title: Comparison of Low- and Standard-Dose CT for the Diagnosis of Acute Appendicitis: A Meta-Analysis.
abstract: OBJECTIVE
  A meta-analysis was performed to compare low-dose CT and standard-dose CT in the diagnosis of acute appendicitis with an emphasis on diagnostic value.
  
  
  METHODS
  A systematic literature search for articles published through June 2016 was performed to identify studies that compared low-dose CT with standard-dose CT for the evaluation of patients suspected of having acute appendicitis. Summary estimates of sensitivity and specificity with 95% CIs were calculated using a bivariate random-effects model. Meta-regression was used to perform statistical comparisons of low-dose CT and standard-dose CT.
  
  
  RESULTS
  Of 154 studies, nine studies investigating a total of 2957 patients were included in this meta-analysis. The pooled sensitivity and specificity of low-dose CT were 96.25% (95% CI, 91.88-98.31%) and 93.22% (95% CI, 88.75-96.00%), respectively. The pooled sensitivity and specificity of standard-dose CT were 96.40% (95% CI, 93.55-98.02%) and 92.17% (95% CI, 88.24-94.86%), respectively. In a joint model estimation of meta-regression, lowand standard-dose CT did not show a statistically significant difference (p = 0.71). Both lowand standard-dose CT seem to be characterized by high positive and negative predictive values across a broad spectrum of pretest probabilities for acute appendicitis.
  
  
  CONCLUSIONS
  Low-dose CT is highly effective for the diagnosis of suspected appendicitis and can be considered a valid alternative first-line imaging test that reduces the potential risk of exposure to ionizing radiation.
authors.affiliation: 1 Department of Medicine, Graduate School, Kyung Hee University, Dongdaemun-gu, Seoul, Republic of Korea.
authors.forename: Seong Jong
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: 2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-Gu, Seoul 134-727, Republic of Korea.
authors.forename: Chang-Woo
authors.initials: CW
authors.lastname: Ryu
authors.affiliation: 2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-Gu, Seoul 134-727, Republic of Korea.
authors.forename: Na Young
authors.initials: NY
authors.lastname: Choi
authors.affiliation: 2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-Gu, Seoul 134-727, Republic of Korea.
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Kim
authors.affiliation: 2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-Gu, Seoul 134-727, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Oh
authors.affiliation: 2 Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-Gu, Seoul 134-727, Republic of Korea.
authors.forename: Dal Mo
authors.initials: DM
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: appendicitis; low-dose CT; meta-analysis; sensitivity; specificity