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

Creative Commons 4.0

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

RDE195

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

RDE197

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

RDE198

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

RDE199

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

RDE200

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

RDE201

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

RDE202

Definition

Opacification of the appendix

Data Type

Categorical

Value Set

0–Unknown

1–Present

2–Absent

Units

N/A