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Comment & Response
July 21, 2021

Comments on Computed Tomography for Evaluating Appendicitis—Reply

Author Affiliations
  • 1Department of Radiology, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
  • 2Department of Applied Bioengineering, Seoul National University Graduate School of Convergence Science and Technology, Seoul, Korea
  • 3Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea
JAMA Surg. 2021;156(11):1073-1074. doi:10.1001/jamasurg.2021.3213

In Reply We thank Hu et al, McCollough et al, and Schaps et al for their comments on our article.1 We hope that our study findings can contribute to better use of computed tomography (CT), rather than inciting unnecessary fear of CT radiation. In that regard, we appreciate them as they led the constructive discussion on our study results.

There have been efforts to replace CT examinations with clinical scoring systems, ultrasonography, or magnetic resonance imaging in the diagnosis of appendicitis in adults. As McCollough et al commented, studies have shown that CT outperforms ultrasonography and clinical scoring systems in terms of diagnostic accuracy and clinical outcomes. Some researchers and practitioners reserve CT as a secondary test following only indeterminate results of other diagnostic tests.2,3 Such strategies should be carefully attempted while maintaining excellent overall diagnostic accuracy.3 As Hu et al pointed out, magnetic resonance imaging is promising; however, it is yet to be determined if the study results can be generalized to average hospitals and to different health care systems.

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