CT Dose Simulation Study for Appendicitis

Optimizing the Radiation Dose for CT Imaging With Iterative Reconstruction in Diagnosing Acute Appendicitis: Dose Simulation Study

The study will explore CT radiation dose as low as reasonably achievable in diagnosing acute appendicitis, by using of dose simulation technique and iterative reconstruction.

Three sequential non-inferiority tests are planned. First, three readers will review the original 2-mSv images. Second, the readers will review the 75%-dose images. After the readers review the 75%-dose images and before the readers reviewed the 50%-dose images, the non-inferiority of 75% dose to the original dose will be tested. If the non-inferiority is not accepted, the study will be terminated with the conclusion of 2 mSv as the lowest acceptable dose. If the non-inferiority is accepted, the study will be continue to the next step. In the same manner, the readers will review the next lower-dose images (50% and then 25%), and then the noninferiority will be tested against the original dose.

Inclusion Criteria:

• 18-44 years of age.
• Emergency department visit with suspected symptoms and signs of acute appendicitis
• Intravenous contrast-enhanced computed tomography examination requested due to suspicion of appendicitis

Exclusion Criteria:

• having contraindications of intravenous contrast agent