Low-dose Contrast Media for Low-kVp Abdomen CT
Primary Purpose
Appendicitis Acute
Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Weight-adjusted low-dose contrast media paired with low-radiation dose abdomen CT
Sponsored by
About this trial
This is an interventional diagnostic trial for Appendicitis Acute focused on measuring acute appendicitis, acute abdomen, CT
Eligibility Criteria
Inclusion criteria: Patients in the emergency department with suspected acute appendicitis based on clinical examination Patients scheduled for contrast-enhanced CT of the abdomen and pelvis for diagnosis of suspected acute appendicitis. Exclusion criteria: Patients who decline to participate Contraindications to contrast-enhanced CT (eGFR < 30 mL/min/173 m^2 or pregnant) BMI >= 30.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Double low-dose CT
Arm Description
Weight-adjusted low-dose contrast media paired with low-radiation dose abdomen CT
Outcomes
Primary Outcome Measures
Diagnostic accuracy for acute appendicitis
The primary outcome of the study is the diagnostic accuracy of double low-dose CT for acute appendicitis in young adults with suspected acute appendicitis. Based on the CT findings, a three-tiered diagnosis of appendicitis will be given (no appendicitis, uncomplicated appendicitis, or complicated appendicitis). In the case of no appendicitis, a possible alternative diagnosis is given. The reference standard for appendicitis is operative findings and surgical pathology reports. In nonoperative cases, sequential radiologic evaluation, clinical follow-up, and the judgment of the attending physician will conclude the diagnosis. Specifically, if the patient is not treated for recurrent symptoms within 6 months, the radiologic diagnosis of CT findings is considered valid. The diagnostic accuracy for acute appendicitis is true positive for acute appendicitis and true negative for acute appendicitis divided by all participants.
Secondary Outcome Measures
Full Information
NCT ID
NCT05878665
First Posted
March 23, 2023
Last Updated
May 18, 2023
Sponsor
Seoul St. Mary's Hospital
Collaborators
GE Healthcare
1. Study Identification
Unique Protocol Identification Number
NCT05878665
Brief Title
Low-dose Contrast Media for Low-kVp Abdomen CT
Official Title
Optimizing Low-dose Contrast Media Protocol for Low-kVp Abdominopelvic CT in Suspected Acute Appendicitis
Study Type
Interventional
2. Study Status
Record Verification Date
May 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 15, 2023 (Anticipated)
Primary Completion Date
April 15, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Seoul St. Mary's Hospital
Collaborators
GE Healthcare
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this clinical study is to test the performance of low radiation dose abdominal CT combined with low dose contrast media for the diagnosis of acute appendicitis in young patients. The main questions to be answered are:
1, Can low-dose contrast media paired with low-dose radiation CT of the abdomen provide acceptable diagnostic accuracy in acute appendicitis? 2. How much radiation dose can be saved by using low radiation dose abdominal CT in combination with low dose contrast media?
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Appendicitis Acute
Keywords
acute appendicitis, acute abdomen, CT
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
292 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Double low-dose CT
Arm Type
Experimental
Arm Description
Weight-adjusted low-dose contrast media paired with low-radiation dose abdomen CT
Intervention Type
Diagnostic Test
Intervention Name(s)
Weight-adjusted low-dose contrast media paired with low-radiation dose abdomen CT
Intervention Description
The investigators are aiming for a 10% reduction in iodine dosage at 10 kVp reduction in CT radiation. Routine iodine dosing is 0.521 g I/kg at 120 kVp. Therefore, at 90 kVp, a 30% reduction in iodine dosing is expected, which is 0.365 g I/kg. At 100 kVp, the iodine dosage is reduced to 0.417 g I/kg, which is a 20% reduction. The kVp value is automatically selected by the CT device according to the body habitus, which is a clinical routine.
Primary Outcome Measure Information:
Title
Diagnostic accuracy for acute appendicitis
Description
The primary outcome of the study is the diagnostic accuracy of double low-dose CT for acute appendicitis in young adults with suspected acute appendicitis. Based on the CT findings, a three-tiered diagnosis of appendicitis will be given (no appendicitis, uncomplicated appendicitis, or complicated appendicitis). In the case of no appendicitis, a possible alternative diagnosis is given. The reference standard for appendicitis is operative findings and surgical pathology reports. In nonoperative cases, sequential radiologic evaluation, clinical follow-up, and the judgment of the attending physician will conclude the diagnosis. Specifically, if the patient is not treated for recurrent symptoms within 6 months, the radiologic diagnosis of CT findings is considered valid. The diagnostic accuracy for acute appendicitis is true positive for acute appendicitis and true negative for acute appendicitis divided by all participants.
Time Frame
For operated patients, postop. period (up to 1 month); If non-operated, at 6 months-FU
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Maximum Age & Unit of Time
44 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria:
Patients in the emergency department with suspected acute appendicitis based on clinical examination
Patients scheduled for contrast-enhanced CT of the abdomen and pelvis for diagnosis of suspected acute appendicitis.
Exclusion criteria:
Patients who decline to participate
Contraindications to contrast-enhanced CT (eGFR < 30 mL/min/173 m^2 or pregnant)
BMI >= 30.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Bohyun Kim, MD, PhD
Phone
82-2-2258-5793
Email
kbh@catholic.ac.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bohyun Kim, MD, PhD
Organizational Affiliation
Seoul St. Mary's Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Low-dose Contrast Media for Low-kVp Abdomen CT
We'll reach out to this number within 24 hrs