Peer-reviewed veterinary case report
How accurate are radiologists at reading CT scans after ventral
By Kanani F et al.·2025·Department of Surgery·View original on Europe PMC →
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Original publication title: Evaluation of radiologists' accuracy and interrater reliability when interpreting CT scans after ventral hernia repair.
Plain-English summary
This study looked at how well radiologists can read CT scans after a surgery called ventral hernia repair (VHR), which involves fixing a hernia using a mesh. Forty radiologists from different centers reviewed 18 CT scans, including 12 from patients who had the surgery and 6 control scans. They found that the radiologists were only correct about 39% of the time when identifying the mesh's position and about 44% when identifying the type of mesh used. The accuracy was better for certain types of mesh and surgical approaches, but overall, the results showed that radiologists struggled with this task, even after training. The study suggests that improving how these scans are interpreted will require better teamwork and training among medical professionals.
Abstract
<h4>Background</h4>Accurate interpretation of computed tomography (CT) prior to ventral hernia repair (VHR) is critical for operative planning, particularly in recurrent cases where prior mesh type and placement influence surgical approach. While radiologists possess specialized expertise in imaging interpretation, their performance in identifying post-VHR mesh characteristics remains unstudied. This study assesses the diagnostic performance of radiologists in identifying mesh plane and type on CT following VHR.<h4>Methods</h4>Forty body radiologists from 16 centers evaluated 18 de-identified CT scans, including 12 post-VHR cases and 6 controls. After receiving standardized training on mesh characteristics and surgical planes, radiologists were tasked with identifying both the VHR mesh plane and the mesh type. The study assessed correct identification rates, interrater reliability, and repeatability.<h4>Results</h4>Radiologists demonstrated overall accuracy rates of 39.2% for mesh plane identification and 43.5% for mesh type identification. Accuracy was highest for intraperitoneal approaches (53.8%) and heavy-weight mesh (52.5%), with significantly lower accuracy (16.9-22.5%) for other surgical planes and mesh types (30.6%). Interrater reliability was poor (Gwet's AC1 = 0.127), with significant between-radiologist variability. Self-reported confidence levels correlated positively with accuracy rates, with high-confidence radiologists showing significantly better performance (OR 4.55, p < 0.001). Years of clinical experience did not predict diagnostic accuracy.<h4>Conclusions</h4>Radiologists demonstrated limited ability to accurately interpret post-VHR CT scans, even after targeted instruction. These diagnostic challenges mirror findings among abdominal wall reconstruction surgeons, suggesting inherent limitations in CT-based assessment rather than discipline-specific deficits. Multidisciplinary collaboration, standardized operative documentation, and dedicated abdominal wall imaging protocol and training are essential to improve diagnostic accuracy and optimize surgical planning.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41171471