The diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients: A systematic review and diagnostic meta-analysis.

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.

journal_name

Eur Radiol

journal_title

European radiology

authors

Yoon HM,Suh CH,Cho YA,Kim JR,Lee JS,Jung AY,Kim JH,Lee JY,Kim SY

doi

10.1007/s00330-017-5231-z

subject

Has Abstract

pub_date

2018-06-01 00:00:00

pages

2537-2548

issue

6

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-017-5231-z

journal_volume

28

pub_type

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