{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:46:40Z","timestamp":1780760800649,"version":"3.54.1"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,11,11]],"date-time":"2021-11-11T00:00:00Z","timestamp":1636588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015738","name":"Mary and Georg C. Ehrnrooth Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015738","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sigrid Juselius Foundation"},{"DOI":"10.13039\/501100002341","name":"Finnish Academy","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100007083","name":"Orion Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Contrast-enhanced CT is the reference standard used in diagnostic imaging for acute appendicitis in adults. The radiation dose has been of concern. This study aimed to assess whether a lower radiation dose would affect the diagnostic accuracy of CT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a prospective single-centre cohort study of patients (aged over 16\u2009years) with suspected appendicitis evaluated for enrolment in concurrent APPAC II\u2013III trials. The diagnostic accuracy of contrast-enhanced low- and standard-dose CT was compared with study protocols guiding imaging based on BMI; this enabled direct CT imaging comparison only in patients with a BMI below 30\u2009kg\/m2. The on-call CT diagnosis was compared with the final clinical diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among all 856 patients investigated, the accuracy of low-dose (454 patients) and standard-dose (402 patients) CT in identifying patients with and without appendicitis was 98\u00b70 and 98\u00b75 per cent respectively. In patients with a BMI under 30\u2009kg\/m2, respective values were 98\u00b72 per cent (434 patients) and 98\u00b76 per cent (210 patients) (P\u2009=\u20091\u00b7000). The corresponding accuracy for differentiating between uncomplicated and complicated acute appendicitis was 90\u00b73 and 87\u00b76 per cent in all patients, and 89\u00b78 and 88\u00b74 per cent respectively among those with a BMI below 30 kg\/m2 (P\u2009=\u20090\u00b7663). The median radiation dose in the whole low- and standard-dose CT groups was 3 and 7\u2009mSv respectively. In the group with BMI below 30\u2009kg\/m2, corresponding median doses were 3 and 5\u2009mSv (P\u2009&amp;lt;\u20090\u00b7001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Low- and standard-dose CT were accurate both in identifying appendicitis and in differentiating between uncomplicated and complicated acute appendicitis. Low-dose CT was associated with a significant radiation dose reduction, suggesting that it should be standard clinical practice at least in patients with a BMI below 30 kg\/m2.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znab383","type":"journal-article","created":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T12:43:07Z","timestamp":1634042587000},"page":"1483-1490","source":"Crossref","is-referenced-by-count":18,"title":["Diagnostic accuracy using low-dose <i>versus<\/i> standard radiation dose CT in suspected acute appendicitis: prospective cohort study"],"prefix":"10.1093","volume":"108","author":[{"given":"Jussi","family":"Haijanen","sequence":"first","affiliation":[{"name":"Division of Digestive Surgery and Urology, Turku University Hospital , Turku, Finland"},{"name":"Department of Surgery, University of Turku , Turku, 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Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siiri","family":"M\u00e4ntyoja","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery and Urology, Turku University Hospital , Turku, Finland"},{"name":"Department of Surgery, University of Turku , Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliisa","family":"L\u00f6yttyniemi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Turku , Turku, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannele","family":"Niiniviita","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical Imaging Centre of Southwest Finland, Turku University Hospital , Turku, Finland"},{"name":"Department of Medical Physics, Turku University Hospital , Turku, 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