IA Model for Acute Appendicitis in CT

Launched by HALLYM UNIVERSITY MEDICAL CENTER · Dec 8, 2023

Keywords

ClinConnect Summary

This clinical trial is studying a new tool called the IA Model, which uses advanced technology to help doctors quickly and accurately identify cases of appendicitis using CT scans. Appendicitis is an inflammation of the appendix that can cause serious problems if not treated promptly. The goal of this study is to see if the IA Model can help reduce the number of patients wrongly diagnosed with appendicitis, while also speeding up the process of reading CT images. Researchers have collected data from many patients who visited emergency departments with abdominal pain to ensure the model works well in real-life situations.

To participate in this study, patients should be adults or adolescents aged 11 and older who have had a CT scan to evaluate abdominal pain in the lower right area. However, certain patients are not eligible, such as those who had CT scans for other reasons or those with poor-quality images. If you qualify and choose to participate, you can expect to contribute to research that may improve how doctors diagnose appendicitis in the future, ultimately leading to better patient care.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Inclusion criteria for broad eligibility were applied to reflect that the CT utilization rate in the emergency room has rapidly expanded, presumably in many other institutions where physicians maintain a reasonably sensitive standpoint in raising a clinical suspicion of appendicitis as a cause of abdominal pain and then use CT as an imaging test to confirm or rule out appendicitis.
• • When the imaging protocol parameters were as follows: abdomen or pelvis (intravenous contrast, 2 mg/kg, maximum 160 mL), scan timing (portal venous phase), range (from 4 cm above the liver dome to 1 cm below the ischial tuberosity), radiation dose (tube potential, KVP from 100 to 120), pitch 1.75:1, and reconstruction (5 mm, cut slice for adults; 3 mm, cut slice for children under 12 years old), anonymized CT images of patients were referred to a randomized dataset.
• Exclusion Criteria:
• Patients who did not fulfill the CT imaging protocol were excluded in detail as follows:
• • i) Failure to meet the CT protocol criteria of this study: liver CT, biliary CT, etc. (if contrast phase was different); ureter CT, etc. (if contrast media was not used and the reconstruction method was different); non-enhanced CT (when contrast media was not used); and appendix CT or low-dose CT (when radiation dose was low).
• • ii) When the quality of the CT image is significantly reduced, as follows: when blurring occurs (motion artifact) or metal artifact (when internal fixation is performed due to spinal surgery).
• • iii) when it was evident from the medical record review that clinical information suggested that APCT was performed due to the suspicion of a condition other than appendicitis, as follows: suspected acute cholecystitis due to RUQ tenderness and Murphy's sign; suspected urolithiasis due to flank pain and gross hematuria; suspected pancreatitis due to a history of pancreatitis; alcohol abuse; and suspected gynecological diseases due to vaginal discharge. Suspected panperitonitis due to whole abdominal tenderness, rebound tenderness, and unstable vital signs. Patients with acute cholecystitis, ureteral stones, pancreatitis, or acute peritonitis due to small bowel or colon perforation were also excluded.
• • iv) Patients younger than 10 years were excluded. Adolescent patients from 11 to 18 years old were included in the study if the exclusion criteria were not applicable.
• • v) diagnosed by ultrasound sonography vi) Patients who were transferred to the emergency department after a diagnosis of appendicitis at an outside hospital or ambulatory care were excluded.
• • vii) Patients with appendicitis who did not undergo surgical treatment because of the enrollment protocol of other ongoing studies.
• • viii) patients who had undergone an appendectomy