36 Chapter 3 Abstract Objectives To explore the potential impact of a dedicated virtual training course on MRI staging confidence and performance in rectal cancer. Methods 42 radiologists completed a stepwise virtual training course on rectal cancer MRI staging composed of a pre-course (baseline) test with 7 test cases (5 staging, 2 restaging), a 1-day online workshop, 1 month of individual case-readings (n=70 cases with online feedback), a live online feedback session supervised by two expert faculty members, and a post-course test. The ESGAR structured reporting templates for (re)staging were used throughout the course. Results of the pre-course and post-course test were compared in terms of group interobserver agreement (Krippendorf’s alpha), staging confidence (perceived staging difficulty) and diagnostic accuracy (using an expert reference standard). Results Though results were largely not statistically significant, the majority of staging variables showed a mild increase in diagnostic accuracy after the course, ranging between +2% and +17%. A similar trend was observed for IOA which improved for nearly all variables when comparing the pre- and post-course. There was a significant decrease in the perceived difficulty level (p=0.03), indicating an improved diagnostic confidence after completion of the course. Conclusions Though exploratory in nature, our study results suggest that use of a dedicated virtual training course and web-platform has potential to enhance staging performance, confidence and interobserver agreement to assess rectal cancer on MRI. Virtual training could thus be a good alternative (or addition) to in-person training.
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