Low-Dose CT Noninferior for Diagnosing Appendicitis
(HealthDay News) – For young adults with suspected appendicitis, low-dose computed tomography (CT) is noninferior to standard-dose CT with respect to negative appendectomy rates.
Kyuseok Kim, MD, from the Seoul National University College of Medicine in South Korea, and colleagues conducted a single-blind noninferiority trial for 891 patients with suspected appendicitis, aged 15–44 years. Participants were randomly allocated to low-dose CT (444 patients; median radiation dose, 116mGy/cm) or standard-dose CT (447 patients; median radiation dose, 521mGy/cm). The rate of negative appendectomies was measured, with a noninferiority margin of 5.5%.
The researchers found that the negative appendectomy rate was 3.5 and 3.2% in the low-dose and standard-dose CT groups, respectively (difference, 0.3%). There were no significant between-group differences in the appendiceal perforation rate (26.5% for low-dose CT vs. 23.3% for standard-dose CT; P=0.46) or in the proportion of patients who required additional imaging (3.2 and 1.6%, respectively; P=0.09).
"We found that the use of low-dose CT as the first-line imaging test was noninferior to standard-dose CT with respect to the negative appendectomy rate among young adults with suspected appendicitis," the authors write.
The study was supported by a grant from GE Healthcare Medical Diagnostics, Korea.