Computed tomography versus ultrasound for the diagnosis of acute cholecystitis: a systematic review and meta-analysis.
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| Title: | Computed tomography versus ultrasound for the diagnosis of acute cholecystitis: a systematic review and meta-analysis. |
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| Authors: | de Oliveira, Guilherme Strieder1 (AUTHOR), Torri, Giovanni Brondani2 (AUTHOR), Gandolfi, Fernanda Engel1 (AUTHOR), Dias, Adriano Basso3 (AUTHOR), Tse, Justin Ruey4 (AUTHOR), Francisco, Martina Zaguini4 (AUTHOR), Hochhegger, Bruno5 (AUTHOR), Altmayer, Stephan4 (AUTHOR) altmayer@stanford.edu |
| Source: | European Radiology. Nov2024, Vol. 34 Issue 11, p6967-6979. 13p. |
| Subjects: | Computed tomography, Sensitivity & specificity (Statistics), Confidence intervals, Secondary analysis, Database searching, Cholecystitis |
| Abstract: | Objectives: Some patients undergo both computed tomography (CT) and ultrasound (US) sequentially as part of the same evaluation for acute cholecystitis (AC). Our goal was to perform a systematic review and meta-analysis comparing the diagnostic performance of US and CT in the diagnosis of AC. Materials and methods: Databases were searched for relevant published studies through November 2023. The primary objective was to compare the head-to-head performance of US and CT using surgical intervention or clinical follow-up as the reference standard. For the secondary analysis, all individual US and CT studies were analyzed. The pooled sensitivities, specificities, and areas under the curve (AUCs) were determined along with 95% confidence intervals (CIs). The prevalence of imaging findings was also evaluated. Results: Sixty-four studies met the inclusion criteria. In the primary analysis of head-to-head studies (n = 5), CT had a pooled sensitivity of 83.9% (95% CI, 78.4–88.2%) versus 79.0% (95% CI, 68.8–86.6%) of US (p = 0.44). The pooled specificity of CT was 94% (95% CI, 82.0–98.0%) versus 93.6% (95% CI, 79.4–98.2%) of US (p = 0.85). The concordance of positive or negative test between both modalities was 82.3% (95% CI, 72.1–89.4%). US and CT led to a positive change in management in only 4 to 8% of cases, respectively, when ordered sequentially after the other test. Conclusion: The diagnostic performance of CT is comparable to US for the diagnosis of acute cholecystitis, with a high rate of concordance between the two modalities. Clinical relevance statement: A subsequent US after a positive or negative CT for suspected acute cholecystitis may be unnecessary in most cases. Key Points: When there is clinical suspicion of acute cholecystitis, patients will often undergo both CT and US. CT has similar sensitivity and specificity compared to US for the diagnosis of acute cholecystitis. The concordance rate between CT and US for the diagnosis of acute cholecystitis is 82.3%. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
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| Header | DbId: egs DbLabel: Engineering Source An: 180550089 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Computed tomography versus ultrasound for the diagnosis of acute cholecystitis: a systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22de+Oliveira%2C+Guilherme+Strieder%22">de Oliveira, Guilherme Strieder</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Torri%2C+Giovanni+Brondani%22">Torri, Giovanni Brondani</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gandolfi%2C+Fernanda+Engel%22">Gandolfi, Fernanda Engel</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dias%2C+Adriano+Basso%22">Dias, Adriano Basso</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tse%2C+Justin+Ruey%22">Tse, Justin Ruey</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Francisco%2C+Martina+Zaguini%22">Francisco, Martina Zaguini</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hochhegger%2C+Bruno%22">Hochhegger, Bruno</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Altmayer%2C+Stephan%22">Altmayer, Stephan</searchLink><relatesTo>4</relatesTo> (AUTHOR)<i> altmayer@stanford.edu</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Nov2024, Vol. 34 Issue 11, p6967-6979. 13p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Sensitivity+%26+specificity+%28Statistics%29%22">Sensitivity & specificity (Statistics)</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Secondary+analysis%22">Secondary analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Database+searching%22">Database searching</searchLink><br /><searchLink fieldCode="DE" term="%22Cholecystitis%22">Cholecystitis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: Some patients undergo both computed tomography (CT) and ultrasound (US) sequentially as part of the same evaluation for acute cholecystitis (AC). Our goal was to perform a systematic review and meta-analysis comparing the diagnostic performance of US and CT in the diagnosis of AC. Materials and methods: Databases were searched for relevant published studies through November 2023. The primary objective was to compare the head-to-head performance of US and CT using surgical intervention or clinical follow-up as the reference standard. For the secondary analysis, all individual US and CT studies were analyzed. The pooled sensitivities, specificities, and areas under the curve (AUCs) were determined along with 95% confidence intervals (CIs). The prevalence of imaging findings was also evaluated. Results: Sixty-four studies met the inclusion criteria. In the primary analysis of head-to-head studies (n = 5), CT had a pooled sensitivity of 83.9% (95% CI, 78.4–88.2%) versus 79.0% (95% CI, 68.8–86.6%) of US (p = 0.44). The pooled specificity of CT was 94% (95% CI, 82.0–98.0%) versus 93.6% (95% CI, 79.4–98.2%) of US (p = 0.85). The concordance of positive or negative test between both modalities was 82.3% (95% CI, 72.1–89.4%). US and CT led to a positive change in management in only 4 to 8% of cases, respectively, when ordered sequentially after the other test. Conclusion: The diagnostic performance of CT is comparable to US for the diagnosis of acute cholecystitis, with a high rate of concordance between the two modalities. Clinical relevance statement: A subsequent US after a positive or negative CT for suspected acute cholecystitis may be unnecessary in most cases. Key Points: When there is clinical suspicion of acute cholecystitis, patients will often undergo both CT and US. CT has similar sensitivity and specificity compared to US for the diagnosis of acute cholecystitis. The concordance rate between CT and US for the diagnosis of acute cholecystitis is 82.3%. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-024-10783-8 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 13 StartPage: 6967 Subjects: – SubjectFull: Computed tomography Type: general – SubjectFull: Sensitivity & specificity (Statistics) Type: general – SubjectFull: Confidence intervals Type: general – SubjectFull: Secondary analysis Type: general – SubjectFull: Database searching Type: general – SubjectFull: Cholecystitis Type: general Titles: – TitleFull: Computed tomography versus ultrasound for the diagnosis of acute cholecystitis: a systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: de Oliveira, Guilherme Strieder – PersonEntity: Name: NameFull: Torri, Giovanni Brondani – PersonEntity: Name: NameFull: Gandolfi, Fernanda Engel – PersonEntity: Name: NameFull: Dias, Adriano Basso – PersonEntity: Name: NameFull: Tse, Justin Ruey – PersonEntity: Name: NameFull: Francisco, Martina Zaguini – PersonEntity: Name: NameFull: Hochhegger, Bruno – PersonEntity: Name: NameFull: Altmayer, Stephan IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 11 Text: Nov2024 Type: published Y: 2024 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 34 – Type: issue Value: 11 Titles: – TitleFull: European Radiology Type: main |
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