X-ray detection of ingested non-metallic foreign bodies

Area of Science:

• Pediatric Radiology
• Medical Imaging Technology
• Foreign Body Detection

Background:

• Accidental ingestion of non-metallic foreign bodies (FBs) is a common pediatric concern.
• Plain radiography is frequently used to detect ingested FBs, but its utility for non-metallic objects is not well-established.

Purpose of the Study:

• To evaluate the effectiveness of X-ray in identifying various non-metallic FBs in a pediatric phantom model.
• To assess the agreement among radiologists in detecting these non-metallic FBs.

Main Methods:

• Twelve common pediatric-ingestible non-metallic objects were embedded in a gelatin phantom simulating a child's abdomen.
• Plain radiography was performed, and five experienced radiologists attempted to identify the embedded FBs.
• Inter-radiologist agreement was analyzed using percent agreement and kappa (κ) coefficient.

Main Results:

• Radiologists identified an average of 67% of the embedded non-metallic FBs.
• Fifty percent of objects were identified by all radiologists, while 33% were not identified by any.
• Inter-radiologist agreement was high (kappa 0.86 ± 0.08), but significant under-identification of certain objects occurred.

Conclusions:

• Plain radiography has limitations in detecting commonly ingested non-metallic FBs in children.
• A registry documenting the radiographic visibility of ingested objects is needed to enhance clinical decision-making and improve diagnostic accuracy.