%0 Journal Article
%T Optimizing imaging in suspected appendicitis (OPTIMAP-study): A multicenter diagnostic accuracy study of MRI in patients with suspected acute appendicitis. Study Protocol
%A Marjolein MN Leeuwenburgh
%A Wytze Lam¨Śris
%A Adrienne van Randen
%A Patrick MM Bossuyt
%A Marja A Boermeester
%A Jaap Stoker
%A the OPTIMAP study group
%J BMC Emergency Medicine
%D 2010
%I BioMed Central
%R 10.1186/1471-227x-10-19
%X Eligible for this study are consecutive patients presenting with clinically suspected appendicitis at the emergency department in six centers. All patients will undergo imaging according to the Dutch guideline for acute appendicitis: initial ultrasonography in all and subsequent CT whenever US does not confirm acute appendicitis. Then MRI is performed in all patients, but the results are not used for patient management. A final diagnosis assigned by an expert panel, based on all available information including 3-months follow-up, except MRI findings, is used as the reference standard in estimating accuracy. We will calculate the sensitivity, specificity, predictive values and inter-observer agreement of MRI, and aim to include 230 patients. Patient acceptance and total imaging costs will also be evaluated.If MRI is found to be sufficiently accurate, it could replace CT in some or all patients. This will limit or obviate the ionizing radiation exposure associated risk of cancer induction and contrast medium induced nephropathy with CT, preventing the burden and the direct and indirect costs associated with treatment. Based on the high intrinsic contrast resolution of MRI, one might envision higher accuracy rates for MRI than for CT. If so, MRI could further decrease the number of unnecessary appendectomies and the number of missed appendicitis cases.NTR2148Acute appendicitis is one of the most common reasons for acute abdomen [1]. Diagnosis based on clinical evaluation only is difficult and results in high negative appendectomy rates and missed diagnoses [2,3]. Negative appendectomies increase mortality, prolong hospital stay, and increase the risk of infectious complications [4]. Appendicitis is missed in approximately 12% of patients, increasing the risk of perforated appendicitis, peritonitis, abscesses and leading to a two to tenfold increased mortality rate [5-7].The use of ultrasonography (US) and computed tomography (CT) to support clinical diagnosis is widesp
%U http://www.biomedcentral.com/1471-227X/10/19