{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T23:48:39Z","timestamp":1768520919899,"version":"3.49.0"},"reference-count":35,"publisher":"Termedia Sp. z.o.o.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pol J Radiol"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The primary objective was to assess the frequency of appropriateness of computed tomography (CT) for acute abdominal pain (AAP) in the emergency department; the secondary aim was to compare the diagnostic accuracy of ultra\u00adsound (US) and CT in the diagnosis of the aetiology of AAP for diseases that can be diagnosed by US; and the third objective was to assess extent to which inappropriate CT examinations for AAP result in ionizing radiation exposure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>In this retrospective single-centre study, we included patients aged between 15 and 46 years referred to the emergency department for AAP in 2016 and submitted to abdominal CT scans, collecting a total of 586 patients. In 152 patients with the more frequent pathologies, we compared the referral reason and current guidelines of the European Society of Radiology (ESR) IGUIDE\u00ae. Then we measured and compared the sensitivity of US and CT for the identification of the aetiology of AAP for diseases whose diagnosis can be reached by US. We also recorded the mean computed tomography dose index (CTDIvol), dose length product (DLP) and its standard deviation, and we calculated the effective dose (ED) using CT-Expo\u00ae software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to IGUIDE and based on the clinical suspicion of CT requests, CT examination was considered crucial in 264 (45.05%) patients. 322 patients had a referral reason for CT scan that could be considered \u201cpossibly appropriate\u201d according Iguide criteria (4, 5, 6 scoring). Of these, 135 had an inappropriate CT request according to image findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A better clinical framing and a correct interpretation of the reference guidelines could reduce unjustified exposure to ionizing radiation.<\/jats:p><\/jats:sec>","DOI":"10.5114\/pjr.2022.115126","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T13:10:50Z","timestamp":1648818650000},"page":"187-193","source":"Crossref","is-referenced-by-count":6,"title":["Are we overusing abdominal computed tomography scans in young patients referred in an emergency for acute abdominal pain?"],"prefix":"10.5114","volume":"87","author":[{"given":"Sergio","family":"Salerno","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Chiara","family":"Terranova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Anzelmo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Vinci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Vernuccio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Collura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Marrale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Lo","family":"Re","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3061","published-online":{"date-parts":[[2022,3,25]]},"reference":[{"key":"ref-1154795","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00330-011-2087-5","article-title":"A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain","volume":"21","author":"vanRanden A","year":"2011","unstructured":"vanRanden A, Lam\u00e9ris W, van Es HW, et al. A comparison of the accuracy of ultrasound and computed tomography in common diagnoses causing acute abdominal pain. Eur Radiol 2011; 21: 1535-1545.","journal-title":"Eur Radiol"},{"key":"ref-1154796","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1007\/s00330-002-1715-5","article-title":"Value of abdominal CT in the emergency department for patients with abdominal pain","volume":"13","author":"Rosen MP","year":"2003","unstructured":"Rosen MP, Siewert B, Sands DZ, et al. Value of abdominal CT in the emergency department for patients with abdominal pain. Eur Radiol 2003; 13: 418-424.","journal-title":"Eur Radiol"},{"key":"ref-1154797","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1148\/radiol.2531090302","article-title":"Imaging patients with acute abdominal pain","volume":"253","author":"Stoker J","year":"2009","unstructured":"Stoker J, van Randen A, Lam\u00e9ris W, Boermeester MA. Imaging patients with acute abdominal pain. Radiology 2009; 253: 31-46.","journal-title":"Radiology"},{"key":"ref-1154798","article-title":"Laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89\/618\/Euratom, 90\/641\/Euratom, 96\/29\/Euratom, 97\/43\/Euratom and 2003\/122\/Euratom","author":"Council Directive 2013\/59\/EURATOMof 5 December 2013","unstructured":"Council Directive 2013\/59\/EURATOMof 5 December 2013. Laying down basic safety standards for protection against the dangers arising from exposure to ionising radiation, and repealing Directives 89\/618\/Euratom, 90\/641\/Euratom, 96\/29\/Euratom, 97\/43\/Euratom and 2003\/122\/Euratom. https:\/\/eur-lex.europa.eu\/legal-content\/EN\/TXT\/HTML\/?uri=CELEX:32013L0059&from=IT (Accessed: 03.04.2019)."