Measurement error in CT assessment of appendix diameter.

Area of Science:

• Radiology
• Pediatric Imaging
• Gastrointestinal Imaging

Background:

• Appendiceal diameter is a key computed tomography (CT) criterion for appendicitis diagnosis.
• Variability in CT measurements may impact diagnostic accuracy.

Purpose of the Study:

• To evaluate sources of error and variability in appendiceal diameter measurements using CT.
• To assess the reliability of CT-based appendiceal diameter measurements in children.

Main Methods:

• Retrospective review of 631 CT scans in children (<18 years).
• Appendiceal diameter measured in axial and coronal planes by two reviewers.
• Inter-reader, intra-reader, and intra-patient variability assessed.
• Comparison with pathological measurements where available.

Main Results:

• Axial and coronal measurements were correlated but coronal measurements were larger.
• Inter-reader measurements showed significant differences.
• Intra-patient measurements demonstrated significant variability in the axial plane.
• Repeat measurements showed significant differences for one reviewer in the axial plane.

Conclusions:

• Multiple sources of measurement error exist for appendiceal diameter on CT.
• The use of rigid diameter cutoffs for appendicitis diagnosis by CT is questionable.
• Further research may be needed to refine CT interpretation for appendicitis.