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Low-dose CT equally effective in diagnosing appendicitis
A lower dose of CT radiation was as effective in diagnosing acute appendicitis as screening performed with a standard dose in a recent study.
In the single-institution, single blind, noninferiority trial, researchers randomly assigned 891 patients aged 15 to 44 years with suspected appendicitis to receive either low-dose (n=444) or standard-dose (n=447) CT. The median dosages were 116 mGy·cm in the low-dose group and 521 mGy·cm in the standard-dose group. Evaluated factors included how many unnecessary appendectomies were performed following screenings, as well as the appendiceal perforation rate and the number of patients who required additional imaging.
In the low-dose group, 172 participants underwent an appendectomy, six of which (3.5%) were negative, compared with 186 appendectomies, six of which (3.2%) were negative, in the standard-dose group (95% CI, –3.8-4.6). The appendiceal perforation rate was 26.5% in the low-dose group vs. 23.3% in the standard-dose group (P=.46), and additional imaging was required by 3.2% of low-dose patients and 1.6% of standard-dose patients (P=.09).
“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 researchers wrote. “Our findings corroborate those of previous exploratory studies that support reduction in the radiation dose when CT is used in the diagnosis of appendicitis.”