Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

Kjelle, Elin; Andersen, Eivind Richter; Krokeide, Arne Magnus; Soril, Lesley J. J.; van Bodegom-Vos, Leti; Clement, Fiona M.; Hofmann, Bjørn Morten

doi:10.1186/s12880-022-00798-2

BMC Medical Imaging

Table 8 Overview of low-value abdominal imaging

From: Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review

Type of imaging	Reason for examination	Outcome	Suggested practice by included study/studies	References
Abdominal XR	Appendicitis Acute gallbladder disease Acute pancreatitis	Low diagnostic accuracy	US or CT should be used	[180]
	Before UGI	No change in management	Use last image hold in fluoroscopy	[181]
	Constipation	No change in management	Clinical examination is sufficient	[183]
	Abdominal pain	4–12% relevant findings		[187, 189]
Abdominal CT	Urolithiasis	1.8% change in management		[190, 204, 206]
	Complicated gallstone disease	Low diagnostic accuracy	Clinical examination or US is superior to CT	[179]
	Acute appendicitis	Avoid for reducing radiation dose	US should be used first. Only use CT if US is inconclusive	[191]
	Acute pancreatitis	< 1.2% relevant findings		[175,176,177,178]
Post-op abdominal CT	Urolithiasis	2.6% relevant findings		[205]
CT pelvis	Gastric cancer	2% change in patient management		[209]
Abdominal MRI	Acute pancreatitis	< 1.2% relevant findings		[175,176,177,178]
Abdominal US	After CT – Poly trauma	1.1% relevant findings		[185]
Pre-op Abdominal US	Bariatric surgery	1.2% change in surgical plan		[194]
Abdominopelvic CT/MRI	Uterine cancer	10% relevant results		[199]
Abdominopelvic CT/MRI	Prostate cancer	1% relevant results		[200, 201]
Liver MRI	Colorectal cancer	After CT – No new findings		[202]
Follow-up adrenals MRI	Adrenal cancer	4% change in surgical plan		[203]
Retrograde urethrography	Penile fracture	No change in management	Use for patients with hematuria or urethrorrhagia	[208]
Renal US	New-onset acute kidney injury—hydronephrosis	1.8% change in management		[207]
Contrast esophagogram	Suspected esophageal perforation	Low diagnostic accuracy	CT is a superior examination	[197]
Contrast esophagogram	Anastomotic leaks after esophagectomy	Low diagnostic accuracy	CT and endoscopy are better examinations	[195, 198]
UGI	Gastroesophageal reflux	4.5% change in management		[188]
Post-op UGI	Swallowing difficulty	Low diagnostic accuracy	CT is a better examination	[193, 196]
Post-op UGI	After laparoscopy	No change in management		[192]

XR X-ray, CT computed tomography, MRI magnetic resonance imaging, US ultrasound, UGI upper gastrointestinal imaging

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ISSN: 1471-2342

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