Do ‘all-in-one’ windows impact radiologist performance?

Reviewing chest CT examinations with an “all-in-one” (AIO) window does not have a negative impact on radiologist performance, according to new findings published in Diagnostic and Interventional Imaging.

Cancer-related imaging utilization is becoming more and more common, wrote lead author Annemiek Snoeckx, MD, PhD, department of radiology at Antwerp University Hospital and University Antwerp in Belgium, and colleagues. Radiologist workloads and the total number of images they are asked to read on a daily basis are also on the rise.  

One potential way to help radiologists decrease reading times in the face of these trends, the authors explained, is using an AIO window that allows radiologists to visualize multiple conventional CT windows in a single window.    

“Since the reading time is proportional to the number of images, one might expect that only reading and comparing a single series of images would save reading time,” the authors wrote. “Decreasing reading time may subsequently improve workload and possibly affect turnaround time.”

To test this new viewing technique, the researchers explored data from 50 consecutive chest CT examinations containing 417 lesions in a thoracic oncology population. Six radiologists were split into two groups of three, with each group reviewing the examinations. Groups were designed to have “similar levels of expertise” and included one senior staff member, one junior staff member and one radiology resident. All CT examinations were reviewed either using conventional window settings or an AIO window.

The team also determined that the use of the AIO window “did not result in an increase of missed lesions.”  

The study did include certain limitations, according to the authors. For example, only contrast-enhanced CT studies were used, and “lesion detection on plain CT examinations might be more challenging.” Also, the researchers did not specifically focus on reading time.

Overall, however, Snoeckx et al. concluded that they saw no signs the AIO window had a negative impact on image interpretation.

 “Lesion detection on a single AIO window is non-inferior to multiple conventional window settings in thoracic oncology chest CT examinations,” they wrote. “Further research is needed to determine the effect of this novel window on lesion size measurement and lesion characterization.”