title: Is hepato-imino diacetic acid scan a better imaging modality than abdominal ultrasound for diagnosing acute cholecystitis?
abstract: BACKGROUND
  The role of hepato-imino diacetic acid scan (HIDA) in the diagnosis of acute cholecystitis remains controversial when compared with the more commonly used abdominal ultrasound (AUS).
  
  
  METHODS
  The diagnostic imaging workup of 1,217 patients who presented to the emergency department at a single hospital with acute abdominal pain and suspicion of acute cholecystitis was reviewed to calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of AUS and HIDA.
  
  
  RESULTS
  In patients undergoing both imaging modalities, HIDA had significantly higher sensitivity (90.7% vs 64.0%, P < .001) and specificity (71.4% vs 58.4%, P = .005) than AUS for the diagnosis of acute cholecystitis. Additionally, PPV and NPV of HIDA (56.2% and 95.0%, respectively) were higher than PPV and NPV of AUS (38.4% and 80.0%, respectively) when both imaging modalities were used for the same patient.
  
  
  CONCLUSIONS
  In adults with acute abdominal pain, HIDA significantly increases the accuracy of the correct diagnosis.
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA. Electronic address: ckaoutzanis@gmail.com.
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Kaoutzanis
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Davies
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Leichtle
authors.affiliation: Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Welch
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Winter
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Lampman
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Franz
authors.affiliation: Department of Surgery, Saint Joseph Mercy Health System, Ann Arbor, MI, USA.
authors.forename: Wallace
authors.initials: W
authors.lastname: Arneson
mesh_terms: D041881:Cholecystitis, Acute / Q000000981:diagnostic imaging* / Q000601:surgery; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007098:Imino Acids; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography
chemical_list: D007098:Imino Acids
keywords: Abdominal ultrasound; Acute cholecystitis; HIDA scan; Negative predictive value; Positive predictive value; Sensitivity and Specificity