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Appropriateness Criteria

Variant 1: Suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. Initial staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 0 1 9 4 4
References Study Quality
26 (33370639) 2
59 (32949282) Good
33 (32152744) Good
29 (32445627) 2
34 (27480073) 2
31 (27373806) 2
60 (25197667) 2
61 (22877952) 4
CT neck with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 9 9 0 0 0 0 0 0 2 2 15
References Study Quality
26 (33370639) 2
22 (32388410) 2
33 (32152744) Good
29 (32445627) 2
32 (30633558) 4
28 (30369373) 2
39 (26013025) 2
36 (28608737) 1
23 (26573595) 2
30 (26307809) 4
38 (25643834) 2
34 (27480073) 2
31 (27373806) 2
27 (22155255) 2
24 (34087615) 1
25 (32554422) 1
35 (31606761) 2
37 (30473166) Good
40 (22996710) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 1 1 2 4 3 8
References Study Quality
49 (30768363) 2
35 (31606761) 2
42 (31635765) 4
37 (30473166) Good
50 (28600822) 2
39 (26013025) 2
36 (28608737) 1
10 (28572489) 2
47 (25131685) 2
48 (26490394) 2
38 (25643834) 2
17 (25405771) 2
44 (21637051) 2
45 (21470899) 2
46 (23538049) Good
43 (21861286) 2
51 (32129894) 2
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 1 2 7 6 2 0 0
References Study Quality
68 (32792295) 2
51 (32129894) 2
69 (30227124) 2
66 (29496048) 2
67 (29362123) 4
47 (25131685) 2
73 (26224226) 2
71 (22039019) 2
70 (24436209) 1
72 (21958435) 2
25 (32554422) 1
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
62 (21604319) 4
CT chest with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 7 3 6 1 1
References Study Quality
20 (31005338) 4
15 (25239083) 4
21 (21232904) 2
11 (10718426) 2
19 (26350882) 2
CT chest without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 4 6 3 4 1 0
References Study Quality
20 (31005338) 4
15 (25239083) 4
21 (21232904) 2
11 (10718426) 2
19 (26350882) 2
FDG-PET/MRI skull base to mid-thigh May be appropriate Strong ☢☢☢ 1-10 mSv 5 5 1 0 2 1 10 3 0 1 0
References Study Quality
52 (24649835) 4
54 (26243264) 2
57 (33247166) 2
42 (31635765) 4
55 (26498514) 4
56 (28129606) 2
58 (27922861) 2
53 (24924545) 2
44 (21637051) 2
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 13 4 0 0 1 0 0 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 19 0 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 2 0 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 17 1 0 1 0 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 2 0 1 0 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 1 1 0 0 0 0 0
MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 2 3 1 1 0 0 0 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 1 1 0 0 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 0 0 1 0 0
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 9 0 2 3 5 0 0 0 0
CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 13 1 2 2 1 0 0 0 0
CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 13 3 2 1 0 0 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 16 2 0 0 0 0 0 0 1
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 2 0 3 0 0 0 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 2 0 1 1 0 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 16 2 0 1 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 3 1 0 0 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 1 0 0 0 1 0 1
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 9 2 1 3 3 1 0 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 2 4 2 0 0 0 0 0
References Study Quality
41 (32113152) 4
Variant 2: Suspected or diagnosed nasopharynx cancer or EBV-associated unknown primary of the head and neck. Initial staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 1 0 0 0 0 1 3 2 11
References Study Quality
92 (26316564) 2
91 (24212004) 2
90 (23769923) 4
82 (18704401) 2
81 (30912815) 2
74 (33416977) 2
CT neck with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 0 0 0 0 0 3 4 3 8
References Study Quality
85 (31635767) 4
84 (11130825) 2
83 (25348201) Good
82 (18704401) 2
81 (30912815) 2
FDG-PET/MRI skull base to mid-thigh Usually appropriate Strong ☢☢☢ 1-10 mSv 7 7 1 0 0 0 2 1 9 4 1
References Study Quality
86 (31746412) 2
53 (24924545) 2
89 (29502310) 2
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 1 0 6 4 7
References Study Quality
83 (25348201) Good
88 (24283555) Not Assessed
17 (25405771) 2
74 (33416977) 2
87 (17873135) 2
85 (31635767) 4
84 (11130825) 2
82 (18704401) 2
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 1 2 10 3 2 0 0
References Study Quality
93 (24764338) 2
47 (25131685) 2
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
62 (21604319) 4
MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 1 2 11 2 0 0 1
CT maxillofacial with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 0 2 0 4 8 2 0 2 0
CT maxillofacial without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 3 0 0 4 8 3 0 0 0
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 7 4 5 1 1
References Study Quality
15 (25239083) 4
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 4 7 3 3 1 0
References Study Quality
15 (25239083) 4
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 11 1 2 1 1 1 1 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 18 0 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 3 1 1 0 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 1 0 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 1 0 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 0 1 1 0 0 1 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 1 0 1 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 4 3 1 0 0 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 0 2 0 0 0 0 0 1
