Generalists just as accurate as fellowship-trained radiologists at diagnosing appendicitis on MRI, CT
General radiologists are just as accurate at diagnosing appendicitis on MRI and CT scans compared to abdominal fellowship-trained experts, according to a new analysis.
Rads working in community hospital settings typically have less clinical exposure to abdominal MRI, and University of Wisconsin-Madison researchers suspected this might hurt their diagnostic accuracy. But that hypothesis turned out to be false, at least for their investigation, authors explained in Emergency Radiology.
“We found that community-based generalist radiologists demonstrated excellent accuracy when using MR to diagnose appendicitis,” Rebecca L. Bracken, with UW Madison’s emergency medicine division, and colleagues wrote July 16. “Specifically, when comparing CT and MR images performed in tandem on patients seen in the ED for possible appendicitis, we found no statistically significant differences in accuracy among 198 paired image sets.”
For their observational study, Bracken et al. compared MRI and CT interpretations performed by six radiologists: three based in community practices and three in academic settings. Each was blinded to clinical information and reviewed exams in random order over 18 months. The final cohort included 198 patients with an average age of 31.
General rads diagnosed appendicitis on MRI with a sensitivity and specificity of 93.8% and 88.8%, respectively. Meanwhile, abdominal imaging specialists did so with 96.6% sensitivity and 89.6% specificity.
Bracken and co-authors reported a similar trend for computed tomography. Generalists reached 96.9% sensitivity and 91.8% specificity when reading CT scans, while fellowship-trained rads scored 98.4% and 93.3%, respectively.
The community-based rads in this study were well-trained in neuroradiology and musculoskeletal radiology, which may affect the generalizability of the results, the authors noted.
Accurate and efficient diagnoses of appendicitis are crucial, as delays can lead to negative consequences. And these findings suggest MRI can be key, regardless of practice setting.
“This [study] suggests MR may be a reliable, radiation-free imaging alternative to CT for the evaluation of appendicitis, including at community-based generalist radiology practices,” the authors concluded.
Read the full analysis here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.