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

Cohort studyInsights into imaging· Jul 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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Abdominal & Body ImagingCohort studyDiagnosisQ1IF 5.8

Adjudicated CT reports show excellent agreement with final diagnosis.

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

Piyachai Siriphiphatcharoen … Napakadol Noppakunsomboon

Insights into imaging · Jul 2026 · Q1 in Radiology

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

kappa = 0.819-0.838

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, acute appendicitis prevalence increased consistently with higher diagnostic certainty.

More results

Several CT features were independently associated with indeterminate reporting.

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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 acute appendicitis.

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

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

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