Significance of Postprocedural Contrast Medium Injection after CT-Guided Abscess Drainage

Round 1

Reviewer 1 Report

Thank you very much for the opportunity to review this interesting manuscript.

Here some suggestions:

1. Title - please shorten the title (eg, drop the words "clinical" + "percutaneous")

2. Fig. 1-3 - please reduce the black surrounding around the images to a minimum in favor of larger images. Please reduce the sizes of the marker-arrows. Please use always the same "arrow-configuration".

3. section "drainage procedure" - please provide detailed information (eg, size, manufacturer, etc.) on the drainage material used

4. line 123: Please add "." at the end of the sentence.

5. line 126: Please check "0or".

6. section "discussion": Please share your thoughts concerning potential limitations due to drain size and CM-characteristics (other results with imeron 400?!). maybe the authors have a recommendation concerning drain-types etc.

7. lines 218-220: Please implement this important recommendation in the "conclusion" section.

8. abstract: ok

9. references: ok

I am looking forward to reading a revised version of your paper! Thank you!

Overall language quality is sufficient- but please correct lines 123 and 126.

Author Response

Please see attachment

Author Response File: Author Response.docx

Reviewer 2 Report

Clinical significance of postprocedural contrast medium injection after CT-guided percutaneous abscess drainage

 

TITLE

Ok

 

ABSTRACT

Ok

 

KEY WORDS

SIRS could be explained

Add post-surgical complications; add intervention

 

INTRODUCTION

PAY attention to typo errors (ex line 36 save - safe)

Add the possible role of precise diagnosis in case of infected fluid collection to give the most appropriate therapy

Emphasize the possibility of MIP or Minip recontruction with CT, very useful for diagnosis of leaks or fistula and to evaluate shape and size of collection

Also, CT allows the evaluation of bowel wall when air is present

Finally include in introduction some papers describing fistulography after pancreatico-duodenectomy, performed under fluoroscopic guidance; those papers could represent a good point also for discussion.

 

METHODS

Please declear type of study (retrospective observational?)

Please clarify inclusion and exclusion criteria

Please declare how many operator were involved in the procedure and in the study itself

Please clarify how the decision making for each patients enrolled were carried out

Please create a diagram with inclusion criteria, patients enrolled and the different sub-grops with outcome

 

Statistical analysis is very simple

Patients enrolled are not few but maybe not enough to compare sub group (maybe post pancreatic survery versus others could be a good starting point to get more analysis) or thorax vs abdominal for example

DISCUSSION

See comments above

Include some comparison with previous studies on fistulography

 

REFERENECES

See above

 

FIGURES AND TABLES

ok

Author Response

Please see attachment

Author Response File: Author Response.docx

Reviewer 3 Report

Review Clinical significance of postprocedural contrast medium injection after CT-guided percutaneous abscess drainage 

 

Abstract ok

Materials and methods I suggest to add a diagram to understand inclusion and exclusion criteria for patients

Figures to zoom it or to better cup CT figures.

Type of included pathology: pancreatitis, post appendicitis surgery, Crohn… with percentage in every group

Drainage procedures: in any case, CT injected was performed before drainage?

Why after CM injection a low dose protocol was not chosen?

2.3 page 4 to correct 0or TO for

Page 5 why you divided into surgery and no surgery groups ??

For data processing or statistical analyses: you should add all descriptive analyses performed and not only comparison with R between the 2 groups

For non CM group: I think it’s was useful to keep this population at least to evaluate to post procedure inflammation et if correlated to contrast injection

In addition it’s useful to add with every number of patients the percentage to estimate the incidence of the event or the variable

Again why you divided pre and no surgery before drainage

Again for SIRS it’s useful to mention percentage on non-flashed drainages 

It’s mandatory to enumerate all additional findings found with CM injection as fistulas, organ communication,…

Discussion 

For radiation dose paragraph: you did not really perform a study on dose so to mention it as a result and in discussion at the end as a drawback as you performed a full dose acquisition and of course a low dose protocol would improve and allow CM series

For CM flash, the discussion is short but concise

For SIRS; as I mentioned a comparison with a non-used contrast is mandatory to have significant results

To highlight the added value of detection of deep fistula and changes in management of patients is important as this point gives the strength of your paper

 

For conclusion

It’s ok however I advise to delete the percentages and to add significant, low…

Ref ok

Tables ok

Figures already reviewed 

 

 

 

 

 

 

 

Author Response

please see attachment

Author Response File: Author Response.docx