Combined method improves trainee accuracy, confidence with fMRI

Educating trainees on fMRI interpretation may be more effective using combined task activation display (CTAD) rather than displaying a single task at a time, reported researchers of a March 29 study published in Clinical Imaging.

“For new learners, interpreting fMRI can be a challenging task, particularly when trying to determine language dominance,” wrote first author Ashwani Gore, MD, Emory University School of Medicine in Atlanta, and colleagues. “We found that using CTAD increased trainee confidence, overall accuracy, reduced time to interpretation and intra-reader variability.”

The researchers asked eight radiology trainees with no prior fMRI experience to determine language lateralization based on activation of Wernicke’s area, Broca’s area and pre-supplementary motor area in 43 unique cases. Gore et al. compared the effectiveness of CTADwhich, in this study, displayed several related blood oxygen level dependent (BOLD) tasks onto a structural seriesversus the conventional single display approach.

Overall, trainee accuracy improved from 70.9 percent using traditional methods to 85.4 percent using the CTAD method. Their mean read time was also better using CTAD (mean of 63 minutes) compared to the mean 90 minute time using the conventional approach.

“These savings in time can be used to review relevant functional neuroanatomy and MRI physics at the workstation, promote discussion, or review additional cases,” the authors noted.

Following the test, trainees responded to a four question survey. Their responses showed a strong preference for the CTAD method. The group found that determining language laterality was easier using CTAD and provided an improved sense of confidence.

“Early exposure to fMRI through this method may simplify a seemingly ‘advanced’ and ‘complex’ technique and promote increased participation and interest in functional neuroimaging,” Gore and colleagues wrote. “This is important as fMRI is increasingly becoming the standard of care for neurosurgical planning and there is growing demand for radiologists competent in fMRI interpretation.”

Additionally, intrareader variability was lower for six of eight trainees using CTAD, but did not change in two participants. Overall, the researchers’ plans to implement a CTAD approach at their institution demonstrates their confidence in the study results.

“We believe CTAD is an effective method to teach fMRI to introductory trainees,” the researchers concluded. “We hope to implement such training approaches at our institution and aim to increase trainee interest in fMRI.”