MRI good radiation-free alternative to CT for evaluation of appendicitis: Study
MRI is a dependable, radiation-free imaging substitute of CT for the examination of appendicitis in community-based generalist radiology practices, according to a study published in the European Radiology.
A group of researchers from the University of Wisconsin-Madison, Madison, WI, USA performed a study to compare the diagnostic accuracy of generalist radiologists working in a community setting against abdominal radiologists working in an academic setting for the interpretation of MR when diagnosing acute appendicitis among emergency department patients.
Through this observational study, the researchers investigated the MR image interpretation from a prospectively enrolled cohort at an academic hospital over 18 months. A total of 198 patients (114 women) with a mean age of 31.6 years and an appendicitis prevalence of 32.3% were enrolled. All the selected patients had an abdominopelvic CT ordered to evaluate for appendicitis and were greater than 11 years old. The reference standard was a combination of surgery and pathology results, phone follow-up, and chart review. 6 radiologists blinded to clinical information, three each from community and academic practices, independently interpreted MR and CT images in random order. They calculated test characteristics for both individual and group (consensus) diagnostic accuracy then performed Chi-square tests to identify any differences between the subgroups.
The results of the study are as follows:
· For generalist radiologists, the sensitivity and specificity were 93.8% and 88.8% respectively for MR and 96.9% and 91.8% respectively for CT. For fellowship-trained radiologists, the sensitivity and specificity were 96.9% and 89.6% respectively for MR and 98.4% and 93.3% respectively for CT.
· No statistically significant differences were detected between radiologist groups or when comparing MR to CT.
The researchers concluded that thus MRI is a reliable, radiation-free imaging alternative to CT for the evaluation of appendicitis in community-based generalist radiology practices.
A study titled, "Abdominal fellowship-trained versus generalist radiologist accuracy when interpreting MR and CT for the diagnosis of appendicitis" by Bracken R et. al published in the European Radiology