Hee Mang Yoon1, Chong Hyun Suh2, Young Ah Cho3, Jeong Rye Kim1, Jin Seong Lee1, Ah Young Jung1, Jung Heon Kim4, Jeong-Yong Lee5, So Yeon Kim1. 1. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro, Songpa-Gu, Seoul, 05505, Republic of Korea. 2. Department of Radiology, Namwon Medical Center, 365, Chungjeong-ro, Namwon-si, Jeollabuk-do, 590-702, Republic of Korea. 3. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro, Songpa-Gu, Seoul, 05505, Republic of Korea. ped.yacho@gmail.com. 4. Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro, Songpa-Gu, Seoul, 05505, Republic of Korea. 5. Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro, Songpa-Gu, Seoul, 05505, Republic of Korea.
Abstract
OBJECTIVE: To evaluate the diagnostic performance of reduced-dose CT for suspected appendicitis. METHODS: A systematic search of the MEDLINE and EMBASE databases was carried out through to 10 January 2017. Studies evaluating the diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients were selected. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modelling. Meta-regression was performed. RESULTS: Fourteen original articles with a total of 3,262 patients were included. For all studies using reduced-dose CT, the summary sensitivity was 96 % (95 % CI 93-98) with a summary specificity of 94 % (95 % CI 92-95). For the 11 studies providing a head-to-head comparison between reduced-dose CT and standard-dose CT, reduced-dose CT demonstrated a comparable summary sensitivity of 96 % (95 % CI 91-98) and specificity of 94 % (95 % CI 93-96) without any significant differences (p=.41). In meta-regression, there were no significant factors affecting the heterogeneity. The median effective radiation dose of the reduced-dose CT was 1.8 mSv (1.46-4.16 mSv), which was a 78 % reduction in effective radiation dose compared to the standard-dose CT. CONCLUSION: Reduced-dose CT shows excellent diagnostic performance for suspected appendicitis. KEY POINTS: • Reduced-dose CT shows excellent diagnostic performance for evaluating suspected appendicitis. • Reduced-dose CT has a comparable diagnostic performance to standard-dose CT. • Median effective radiation dose of reduced-dose CT was 1.8 mSv (1.46-4.16). • Reduced-dose CT achieved a 78 % dose reduction compared to standard-dose CT.
OBJECTIVE: To evaluate the diagnostic performance of reduced-dose CT for suspected appendicitis. METHODS: A systematic search of the MEDLINE and EMBASE databases was carried out through to 10 January 2017. Studies evaluating the diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients were selected. Pooled summary estimates of sensitivity and specificity were calculated using hierarchical logistic regression modelling. Meta-regression was performed. RESULTS: Fourteen original articles with a total of 3,262 patients were included. For all studies using reduced-dose CT, the summary sensitivity was 96 % (95 % CI 93-98) with a summary specificity of 94 % (95 % CI 92-95). For the 11 studies providing a head-to-head comparison between reduced-dose CT and standard-dose CT, reduced-dose CT demonstrated a comparable summary sensitivity of 96 % (95 % CI 91-98) and specificity of 94 % (95 % CI 93-96) without any significant differences (p=.41). In meta-regression, there were no significant factors affecting the heterogeneity. The median effective radiation dose of the reduced-dose CT was 1.8 mSv (1.46-4.16 mSv), which was a 78 % reduction in effective radiation dose compared to the standard-dose CT. CONCLUSION: Reduced-dose CT shows excellent diagnostic performance for suspected appendicitis. KEY POINTS: • Reduced-dose CT shows excellent diagnostic performance for evaluating suspected appendicitis. • Reduced-dose CT has a comparable diagnostic performance to standard-dose CT. • Median effective radiation dose of reduced-dose CT was 1.8 mSv (1.46-4.16). • Reduced-dose CT achieved a 78 % dose reduction compared to standard-dose CT.
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