},{"key":"ref-1154799","volume-title":"BFCR","author":"Royal College of Radiologist","unstructured":"Royal College of Radiologist. IRefer: making the best use of clinical radiology. BFCR(12)2. ISBN: 978-1-905034-55-0."},{"key":"ref-1154800","article-title":"ESR IGuide","unstructured":"ESR IGuide. https:\/\/www.myesr.org\/esriguide\/ (Accessed: 03.04.2019)."},{"key":"ref-1154801","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s10140-017-1554-y","article-title":"Radiation overexposure from repeated CT scans in young adults with acute abdominal pain","volume":"25","author":"Tonolini M","year":"2018","unstructured":"Tonolini M, Valconi E, Vanzulli A, Bianco R. Radiation overexposure from repeated CT scans in young adults with acute abdominal pain. Emerg Radiol 2018; 25: 21-27.","journal-title":"Emerg Radiol"},{"key":"ref-1154802","first-page":"1","article-title":"ICRP publication 103","volume":"37","author":"The 2007 Recommendations of the International Commission on Radiological Protection","year":"2007","unstructured":"The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication 103. 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Cancer risks attributable to low doses of ionizing radiation: assessing what we really know. Proc Natl Acad Sci U S A 2003; 100: 13761-13766.","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref-1154821","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1056\/NEJMra072149","article-title":"Computed tomography-an increasing source of radiation expose","volume":"357","author":"Brenner DJ","year":"2007","unstructured":"Brenner DJ, Hall EJ. Computed tomography-an increasing source of radiation expose. N Engl J Med 2007; 357: 2277-2284.","journal-title":"N Engl J Med"},{"key":"ref-1154822","first-page":"312","article-title":"Radiation risks of medical imaging: separating fact from fantasy radiology","volume":"264","author":"Hendee WR","year":"2012","unstructured":"Hendee WR, O\u2019Connor. Radiation risks of medical imaging: separating fact from fantasy radiology. 2012; 264: 312-321."},{"key":"ref-1154823","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1001\/archinternmed.2009.427","article-title":"Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer","volume":"169","author":"Smith-Bindman R","year":"2009","unstructured":"Smith-Bindman R, Lipson J, Marcus R, et al. Radiation dose associated with common computed tomography examinations and the associated lifetime attributable risk of cancer. Arch Intern Med 2009; 169: 2078-2086.","journal-title":"Arch Intern Med"},{"key":"ref-1154824","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1093\/jrr\/rru019","article-title":"Classification of radiation effects for dose limitation purposes: history, current situation and future prospects","volume":"55","author":"Hamada N","year":"2014","unstructured":"Hamada N, Fujimichi Y. Classification of radiation effects for dose limitation purposes: history, current situation and future prospects. J Radiat Res 2014; 55: 629-640.","journal-title":"J Radiat Res"},{"key":"ref-1154825","first-page":"312","article-title":"Radiationrisks of medicalimaging: separatingfact from fantasy","volume":"264","author":"HendeeWR O\u2019Connor MK","year":"2012","unstructured":"HendeeWR O\u2019Connor MK. Radiationrisks of medicalimaging: separatingfact from fantasy. Radiology 2012; 264: 312-321.","journal-title":"Radiology"},{"key":"ref-1154826","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3322\/caac.21132","article-title":"Cancer risks associated with external radiation from diagnostic imaging procedures","volume":"62","author":"Linet MS","year":"2012","unstructured":"Linet MS, Slovis TL, Miller DL, et al. Cancer risks associated with external radiation from diagnostic imaging procedures. CA Cancer J Clin 2012; 62: 75-100.","journal-title":"CA Cancer J Clin"},{"key":"ref-1154827","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1001\/jama.2018.20295","article-title":"Curbing unnecessary and wasted diagnostic imaging","volume":"321","author":"Oren O","year":"2019","unstructured":"Oren O, Kebebew E, Ioannidis JPA. Curbing unnecessary and wasted diagnostic imaging. JAMA 2019; 321: 245-246.","journal-title":"JAMA"},{"key":"ref-1154828","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1053\/crad.2001.0925","article-title":"Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults","volume":"57","author":"Tsushima Y","year":"2002","unstructured":"Tsushima Y, Yamada S, Aoki J, et al. Effect of contrast-enhanced computed tomography on diagnosis and management of acute abdomen in adults. 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