Low vs. standard dose computed tomography in suspected acute appendicitis

Is it time for a change?

Noha E. Aly, Dympna McAteer, Emad H. Aly (Corresponding Author)

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

BACKGROUND: Clinical diagnosis is accurate in only 80% of patients with suspected appendicitis with negative appendectomy rates of up to 21%. In the UK the use of standard-dose CT (SDCT) is conservative due to concerns over radiation exposure and resource implications. The use of low dose computer tomography (LDCT) instead of standard dose computer tomography (SDCT) may partially address these concerns.

AIM: To compare LDCT and SDCT in the diagnosis of appendicitis.

METHODS: A literature search of the EMBASE and MEDLINE databases in July 2015 was conducted using the keywords 'low dose CT' and 'appendicitis'. Data were analysed and p values calculated using the Chi-square test. P values less than 0.05 were considered to be significant.

RESULTS: LDCT (1.2-5.3 mSv) was not inferior to SDCT (5.2-10.2 mSv) in the diagnosis of acute appendicitis and proposing alternative diagnoses. SDCT was superior to LDCT in the negative predictive value of diagnosis of appendiceal perforation. There was no significant difference between LDCT and SDCT in negative appendectomy rate, appendiceal perforation rate and the need for additional imaging.

CONCLUSION: LDCT is not inferior to SDCT in the diagnosis of acute appendicitis and proposing alternative diagnoses. Further studies are recommended to further assess the potential role of LDCT & its cost effectiveness. Its use may improve the current management of patients with suspected acute appendicitis.

Original languageEnglish
Pages (from-to)71-79
Number of pages9
JournalInternational Journal of Surgery
Volume31
Early online date2 Jun 2016
DOIs
Publication statusPublished - Jul 2016

Fingerprint

Appendicitis
Tomography
Appendectomy
Chi-Square Distribution
MEDLINE
Cost-Benefit Analysis
Databases

Keywords

  • Low dose
  • Standard dose
  • CT
  • acute appendicitis

Cite this

Low vs. standard dose computed tomography in suspected acute appendicitis : Is it time for a change? / Aly, Noha E.; McAteer, Dympna; Aly, Emad H. (Corresponding Author).

In: International Journal of Surgery , Vol. 31, 07.2016, p. 71-79.

Research output: Contribution to journalReview article

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title = "Low vs. standard dose computed tomography in suspected acute appendicitis: Is it time for a change?",
abstract = "BACKGROUND: Clinical diagnosis is accurate in only 80{\%} of patients with suspected appendicitis with negative appendectomy rates of up to 21{\%}. In the UK the use of standard-dose CT (SDCT) is conservative due to concerns over radiation exposure and resource implications. The use of low dose computer tomography (LDCT) instead of standard dose computer tomography (SDCT) may partially address these concerns.AIM: To compare LDCT and SDCT in the diagnosis of appendicitis.METHODS: A literature search of the EMBASE and MEDLINE databases in July 2015 was conducted using the keywords 'low dose CT' and 'appendicitis'. Data were analysed and p values calculated using the Chi-square test. P values less than 0.05 were considered to be significant.RESULTS: LDCT (1.2-5.3 mSv) was not inferior to SDCT (5.2-10.2 mSv) in the diagnosis of acute appendicitis and proposing alternative diagnoses. SDCT was superior to LDCT in the negative predictive value of diagnosis of appendiceal perforation. There was no significant difference between LDCT and SDCT in negative appendectomy rate, appendiceal perforation rate and the need for additional imaging.CONCLUSION: LDCT is not inferior to SDCT in the diagnosis of acute appendicitis and proposing alternative diagnoses. Further studies are recommended to further assess the potential role of LDCT & its cost effectiveness. Its use may improve the current management of patients with suspected acute appendicitis.",
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T1 - Low vs. standard dose computed tomography in suspected acute appendicitis

T2 - Is it time for a change?

AU - Aly, Noha E.

AU - McAteer, Dympna

AU - Aly, Emad H.

N1 - Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

PY - 2016/7

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N2 - BACKGROUND: Clinical diagnosis is accurate in only 80% of patients with suspected appendicitis with negative appendectomy rates of up to 21%. In the UK the use of standard-dose CT (SDCT) is conservative due to concerns over radiation exposure and resource implications. The use of low dose computer tomography (LDCT) instead of standard dose computer tomography (SDCT) may partially address these concerns.AIM: To compare LDCT and SDCT in the diagnosis of appendicitis.METHODS: A literature search of the EMBASE and MEDLINE databases in July 2015 was conducted using the keywords 'low dose CT' and 'appendicitis'. Data were analysed and p values calculated using the Chi-square test. P values less than 0.05 were considered to be significant.RESULTS: LDCT (1.2-5.3 mSv) was not inferior to SDCT (5.2-10.2 mSv) in the diagnosis of acute appendicitis and proposing alternative diagnoses. SDCT was superior to LDCT in the negative predictive value of diagnosis of appendiceal perforation. There was no significant difference between LDCT and SDCT in negative appendectomy rate, appendiceal perforation rate and the need for additional imaging.CONCLUSION: LDCT is not inferior to SDCT in the diagnosis of acute appendicitis and proposing alternative diagnoses. Further studies are recommended to further assess the potential role of LDCT & its cost effectiveness. Its use may improve the current management of patients with suspected acute appendicitis.

AB - BACKGROUND: Clinical diagnosis is accurate in only 80% of patients with suspected appendicitis with negative appendectomy rates of up to 21%. In the UK the use of standard-dose CT (SDCT) is conservative due to concerns over radiation exposure and resource implications. The use of low dose computer tomography (LDCT) instead of standard dose computer tomography (SDCT) may partially address these concerns.AIM: To compare LDCT and SDCT in the diagnosis of appendicitis.METHODS: A literature search of the EMBASE and MEDLINE databases in July 2015 was conducted using the keywords 'low dose CT' and 'appendicitis'. Data were analysed and p values calculated using the Chi-square test. P values less than 0.05 were considered to be significant.RESULTS: LDCT (1.2-5.3 mSv) was not inferior to SDCT (5.2-10.2 mSv) in the diagnosis of acute appendicitis and proposing alternative diagnoses. SDCT was superior to LDCT in the negative predictive value of diagnosis of appendiceal perforation. There was no significant difference between LDCT and SDCT in negative appendectomy rate, appendiceal perforation rate and the need for additional imaging.CONCLUSION: LDCT is not inferior to SDCT in the diagnosis of acute appendicitis and proposing alternative diagnoses. Further studies are recommended to further assess the potential role of LDCT & its cost effectiveness. Its use may improve the current management of patients with suspected acute appendicitis.

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JO - International Journal of Surgery

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