times were compared for the first and second 50 datasets and compared with the results of a radiologist experienced in CT colonography. Before training only the consultant reader achieved statistical equivalence with the reference standard for detection of larger polyps. After training, detection rates ranged between 25 and 58% for larger polyps. Only the trainee significantly improved after training ( P=0.007), with performance of other readers unchanged or even worse. Reporting times following training were reduced significantly for the consultant and fellow ( P<0.001 and P=0.03, respectively), but increased for the trainee ( P<0.001). In comparison to the consultant reader, the odds of detection of larger polyps was 0.36 (CI 0.16, 0.82) for the fellow and 0.36 (CI 0.14, 0.91) for the trainee. There is considerable variation in the ability to report CT colonography. Prior experience in gastrointestinal radiology is a distinct advantage. Competence cannot be assumed even after directed training via a database of 50 cases.

Clinical Competence↗

Computerized tomography colonography.

First introduced a decade ago, computerized tomography (CT) colonography (virtual colonoscopy) is emerging as an important radiologic investigation for colorectal neoplasia, with diagnostic performance likely exceeding barium enema and comparable with optical colonoscopy. Employing state-of-the-art multislice technology, CT colonography allows a complete examination of the colon and surrounding organs in less than 30 seconds. This article reviews current techniques, indications, comparison with existing technologies, and diagnostic performance. Although already widely disseminated, important future developments, such as prepless bowel cleansing (laxative free) and computer-aided diagnosis, may establish CT colonography as the preferred first-line, whole-colon investigation.

Accreditation↗