Acute Appendicitis
| Purpose | Detect acute appendicitis |
| Tag(s) |
|
| Panel | Abdominal |
| Define-AI ID | 18020001 |
| Originator | Abdominal Panel |
| Panel Chair | Arun Krishnaraj |
| Panel Reviewers | Abdominal Panel |
| License | |
| Status | Published |
Clinical Implementation
Value Proposition
Acute appendicitis is the most common abdominal emergency and often requires surgical intervention. Most cases, if positive on CT, are heading to the OR, though some patients are treated with antibiotics for early appendicitis. The rapid identification of acute appendicitis can streamline these processes and ensure people get the treatment they need. An algorithm meeting this use case would also help prioritize the case on the worklist.
Narrative(s)
A 25-year-old male presents to the emergency room with fever and abdominal pain. The patient has been getting progressively worse over the past few days. Associated lab findings are leukocytosis (elevated white blood cell count) and anorexia.
Workflow Description
An algorithm may be written to query patient records and identify eating disorders, lab tests, or other patient records that may indicate a patient is susceptible to acute appendicitis and aid in the diagnosis.
An image is obtained from the modality and sent to PACS and the AI engine. The image is analyzed by the engine. The system categorizes the status of the appendix as normal, ruptured appendicitis, nonruptured appendicitis, or undetermined. A message is sent to PACS from the engine with the classification information. Ancillary data is also sent to the PACS if collected by the engine.
Considerations for Dataset Development
Procedures(s): {CT, CECT}
Sex at Birth: {Male, Female}
Age: [0,90]
Obstruction: {Stone, fecalith, tumor, other mass}
Peri-appendiceal: {Fat stranding, free fluid, abscess}
Lumen Contents: {Air-filled, contrast-filled, fluid-filled}
Appendicitis: {Ruptured, nonruptured}
Technical Specifications
Inputs
DICOM Study
| Procedure | CT, CECT |
| Data Type | DICOM |
| Modality | CT |
| Body Region | Abdomen |
| Anatomic Focus | Appendix |
Primary Outputs
Appendicitis Detection
| RadElement ID | |
| Definition | The status of the appendix |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Normal 2–Nonruptured appendicitis 3–Ruptured appendicitis |
| Units | N/A |
Secondary Outputs
Appendiceal Diameter
| RadElement ID | RDE196 |
| Definition | Diameter of the appendiceal |
| Data Type | Numerical |
| Value Set |
|
| Units | mm |
Peri-appendiceal Fat Stranding
| RadElement ID | |
| Definition | Detection of fat stranding around appendiceal |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Present 2–Absent |
| Units | N/A |
Free Fluid
| RadElement ID | |
| Definition | Detection of free fluid around appendiceal |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Present 2–Absent |
| Units | N/A |
Obstructing Focus
| RadElement ID | |
| Definition | Presence of obstructing mass such as a stone or fecalith |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Present 2–Absent |
| Units | N/A |
Lumen Contents
| RadElement ID | |
| Definition | Content within the lumen |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Air-filled 2–Contrast-filled 3–Fluid-filled |
| Units | N/A |
Peri-appendiceal Abscess
| RadElement ID | |
| Definition | States the presence of the peri-appendiceal abscess |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Present 2–Absent |
| Units | N/A |
Opacification
| RadElement ID | |
| Definition | Opacification of the appendix |
| Data Type | Categorical |
| Value Set | 0–Unknown 1–Present 2–Absent |
| Units | N/A |
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