A novel reporting system to improve accuracy in appendicitis imaging.

Area of Science:

• Radiology
• Medical Imaging
• Diagnostic Accuracy

Background:

• Appendicitis diagnosis relies heavily on imaging, but interpretation can be subjective.
• Standardized reporting aims to improve consistency and accuracy in radiologic assessments.

Purpose of the Study:

• To evaluate if a standardized radiologic reporting system enhances diagnostic accuracy for appendicitis.
• To assess the utility of objective imaging findings and a certainty score in appendicitis diagnosis.

Main Methods:

• Developed a standardized reporting system with objective appendicitis imaging findings and a 1-5 certainty score.
• Four radiologists retrospectively reviewed 96 preoperative CT scans using the system.
• Compared imaging findings and certainty scores with final pathology, using odds ratios (ORs) and AUC.

Main Results:

• Appendicitis was confirmed in 71 of 89 visualized appendices (80%).
• Key imaging findings included appendiceal diameter, fat stranding, and mucosal hyperenhancement (all significant ORs).
• In indeterminate cases, the system correctly assigned high certainty scores (4 or 5) to 75% of appendicitis cases (AUC = 0.90).

Conclusions:

• Standardized reporting of objective findings correlates well with appendicitis pathology.
• This system may reduce the frequency of indeterminate CT findings for appendicitis.
• Prospective evaluation in clinically suspected appendicitis cases is ongoing.