Comparison of diagnostic performance of CT with rectal contrast vs. CT with rectal and intravenous contrast for the diagnosis of acute appendicitis

Authors

DOI:

https://doi.org/10.59667/sjoranm.v26i1.18

Keywords:

Acute appendicitis, Computed Tomography, rectal contrast, intravenous contrast, diagnostic accuracy

Abstract

Aim: To describe the diagnostic performance of CT with rectal contrast (CT-RC) and CT with rectal and intravenous contrast (CT-IVRC) in patients with suspected acute appendicitis.

Materials and methods: The reported single-centre retrospective cohort comprised 135 patients examined in 2020 with both CT techniques and assessed by two radiologists. The reference diagnosis was based on surgery/histopathology or clinical follow-up. For this revision, diagnostic measures and 95% Wilson confidence intervals were recalculated from the reported aggregate counts. Indeterminate results were reported separately; determinate-case estimates and alternative classification scenarios were examined.

Results: The reported cohort contained 56 patients with appendicitis and 79 without appendicitis. For observer 1, accuracy was 89.6% (95% CI, 83.3-93.7) for CT-RC and 87.4% (80.8-92.0) for CT-IVRC. Observer 2 had two indeterminate results per technique, both in the non-appendicitis group. Among 133 determinate results, accuracy was 86.5% (79.6-91.3) for CT-RC and 89.5% (83.1-93.6) for CT-IVRC. Alternative classifications of the indeterminate results changed these estimates.

Conclusions: These descriptive estimates depend on the accuracy of the reported counts, which could not be independently verified against patient-level data. The available aggregate information does not establish equivalence between the techniques or support a specific recommendation for patients with contraindications to intravenous contrast.

Author Biographies

  • Ahmet Aslan, Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Ahmet ASLAN, M.D, Assoc Professor. Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Arshed Hussain Parry, Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain, Department of Radiodiagnosis, Government Medical College, Srinagar, Jammu and Kashmir, India

    Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain. Department of Radiodiagnosis, Government Medical College, Srinagar, Jammu and Kashmir, India

  • Muhammed Taher AlAli, Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Banoo Loai Alsaleh, Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Rami Moraya Sharahili, Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Radiology, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Abdulaziz Almutawea, Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Husham Bakry, Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

  • Isam Mazin Juma, Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

    Department of Surgery, King Hamad University Hospital, Busaiteen, Al Muharraq, Bahrain

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SJORANM article cover, Vol. 26 No. 1 (2025). Holographic symbolic illustration for article 97.

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Published

2025-12-29

Data Availability Statement

This revised analysis uses aggregate counts and summary statistics from the submitted manuscript and tables. Patient-level data and the original statistical output were not available to the editorial team for independent verification. No claim is made that individual datasets have been archived or can be supplied on request.

Issue

Vol. 26 No. 1 (2025)

Section

Research Articles

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Copyright (c) 2025 Ahmet Aslan, Arshed Hussain Parry, Muhammed Taher Alali, Banoo Loai Alsaleh, Rami Moraya Sharahili, Abdulaziz Almutawea, Husham Bakry, Isam Mazin Juma

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How to Cite

Aslan, A., Parry, A. H., AlAli, M. T., Alsaleh, B. L., Sharahili, R. M., Almutawea, A., Bakry, H., & Juma, I. M. (2025). Comparison of diagnostic performance of CT with rectal contrast vs. CT with rectal and intravenous contrast for the diagnosis of acute appendicitis. Swiss Journal of Radiology and Nuclear Medicine, 26(1), 17-30. https://doi.org/10.59667/sjoranm.v26i1.18

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