• Pierre-Alexandre Poletti, Laurent Canel, Christoph D Becker, Hans Wolff, Bernice Elger, Eric Lock, François Sarasin, Monica S Bonfanti, Elise Dupuis-Lozeron, Thomas Perneger, and Alexandra Platon.
• Department of Radiology, Emergency Center, Department of Forensic Medicine, and Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland. erre-alexandre.poletti@hcuge.ch
• Radiology. 2012 Dec 1; 265 (3): 772-9.

PurposeTo evaluate the diagnostic performance of abdominal radiography in the detection of illegal intracorporeal containers (hereafter, packets), with low-dose computed tomography (CT) as the reference standard.Materials And MethodsThis study was approved by the institutional ethical review board, with written informed consent. From July 2007 to July 2010, 330 people (296 men, 34 women; mean age, 32 years [range, 18-55 years]) suspected of having ingested drug packets underwent supine abdominal radiography and low-dose CT. The presence or absence of packets at abdominal radiography was reported, with low-dose CT as the reference standard. The density and number of packets (≤ 12 or >12) at low-dose CT were recorded and analyzed to determine whether those variables influence interpretation of results at abdominal radiography.ResultsPackets were detected at low-dose CT in 53 (16%) suspects. Sensitivity of abdominal radiography for depiction of packets was 0.77 (41 of 53), and specificity was 0.96 (267 of 277). The packets appeared isoattenuated to the bowel contents at low-dose CT in 16 (30%) of the 53 suspects with positive results. Nineteen (36%) of the 53 suspects with positive low-dose CT results had fewer than 12 packets. Packets that were isoattenuated at low-dose CT and a low number of packets (≤12) were both significantly associated with false-negative results at abdominal radiography (P = .004 and P = .016, respectively).ConclusionAbdominal radiography is mainly limited by low sensitivity when compared with low-dose CT in the screening of people suspected of carrying drug packets. Low-dose CT is an effective imaging alternative to abdominal radiography.© RSNA, 2012.

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