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New research · Radiology
Insights into imaging · 23h
Cohort studyInsights into imaging · 2026

Indeterminate CT reporting of adult acute appendicitis: radiologist versus lexicon-based diagnostic certainty.

Piyachai Siriphiphatcharoen, Rathachai Kaewlai, Sasima Tongsai … Napakadol Noppakunsomboon
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RadiologyCohort study

Adjudicated CT reports show excellent agreement with final diagnosis.

Indeterminate CT reporting of adult acute appendicitis: radiologist versus lexicon-based diagnostic certainty.

Piyachai Siriphiphatcharoen et al. · Insights into imaging · 2026
Purpose

We also aimed to identify factors associated with indeterminate reporting.

Methods

A total of 983 consecutive CT reports between August 2021 and July 2025 were reviewed.

n = 393 patients
kappa = 0.819-0.838
Results
adjudicated CT reports showed excellent agreement with the final diagnosis
n = 393 patients
More results

Acute appendicitis was confirmed in 393 patients (40%).

Indeterminate reporting occurred in 15.5% of original reports, 12% of adjudicated reports, and 27.9-46.1% of lexicon-based schemes.

Across all approaches, AA prevalence increased consistently with higher diagnostic certainty.

More results

Several CT features were independently associated with indeterminate reporting.

“
Conclusion · 1 of 2

Radiologist-adjudicated impressions conveyed diagnostic certainty more effectively than original reports and lexicon-based schemes, with lower indeterminacy and stronger agreement with the final diagnosis.

Conclusion · 2 of 2

These findings underscore the practical importance of careful wording and judicious use of indeterminate categories when communicating CT findings for suspected adult AA.

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