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Eur Radiol. 2016 Jun;26(6):1766-74. doi: 10.1007/s00330-015-3984-9. Epub 2015 Sep 18.

Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain: prospective study and systematic review.

Author information

1
Department of Radiology, Faculty of Medicine and Health, Örebro University, SE 701 85, Örebro, Sweden. muhammed.alshamari@regionorebrolan.se.
2
Department of Medical Physics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
3
Department of Medical Imaging and Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
4
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
5
Department of Radiology, Faculty of Medicine and Health, Örebro University, SE 701 85, Örebro, Sweden.

Abstract

OBJECTIVES:

Abdominal radiography is frequently used in acute abdominal non-traumatic pain despite the availability of more advanced diagnostic modalities. This study evaluates the diagnostic accuracy of low-dose CT compared with abdominal radiography, at similar radiation dose levels.

METHODS:

Fifty-eight patients were imaged with both methods and were reviewed independently by three radiologists. The reference standard was obtained from the diagnosis in medical records. Sensitivity and specificity were calculated. A systematic review was performed after a literature search, finding a total of six relevant studies including the present.

RESULTS:

Overall sensitivity with 95 % CI for CT was 75 % (66-83 %) and 46 % (37-56 %) for radiography. Specificity was 87 % (77-94 %) for both methods. In the systematic review the overall sensitivity for CT varied between 75 and 96 % with specificity from 83 to 95 % while the overall sensitivity for abdominal radiography varied between 30 and 77 % with specificity 75 to 88 %.

CONCLUSIONS:

Based on the current study and available evidence, low-dose CT has higher diagnostic accuracy than abdominal radiography and it should, where logistically possible, replace abdominal radiography in the workup of adult patients with acute non-traumatic abdominal pain.

KEY POINTS:

• Low-dose CT has a higher diagnostic accuracy than radiography. • A systematic review shows that CT has better diagnostic accuracy than radiography. • Radiography has no place in the workup of acute non-traumatic abdominal pain.

KEYWORDS:

Abdomen, Acute; Abdominal pain; Abdominal radiography; Sensitivity and specificity; X-ray computed tomography

PMID:
26385800
DOI:
10.1007/s00330-015-3984-9
[Indexed for MEDLINE]

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