Inappropriate imaging requests in abdominal imaging: observations from the MIDAS study, a multicenter randomized
Stijntje Willemijn Dijk1,2, Michiel Mommersteeg3, Sanne Steltenpool4
1Erasmus MC, Rotterdam, The Netherlands. s.dijk@erasmusmc.nl.
Abdominal Radiology (New York)
|December 19, 2025
Summary
Inappropriate abdominal imaging requests were uncommon (6.19%), with ultrasound showing the highest rate. This highlights opportunities to improve imaging practices and guideline adherence.
Area of Science:
- Radiology
- Medical Imaging Analysis
Background:
- Diagnostic imaging is crucial for abdominal pathology evaluation.
- Inappropriate imaging requests pose risks like radiation exposure and increased costs.
Purpose of the Study:
- To investigate the prevalence of inappropriate abdominal imaging requests.
- To analyze variations across imaging modalities and hospital departments.
Main Methods:
- Analysis of 3393 abdominal imaging requests from three German hospitals over 2.5 years.
- Scoring appropriateness using the European Society of Radiology (ESR) iGuide.
- Calculation of estimated radiation exposure and costs.
Main Results:
- 6.19% of imaging requests were inappropriate.
- Ultrasound had the highest inappropriateness rate (12.35%), followed by fluoroscopy, CT, MRI, and radiography.
- Total estimated radiation exposure was 27,954 mGy, with associated costs of €604,411.
Conclusions:
- Inappropriate abdominal imaging requests are relatively uncommon but vary by modality.
- Findings suggest areas for improving imaging practices, training, and clinical decision support tools.
- Enhancing guideline adherence in real-world settings is a key objective.
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