需要方法来改进对肝转移瘤的检测。在病变检测（搜索）和良恶性决策（分类）方面都存在错误。我们的目的是评估一项培训计划，以减少对增强腹部计算机断层扫描（CT）中肝转移瘤检测中的搜索错误和分类错误。在获得机构审查委员会批准后，我们进行了一项单组前后测试研究。前后测试相同，包括解释40个含有91个肝转移瘤的增强腹部CT检查，并进行注视追踪。在前后测试之间，读者完成了搜索训练，使用注视追踪反馈和指导来增加解释时间，使用肝脏窗口和冠状重组。他们还完成了分类训练，进行部分任务实践，将病变评级为良性或恶性。主要结果是因为搜索错误而未能检测到的转移瘤（<2秒的注视时间），以及因为分类错误而未能检测到的转移瘤（>2秒）。还进行了插座自由响应接收者操作特性（JAFROC）分析。共有31名放射科医生参与了研究（8名腹部专家，8名非腹部专家，15名高年级住院医师/研究员）。搜索错误减少（前测11％，后测8％，差异3％[95％置信区间，0.3％-5.1％]，P = .01），但分类错误无差异（差异0％，P = .97），JAFROC综合评偏差分析（差异-0.01，P = .36）。在亚组分析中，腹部专家未显示出改变的证据。针对性培训减少了在增强腹部CT中检测肝转移瘤时的搜索错误，但未减少分类错误。并非所有亚组均观察到改进。 版权所有©2023年大学放射学协会。由Elsevier Inc.出版。保留所有权利。

Methods are needed to improve the detection of hepatic metastases. Errors occur in both lesion detection (search) and decisions of benign versus malignant (classification). Our purpose was to evaluate a training program to reduce search errors and classification errors in the detection of hepatic metastases in contrast-enhanced abdominal computed tomography (CT).After Institutional Review Board approval, we conducted a single-group prospective pretest-posttest study. Pretest and posttest were identical and consisted of interpreting 40 contrast-enhanced abdominal CT exams containing 91 liver metastases under eye tracking. Between pretest and posttest, readers completed search training with eye-tracker feedback and coaching to increase interpretation time, use liver windows, and use coronal reformations. They also completed classification training with part-task practice, rating lesions as benign or malignant. The primary outcome was metastases missed due to search errors (<2 seconds gaze under eye tracker) and classification errors (>2 seconds). Jackknife free-response receiver operator characteristic (JAFROC) analysis was also conducted.A total of 31 radiologist readers (8 abdominal subspecialists, 8 nonabdominal subspecialists, 15 senior residents/fellows) participated. Search errors were reduced (pretest 11%, posttest 8%, difference 3% [95% confidence interval, 0.3%-5.1%], P = .01), but there was no difference in classification errors (difference 0%, P = .97) or in JAFROC figure of merit (difference -0.01, P = .36). In subgroup analysis, abdominal subspecialists demonstrated no evidence of change.Targeted training reduced search errors but not classification errors for the detection of hepatic metastases at contrast-enhanced abdominal CT. Improvements were not seen in all subgroups.Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.