Accuracy and radiation dose reduction of a limited abdominopelvic CT in the diagnosis of acute appendicitis

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Abstract

Purpose: To determine the accuracy and radiation dose reduction of a limited abdominopelvic CT from the bottom of T10 to the top of the pubic symphysis in patients with suspected acute appendicitis. Methods: We performed a HIPAA compliant and IRB-approved retrospective study of adult patients who underwent CT abdomen/pelvis for suspected appendicitis. The Z-axis length and whole body effective doses of the original full scan and theoretical limited scan from the bottom of T10 to the top of the pubic symphysis were recorded. Images were reviewed to determine if the appendix or entire cecum would be visualized and if any cases of appendicitis or alternative diagnoses would be missed with the limited scan. Results: 235 patients (89 male, mean age 44.6 years) were included. The limited scan resulted in a mean Z-axis length reduction of 5.1 cm superiorly, 6.1 cm inferiorly, and a total reduction of 11.2 cm (24%). The mean whole body effective dose was 11.8 and 9.1 mSv for the original and limited scans, respectively (23% reduction). The entire appendix or cecum was visualized in all cases. Appendicitis was present in 24 cases and an alternative diagnosis was made in 75. No cases of appendicitis or alternative diagnoses were missed using the limited scan. Conclusions: A limited range CT from the bottom of T10 to the top of the pubic symphysis is as accurate as full abdominopelvic CT in evaluating patients with suspected acute appendicitis and results in approximately 23% dose reduction.

Original languageEnglish (US)
Pages (from-to)1177-1182
Number of pages6
JournalAbdominal Imaging
Volume40
Issue number5
DOIs
StatePublished - Oct 21 2014

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Appendicitis
Pubic Symphysis
Radiation
Cecum
Appendix
Health Insurance Portability and Accountability Act
Research Ethics Committees
Pelvis
Abdomen
Retrospective Studies

Keywords

  • Appendicitis
  • Dose reduction
  • MDCT

ASJC Scopus subject areas

  • Gastroenterology
  • Urology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

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title = "Accuracy and radiation dose reduction of a limited abdominopelvic CT in the diagnosis of acute appendicitis",
abstract = "Purpose: To determine the accuracy and radiation dose reduction of a limited abdominopelvic CT from the bottom of T10 to the top of the pubic symphysis in patients with suspected acute appendicitis. Methods: We performed a HIPAA compliant and IRB-approved retrospective study of adult patients who underwent CT abdomen/pelvis for suspected appendicitis. The Z-axis length and whole body effective doses of the original full scan and theoretical limited scan from the bottom of T10 to the top of the pubic symphysis were recorded. Images were reviewed to determine if the appendix or entire cecum would be visualized and if any cases of appendicitis or alternative diagnoses would be missed with the limited scan. Results: 235 patients (89 male, mean age 44.6 years) were included. The limited scan resulted in a mean Z-axis length reduction of 5.1 cm superiorly, 6.1 cm inferiorly, and a total reduction of 11.2 cm (24{\%}). The mean whole body effective dose was 11.8 and 9.1 mSv for the original and limited scans, respectively (23{\%} reduction). The entire appendix or cecum was visualized in all cases. Appendicitis was present in 24 cases and an alternative diagnosis was made in 75. No cases of appendicitis or alternative diagnoses were missed using the limited scan. Conclusions: A limited range CT from the bottom of T10 to the top of the pubic symphysis is as accurate as full abdominopelvic CT in evaluating patients with suspected acute appendicitis and results in approximately 23{\%} dose reduction.",
keywords = "Appendicitis, Dose reduction, MDCT",
author = "Corwin, {Michael T} and Melanie Chang and Ghaneh Fananapazir and Seibert, {J Anthony} and Ramit Lamba",
year = "2014",
month = "10",
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doi = "10.1007/s00261-014-0280-0",
language = "English (US)",
volume = "40",
pages = "1177--1182",
journal = "Abdominal Radiology",
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T1 - Accuracy and radiation dose reduction of a limited abdominopelvic CT in the diagnosis of acute appendicitis

AU - Corwin, Michael T

AU - Chang, Melanie

AU - Fananapazir, Ghaneh

AU - Seibert, J Anthony

AU - Lamba, Ramit

PY - 2014/10/21

Y1 - 2014/10/21

N2 - Purpose: To determine the accuracy and radiation dose reduction of a limited abdominopelvic CT from the bottom of T10 to the top of the pubic symphysis in patients with suspected acute appendicitis. Methods: We performed a HIPAA compliant and IRB-approved retrospective study of adult patients who underwent CT abdomen/pelvis for suspected appendicitis. The Z-axis length and whole body effective doses of the original full scan and theoretical limited scan from the bottom of T10 to the top of the pubic symphysis were recorded. Images were reviewed to determine if the appendix or entire cecum would be visualized and if any cases of appendicitis or alternative diagnoses would be missed with the limited scan. Results: 235 patients (89 male, mean age 44.6 years) were included. The limited scan resulted in a mean Z-axis length reduction of 5.1 cm superiorly, 6.1 cm inferiorly, and a total reduction of 11.2 cm (24%). The mean whole body effective dose was 11.8 and 9.1 mSv for the original and limited scans, respectively (23% reduction). The entire appendix or cecum was visualized in all cases. Appendicitis was present in 24 cases and an alternative diagnosis was made in 75. No cases of appendicitis or alternative diagnoses were missed using the limited scan. Conclusions: A limited range CT from the bottom of T10 to the top of the pubic symphysis is as accurate as full abdominopelvic CT in evaluating patients with suspected acute appendicitis and results in approximately 23% dose reduction.

AB - Purpose: To determine the accuracy and radiation dose reduction of a limited abdominopelvic CT from the bottom of T10 to the top of the pubic symphysis in patients with suspected acute appendicitis. Methods: We performed a HIPAA compliant and IRB-approved retrospective study of adult patients who underwent CT abdomen/pelvis for suspected appendicitis. The Z-axis length and whole body effective doses of the original full scan and theoretical limited scan from the bottom of T10 to the top of the pubic symphysis were recorded. Images were reviewed to determine if the appendix or entire cecum would be visualized and if any cases of appendicitis or alternative diagnoses would be missed with the limited scan. Results: 235 patients (89 male, mean age 44.6 years) were included. The limited scan resulted in a mean Z-axis length reduction of 5.1 cm superiorly, 6.1 cm inferiorly, and a total reduction of 11.2 cm (24%). The mean whole body effective dose was 11.8 and 9.1 mSv for the original and limited scans, respectively (23% reduction). The entire appendix or cecum was visualized in all cases. Appendicitis was present in 24 cases and an alternative diagnosis was made in 75. No cases of appendicitis or alternative diagnoses were missed using the limited scan. Conclusions: A limited range CT from the bottom of T10 to the top of the pubic symphysis is as accurate as full abdominopelvic CT in evaluating patients with suspected acute appendicitis and results in approximately 23% dose reduction.

KW - Appendicitis

KW - Dose reduction

KW - MDCT

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