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 2 2 0 0 1 1 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 1 1 0 1 0 1 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 1 1 0 0 1 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 2 2 0 0 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 1 0 0 0 1 0 1
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 9 3 2 0 2 2 0 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 1 4 2 0 0 0 0 0
References Study Quality
41 (32113152) 4
Variant 3: Suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Initial staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 3 2 13
References Study Quality
103 (32608548) 2
104 (31529977) 4
105 (25698188) 2
96 (26476381) 4
CT neck with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 0 0 0 0 2 0 5 4 8
References Study Quality
96 (26476381) 4
99 (26830408) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 1 2 1 5 2 8
References Study Quality
42 (31635765) 4
100 (21713453) 4
102 (16343913) 2
101 (7562038) 2
85 (31635767) 4
49 (30768363) 2
37 (30473166) Good
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 1 1 12 3 1 0 0
References Study Quality
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
62 (21604319) 4
47 (25131685) 2
MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 2 1 2 9 3 0 1 0
CT maxillofacial with IV contrast May be appropriate Expert Consensus ☢☢ 0.1-1mSv 6 6 0 0 0 1 8 6 0 2 1
CT maxillofacial without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 1 1 1 2 7 4 1 1 0
CT chest with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 9 5 2 1 1
References Study Quality
15 (25239083) 4
21 (21232904) 2
20 (31005338) 4
19 (26350882) 2
11 (10718426) 2
CT chest without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 1 2 9 4 1 1 0
References Study Quality
15 (25239083) 4
11 (10718426) 2
21 (21232904) 2
20 (31005338) 4
19 (26350882) 2
FDG-PET/MRI skull base to mid-thigh May be appropriate Strong ☢☢☢ 1-10 mSv 5 5 1 0 1 1 9 5 0 1 0
References Study Quality
52 (24649835) 4
54 (26243264) 2
42 (31635765) 4
53 (24924545) 2
57 (33247166) 2
56 (28129606) 2
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 11 1 1 2 3 0 1 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 17 0 1 0 1 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 2 0 0 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 2 1 0 0 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 17 1 1 0 0 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 1 1 0 0 2 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 0 1 1 0 1 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 6 1 0 0 0 0 0 1
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 2 0 0 0 0 0 1
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 1 1 2 2 0 1 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 0 2 0 0 0 1 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 16 1 1 0 0 1 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 13 2 0 1 2 0 1 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 2 0 0 0 1 0 1
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 9 1 3 2 2 1 1 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 3 1 0 0 0 0 0
References Study Quality
41 (32113152) 4
Variant 4: Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 1 1 3 13
References Study Quality
113 (25577417) Good
112 (18337041) 4
108 (27236737) 4
107 (33866123) 4
106 (31327623) Good
CT neck with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 0 0 0 0 0 3 4 3 9
References Study Quality
113 (25577417) Good
112 (18337041) 4
111 (22842859) 4
108 (27236737) 4
107 (33866123) 4
106 (31327623) Good
FDG-PET/CT skull base to mid-thigh Usually appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 1 0 1 0 3 2 4 2 6
References Study Quality
110 (31635766) 4
42 (31635765) 4
114 (31102059) 2
115 (27890182) 4
108 (27236737) 4
US neck May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 0 11 5 1 0 0
References Study Quality
116 (26224227) 3
112 (18337041) 4
108 (27236737) 4
107 (33866123) 4
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 8 5 3 1 1
References Study Quality
15 (25239083) 4
108 (27236737) 4
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 1 3 8 4 1 1 0
References Study Quality
15 (25239083) 4
108 (27236737) 4
FDG-PET/MRI skull base to mid-thigh May be appropriate Limited ☢☢☢ 1-10 mSv 5 5 1 0 1 1 9 5 0 1 0
References Study Quality
110 (31635766) 4
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 11 1 2 2 2 0 1 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 19 0 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 1 1 0 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 2 0 1 0 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 17 1 0 1 0 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 1 1 0 0 0 0 1
MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 1 2 0 0 0 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 2 0 1 0 0 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 8 0 2 2 5 1 0 1 0
CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 10 1 3 2 2 1 0 0 0
CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 15 1 1 1 1 0 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 2 0 0 0 0 0 1
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 17 1 0 1 0 0 0 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 17 0 2 0 0 0 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 19 0 0 0 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 17 1 1 0 0 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 2 0 0 0 1 0 1
