KMID : 0880420230240060529
|
|
Korean Journal of Radiology 2023 Volume.24 No. 6 p.529 ~ p.540
|
|
Radiology Residents¡¯ Independent Diagnosis of Appendicitis Using 2-mSv Computed Tomography: A Secondary Analysis of a Large Pragmatic Randomized Trial
|
|
Cho Jung-Heum
Kim Hae-Young Lee Seung-Jae Park Ji-Hoon Lee Kyoung-Ho
|
|
Abstract
|
|
|
Objective : To compare the diagnostic performance and clinical outcomes of 2-mSv computed tomography (CT) and conventional-dose CT (CDCT), following radiology residents¡¯ interpretation of CT examinations for suspected appendicitis.
Materials and Methods : Altogether, 3074 patients with suspected appendicitis aged 15?44 years (28 ¡¾ 9 years, 1672 females) from 20 hospitals were randomly assigned to the 2-mSv CT (n = 1535) or CDCT (n = 1539) groups in a pragmatic trial from December 2013 and August 2016. Overall, 107 radiology residents participated in the trial as readers in the form of daily practice after online training for 2-mSv CT. They made preliminary CT reports, which were later finalized by attending radiologists via addendum reports, for 640 and 657 patients in the 2-mSv CT and CDCT groups, respectively. We compared the diagnostic performance of the residents, discrepancies between preliminary and addendum reports, and clinical outcomes between the two groups.
Results : Patient characteristics were similar between the 640 and 657 patients. Residents¡¯ diagnostic performance was not significantly different between the 2-mSv CT and CDCT groups, with a sensitivity of 96.0% and 97.1%, respectively (difference [95% confidence interval {CI}], -1.1% [-4.9%, 2.6%]; P = 0.69) and specificity of 93.2% and 93.1%, respectively (0.1% [-3.6%, 3.7%]; P > 0.99). The 2-mSv CT and CDCT groups did not significantly differ in discrepancies between the preliminary and addendum reports regarding the presence of appendicitis (3.3% vs. 5.2%; -1.9% [-4.2%, 0.4%]; P = 0.12) and alternative diagnosis (5.5% vs. 6.4%; -0.9% [-3.6%, 1.8%]; P = 0.56). The rates of perforated appendicitis (12.0% vs. 12.6%; -0.6% [-4.3%, 3.1%]; P = 0.81) and negative appendectomies (1.9% vs. 1.1%; 0.8% [-0.7%, 2.3%]; P = 0.33) were not significantly different between the two groups.
Conclusion : Diagnostic performance and clinical outcomes were not significantly different between the 2-mSv CT and CDCT groups following radiology residents¡¯ CT readings for suspected appendicitis.
|
|
KEYWORD
|
|
Abdomen, Appendicitis, Radiation dosage, Tomography, X-ray computed
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|