Final diagnosis and patient disposition following equivocal results on 2-mSv CT vs. conventional-dose CT in adolescents and young adults with ... View Full Text


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Article Info

DATE

2021-05-15

AUTHORS

Jungheum Cho, Seungjae Lee, Hooney Daniel Min, Hae Young Kim, Yousun Ko, Ji Hoon Park, Sung Bin Park, Kyoung Ho Lee

ABSTRACT

ObjectiveTo compare 2-mSv CT and conventional-dose CT (CDCT, typically 7–8 mSv) regarding final diagnosis and patient disposition following equivocal CT results in adolescents and young adults with suspected appendicitis.MethodsIn total, 3074 patients of 15–44 years (28 ± 9 years, 1672 women) from 20 hospitals were randomized to undergo contrast-enhanced 2-mSv CT (n = 1535) or CDCT (n = 1539) from December 2013 through August 2016. One hundred sixty-one radiologists prospectively rated the likelihood of appendicitis in a Likert scale (i.e., grades 1–5). The final diagnosis was based on CT image, surgical, pathologic, and clinical findings. Post hoc analysis was performed for final diagnosis, surgical procedure, and delay in patient management following equivocal results (i.e., grade 3).ResultsThe 2-mSv CT and CDCT groups were comparable for final diagnosis following equivocal results, including confirmed appendicitis (1.2% [18 patients] vs. 1.2% [19], p > 0.99), negative appendectomy (0.1% [2] vs. 0.3% [4], p = 0.53), and perforated appendicitis (0.1% [1] vs. 0.2% [3], p = 0.53). More patients were confirmed as not having appendicitis following equivocal results in the CDCT group than in the 2-mSv CT group (2.2% [34] vs. 1.0% [16], p = 0.016). The two groups were comparable for the need of appendectomy (1.4% [22] vs. 1.5% [23], p > 0.99), need of additional imaging tests (0.7% [11] vs. 1.1% [17], p = 0.35), and delay in patient management following equivocal results.Conclusion2-mSv CT is comparable to CDCT regarding final diagnosis and patient disposition following equivocal CT results.Key Points• Our results strengthen evidence justifying the use of low-dose CT instead of conventional-dose CT (CDCT) in adolescents and young adults with suspected appendicitis.• The 2-mSv CT and CDCT groups were comparable for final diagnosis following equivocal CT results, including confirmed appendicitis (1.2% vs. 1.2%, p > 0.99), negative appendectomy (0.1% vs. 0.3%, p = 0.53), and perforated appendicitis (0.1% vs. 0.2%, p = 0.53).• The two groups were comparable for the need for appendectomy (1.4% vs. 1.5%, p > 0.99), need for additional imaging tests (0.7% vs. 1.1%, p = 0.35), and delay in patient management, following equivocal CT results. More... »

PAGES

9176-9187

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-021-08020-7

DOI

http://dx.doi.org/10.1007/s00330-021-08020-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1138089786

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33993331


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