title: Screening of illegal intracorporeal containers ("body packing"): is abdominal radiography sufficiently accurate? A comparative study with low-dose CT.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of abdominal radiography in the detection of illegal intracorporeal containers (hereafter, packets), with low-dose computed tomography (CT) as the reference standard.
  
  
  METHODS
  This study was approved by the institutional ethical review board, with written informed consent. From July 2007 to July 2010, 330 people (296 men, 34 women; mean age, 32 years [range, 18-55 years]) suspected of having ingested drug packets underwent supine abdominal radiography and low-dose CT. The presence or absence of packets at abdominal radiography was reported, with low-dose CT as the reference standard. The density and number of packets (≤ 12 or >12) at low-dose CT were recorded and analyzed to determine whether those variables influence interpretation of results at abdominal radiography.
  
  
  RESULTS
  Packets were detected at low-dose CT in 53 (16%) suspects. Sensitivity of abdominal radiography for depiction of packets was 0.77 (41 of 53), and specificity was 0.96 (267 of 277). The packets appeared isoattenuated to the bowel contents at low-dose CT in 16 (30%) of the 53 suspects with positive results. Nineteen (36%) of the 53 suspects with positive low-dose CT results had fewer than 12 packets. Packets that were isoattenuated at low-dose CT and a low number of packets (≤12) were both significantly associated with false-negative results at abdominal radiography (P = .004 and P = .016, respectively).
  
  
  CONCLUSIONS
  Abdominal radiography is mainly limited by low sensitivity when compared with low-dose CT in the screening of people suspected of carrying drug packets. Low-dose CT is an effective imaging alternative to abdominal radiography.
authors.affiliation: Department of Radiology, Emergency Center, Department of Forensic Medicine, and Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland. erre-alexandre.poletti@hcuge.ch
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Poletti
authors.forename: Laurent
authors.initials: L
authors.lastname: Canel
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.forename: Hans
authors.initials: H
authors.lastname: Wolff
authors.forename: Bernice
authors.initials: B
authors.lastname: Elger
authors.forename: Eric
authors.initials: E
authors.lastname: Lock
authors.forename: François
authors.initials: F
authors.lastname: Sarasin
authors.forename: Monica S
authors.initials: MS
authors.lastname: Bonfanti
authors.forename: Elise
authors.initials: E
authors.lastname: Dupuis-Lozeron
authors.forename: Thomas
authors.initials: T
authors.lastname: Perneger
authors.forename: Alexandra
authors.initials: A
authors.lastname: Platon
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal / Q000379:methods*; D012680:Sensitivity and Specificity; D016683:Supine Position; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D013287:Illicit Drugs