title: Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain: prospective study and systematic review.
abstract: OBJECTIVE
  Abdominal radiography is frequently used in acute abdominal non-traumatic pain despite the availability of more advanced diagnostic modalities. This study evaluates the diagnostic accuracy of low-dose CT compared with abdominal radiography, at similar radiation dose levels.
  
  
  METHODS
  Fifty-eight patients were imaged with both methods and were reviewed independently by three radiologists. The reference standard was obtained from the diagnosis in medical records. Sensitivity and specificity were calculated. A systematic review was performed after a literature search, finding a total of six relevant studies including the present.
  
  
  RESULTS
  Overall sensitivity with 95 % CI for CT was 75 % (66-83 %) and 46 % (37-56 %) for radiography. Specificity was 87 % (77-94 %) for both methods. In the systematic review the overall sensitivity for CT varied between 75 and 96 % with specificity from 83 to 95 % while the overall sensitivity for abdominal radiography varied between 30 and 77 % with specificity 75 to 88 %.
  
  
  CONCLUSIONS
  Based on the current study and available evidence, low-dose CT has higher diagnostic accuracy than abdominal radiography and it should, where logistically possible, replace abdominal radiography in the workup of adult patients with acute non-traumatic abdominal pain.
  
  
  CONCLUSIONS
  • Low-dose CT has a higher diagnostic accuracy than radiography. • A systematic review shows that CT has better diagnostic accuracy than radiography. • Radiography has no place in the workup of acute non-traumatic abdominal pain.
authors.affiliation: Department of Radiology, Faculty of Medicine and Health, Örebro University, SE 701 85, Örebro, Sweden. muhammed.alshamari@regionorebrolan.se.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Alshamari
authors.affiliation: Department of Medical Physics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Norrman
authors.affiliation: Department of Medical Imaging and Physiology, Lund University and Skåne University Hospital, Lund, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
authors.affiliation: Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Jansson
authors.affiliation: Department of Radiology, Faculty of Medicine and Health, Örebro University, SE 701 85, Örebro, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Geijer
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003951:Diagnostic Errors; D004239:Diverticulitis, Colonic / Q000150:complications / Q000000981:diagnostic imaging; D005260:Female; D046449:Hernia, Abdominal / Q000150:complications / Q000000981:diagnostic imaging; D006552:Hernia, Inguinal / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011446:Prospective Studies; D011829:Radiation Dosage; D011860:Radiography, Abdominal / Q000379:methods; D012680:Sensitivity and Specificity; D012811:Sigmoid Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards; D055815:Young Adult
keywords: Abdomen, Acute; Abdominal pain; Abdominal radiography; Sensitivity and specificity; X-ray computed tomography