Abstract：
OBJECTIVE: To evaluate the impact of a four-month training program on radiology residents\' diagnostic accuracy in assessing deep myometrial invasion (DMI) in endometrial cancer (EC) using MRI.
METHODS: Three radiology residents with limited EC MRI experience participated in the training program, which included conventional didactic sessions, case-centric workshops, and interactive classes. Utilizing a training dataset of 120 EC MRI scans, trainees independently assessed subsets of cases over five reading sessions. Each subset consisted of 30 scans, the first and the last with the same cases, for a total of 150 reads. Diagnostic accuracy metrics, assessment time (rounded to the nearest minute), and confidence levels (using a 5-point Likert scale) were recorded. The learning curve was obtained plotting the diagnostic accuracy of the three trainees and the average over the subsets. Anatomopathological results served as the reference standard for DMI presence.
RESULTS: The three trainees exhibited heterogeneous starting point, with a learning curve and a trend to more homogeneous performance with training. The diagnostic accuracy of the average trainee raised from 64 % (56 %-76 %) to 88 % (80 %-94 %) across the five subsets (p < 0.001). Reductions in assessment time (5.92 to 4.63 min, p < 0.018) and enhanced confidence levels (3.58 to 3.97, p = 0.12) were observed. Improvements in sensitivity, specificity, positive predictive value, and negative predictive value were noted, particularly for specificity which raised from 56 % (41 %-68 %) in the first to 86 % (74 %-94 %) in the fifth subset (p = 0.16). Although not reaching statistical significance, these advancements aligned the trainees with literature performance benchmarks.
CONCLUSIONS: The structured training program significantly enhanced radiology residents\' diagnostic accuracy in assessing DMI for EC on MRI, emphasizing the effectiveness of active case-based training in refining oncologic imaging skills within radiology residency curricula.
METHODS: Three radiology residents with limited EC MRI experience participated in the training program, which included conventional didactic sessions, case-centric workshops, and interactive classes. Utilizing a training dataset of 120 EC MRI scans, trainees independently assessed subsets of cases over five reading sessions. Each subset consisted of 30 scans, the first and the last with the same cases, for a total of 150 reads. Diagnostic accuracy metrics, assessment time (rounded to the nearest minute), and confidence levels (using a 5-point Likert scale) were recorded. The learning curve was obtained plotting the diagnostic accuracy of the three trainees and the average over the subsets. Anatomopathological results served as the reference standard for DMI presence.
RESULTS: The three trainees exhibited heterogeneous starting point, with a learning curve and a trend to more homogeneous performance with training. The diagnostic accuracy of the average trainee raised from 64 % (56 %-76 %) to 88 % (80 %-94 %) across the five subsets (p < 0.001). Reductions in assessment time (5.92 to 4.63 min, p < 0.018) and enhanced confidence levels (3.58 to 3.97, p = 0.12) were observed. Improvements in sensitivity, specificity, positive predictive value, and negative predictive value were noted, particularly for specificity which raised from 56 % (41 %-68 %) in the first to 86 % (74 %-94 %) in the fifth subset (p = 0.16). Although not reaching statistical significance, these advancements aligned the trainees with literature performance benchmarks.
CONCLUSIONS: The structured training program significantly enhanced radiology residents\' diagnostic accuracy in assessing DMI for EC on MRI, emphasizing the effectiveness of active case-based training in refining oncologic imaging skills within radiology residency curricula.
摘要：
目的：评估为期4个月的培训计划对放射科住院医师使用MRI评估子宫内膜癌（EC）深肌层侵犯（DMA）诊断准确性的影响。
方法：三名具有有限ECMRI经验的放射科住院医师参加了培训计划，其中包括传统的说教课程，以案例为中心的研讨会，和互动类。利用120次ECMRI扫描的训练数据集，学员在五个阅读课程中独立评估了案例的子集。每个子集由30次扫描组成，第一个和最后一个案例相同，共读取150次。诊断准确性指标，评估时间(四舍五入到最近的分钟)，并记录置信水平（使用5点Likert量表）。获得学习曲线，绘制了三名受训者的诊断准确性和子集的平均值。解剖病理学结果作为存在dmi的参考标准。
结果：三名学员表现出不同的起点，具有学习曲线和训练表现更加同质化的趋势。在五个子集中，平均受训者的诊断准确性从64％（56％-76％）提高到88％（80％-94％）（p<0.001）。减少评估时间（5.92至4.63分钟，p<0.018）和增强的置信水平（3.58至3.97，p=0.12）。灵敏度的提高，特异性，正预测值，并注意到阴性预测值，特别是特异性从第一个子集的56％（41％-68％）提高到第五个子集的86％（74％-94％）（p=0.16）。虽然没有达到统计学意义，这些进步使学员与文学表现基准保持一致。
结论：结构化培训计划显着提高了放射科住院医师在MRI上评估ECMI的诊断准确性，强调积极的基于病例的培训在放射学住院医师课程中提高肿瘤成像技能的有效性。
方法：三名具有有限ECMRI经验的放射科住院医师参加了培训计划，其中包括传统的说教课程，以案例为中心的研讨会，和互动类。利用120次ECMRI扫描的训练数据集，学员在五个阅读课程中独立评估了案例的子集。每个子集由30次扫描组成，第一个和最后一个案例相同，共读取150次。诊断准确性指标，评估时间(四舍五入到最近的分钟)，并记录置信水平（使用5点Likert量表）。获得学习曲线，绘制了三名受训者的诊断准确性和子集的平均值。解剖病理学结果作为存在dmi的参考标准。
结果：三名学员表现出不同的起点，具有学习曲线和训练表现更加同质化的趋势。在五个子集中，平均受训者的诊断准确性从64％（56％-76％）提高到88％（80％-94％）（p<0.001）。减少评估时间（5.92至4.63分钟，p<0.018）和增强的置信水平（3.58至3.97，p=0.12）。灵敏度的提高，特异性，正预测值，并注意到阴性预测值，特别是特异性从第一个子集的56％（41％-68％）提高到第五个子集的86％（74％-94％）（p=0.16）。虽然没有达到统计学意义，这些进步使学员与文学表现基准保持一致。
结论：结构化培训计划显着提高了放射科住院医师在MRI上评估ECMI的诊断准确性，强调积极的基于病例的培训在放射学住院医师课程中提高肿瘤成像技能的有效性。
