{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:14:58Z","timestamp":1783556098809,"version":"3.55.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can Assoc Radiol J"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Negative appendicectomies in children can be associated with morbidity. MRI has become a radiation-free alternative to CT to assist in the diagnosis of paediatric appendicitis, particularly when ultrasound is equivocal. A systematic review and meta-analysis were performed to assess the diagnostic accuracy of MRI for paediatric appendicitis and its role in reducing negative appendicectomy rates (NAR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Searches were performed across PubMed, Embase, Cochrane Library, Scopus, Web of Science, for studies from 1 January 2000 to 31 July 2025. The inclusion criteria were studies of children (&lt;18\u2009years) with suspected appendicitis undergoing MRI. Bivariate random-effects meta-analyses were performed. Meta-regression explored the impact of covariates for example, DWI, contrast use, image reviewer blinding, and magnetic field strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twelve studies (n\u2009=\u20093242) met inclusion. Pooled MRI sensitivity was 96.7% (95% CI: 93.4%-98.9%), specificity 97.9% (95% CI: 95.6%-99.3%). MRI NARs ranged from 0.66% to 11.1%, with 3\/12 studies reporting NARs &lt;5%. Meta-regression showed non-significant associations between NAR and DWI use (+3.12%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.264), MRI contrast use (\u22125.64%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.110), and magnetic field strength (\u22121.63% per Tesla,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.361). No significant publication bias was detected (Deeks\u2019\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.152).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MRI demonstrates high diagnostic accuracy and is associated with low negative appendicectomy rates in children. Its use is particularly effective where ultrasound\/clinical findings are inconclusive as MRI overcomes ultrasound limitations, poor appendix visualisation, operator-dependence, and inability to exclude alternate diagnoses. Given its radiation-free nature and CT-like diagnostic performance, wider adoption of MRI within paediatric appendicitis pathways may help avoid surgery and reduce exposure to ionising radiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08465371251409633","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T15:17:43Z","timestamp":1769613463000},"page":"551-561","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of MRI in Reducing Paediatric Negative Appendicectomy Rates in Children Under 18 Years Old: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2806-9662","authenticated-orcid":false,"given":"Subiksha","family":"Subramonian","sequence":"first","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amina","family":"Akhtar","sequence":"additional","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Borgas","sequence":"additional","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavya","family":"Byreddy","sequence":"additional","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahed","family":"Zaman","sequence":"additional","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Nair","sequence":"additional","affiliation":[{"name":"Department of General Surgery, North Middlesex University Hospital, Royal Free London NHS Foundation Trust, UK"},{"name":"University College London, UCL Medical School, UK"},{"name":"St Georges University Medical School, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2000.105658"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.14.1748"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-025-06261-y"},{"key":"e_1_3_3_5_2","unstructured":"Royal College of Radiologists. Assessing the Diagnostic Sensitivity of CT and Ultrasound in Suspected Appendicitis. London UK: Royal College of Radiologists; 2014. Accessed December 2 2025. https:\/\/www.rcr.ac.uk"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-2128"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2023.09.040"},{"issue":"4","key":"e_1_3_3_8_2","first-page":"594","article-title":"Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis","volume":"31","author":"Bayraktutan U","year":"2013","unstructured":"Bayraktutan U, Oral A, Kantarci M, et al. Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis. Magn Reson Imaging. 2013;31(4):594-598.","journal-title":"Magn Reson Imaging"},{"issue":"1","key":"e_1_3_3_9_2","first-page":"182","article-title":"Pediatric MRI for appendicitis after equivocal ultrasound: accuracy and impact on appendectomy","volume":"212","author":"Covelli JD","year":"2019","unstructured":"Covelli JD, Madireddi S, Bates DG, et al. Pediatric MRI for appendicitis after equivocal ultrasound: accuracy and impact on appendectomy. AJR Am J Roentgenol. 2019;212(1):182-189.","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-017-3897-7"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.10078"},{"issue":"8","key":"e_1_3_3_12_2","first-page":"923","article-title":"Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis","volume":"42","author":"Johnson AK","year":"2012","unstructured":"Johnson AK, Baker W, Kline JA. Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis. Pediatr Radiol. 2012;42(8):923-932.","journal-title":"Pediatr Radiol"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/0846537121993797"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.12.012"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-016-3557-3"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2023.06.026"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-3044-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.25825"}],"container-title":["Canadian Association of Radiologists Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08465371251409633","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08465371251409633","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08465371251409633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:22:49Z","timestamp":1783552969000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08465371251409633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,28]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1177\/08465371251409633"],"URL":"https:\/\/doi.org\/10.1177\/08465371251409633","relation":{},"ISSN":["0846-5371","1488-2361"],"issn-type":[{"value":"0846-5371","type":"print"},{"value":"1488-2361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,28]]}}}