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 1 3 1 3 0 0 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 1 3 2 0 0 0 0 0
References Study Quality
41 (32113152) 4
Variant 5: Treated cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. Surveillance imaging or follow-up imaging for suspected or known recurrence.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 1 0 4 5 8
References Study Quality
43 (21861286) 2
128 (29754496) 2
139 (20862388) 2
CT neck with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 9 9 0 0 0 0 0 0 2 6 10
References Study Quality
125 (21439046) 4
40 (22996710) 4
128 (29754496) 2
127 (25892275) 2
126 (25829083) 4
124 (10715030) 2
123 (21990217) 2
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 0 1 5 4 8
References Study Quality
118 (26715675) 4
131 (26315809) 2
119 (26188656) 2
129 (29478080) Good
136 (25917499) 2
135 (25716933) 2
126 (25829083) 4
127 (25892275) 2
133 (25169701) 2
134 (21665394) 2
117 (24149172) 2
130 (23639557) 2
132 (23817791) 4
19 (26350882) 2
128 (29754496) 2
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 0 3 9 5 1 0 0
References Study Quality
140 (28638103) 2
47 (25131685) 2
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
141 (22201409) 4
CT chest with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 7 5 3 2 1
References Study Quality
121 (30409312) 2
15 (25239083) 4
120 (26976351) 2
21 (21232904) 2
20 (31005338) 4
CT chest without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 8 4 2 1 0
References Study Quality
121 (30409312) 2
15 (25239083) 4
120 (26976351) 2
20 (31005338) 4
21 (21232904) 2
122 (22520870) 2
FDG-PET/MRI skull base to mid-thigh May be appropriate Limited ☢☢☢ 1-10 mSv 6 6 1 0 1 0 3 5 5 2 1
References Study Quality
138 (29922943) 4
137 (25958189) 2
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 13 4 0 0 1 0 0 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 17 1 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 1 1 0 0 1 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 1 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 1 1 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 3 0 1 0 0 0 1 0
MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 0 1 0 0 1 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 0 1 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 7 1 2 2 4 2 0 0 0
CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 11 3 2 0 2 0 0 0 0
CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 14 2 0 2 0 0 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 0 1 0 0 1 1 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 1 1 1 0 0 0 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 1 0 1 0 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 17 1 0 0 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 2 1 0 0 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 2 0 0 0 1 1 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 1 1 1 3 0 2 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 1 3 1 0 1 1 0 0
References Study Quality
41 (32113152) 4
Variant 6: Treated nasopharynx cancer or EBV-associated unknown primary of the head and neck. Surveillance imaging or follow-up imaging for suspected or known recurrence.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 2 4 12
References Study Quality
148 (30578604) 4
146 (16954552) 2
145 (16622711) 2
143 (26547126) Good
142 (23937825) 4
CT neck with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 2 0 0 0 0 3 3 5 5
References Study Quality
144 (21777548) 2
FDG-PET/MRI skull base to mid-thigh Usually appropriate Limited ☢☢☢ 1-10 mSv 7 7 1 0 0 0 4 1 6 4 2
References Study Quality
137 (25958189) 2
138 (29922943) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 0 1 4 5 8
References Study Quality
143 (26547126) Good
136 (25917499) 2
75 (25055290) 4
90 (23769923) 4
88 (24283555) Not Assessed
149 (23715831) 2
145 (16622711) 2
146 (16954552) 2
147 (21501441) 4
148 (30578604) 4
87 (17873135) 2
82 (18704401) 2
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 0 2 11 4 1 0 0
References Study Quality
140 (28638103) 2
47 (25131685) 2
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 2 1 9 5 0 0 0
CT maxillofacial with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 0 2 0 2 8 4 1 1 0
CT maxillofacial without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 3 0 0 3 8 3 0 1 0
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 8 4 4 1 1
References Study Quality
15 (25239083) 4
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 8 4 2 1 0
References Study Quality
15 (25239083) 4
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 13 3 1 0 1 0 0 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 18 0 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 1 0 2 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 0 2 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 1 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 1 0 0 1 1 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 2 0 0 1 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 4 3 0 0 0 0 0 1
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 2 0 0 0 0 1 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 3 0 1 0 0 1 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 1 0 1 0 1 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 3 0 0 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 3 1 0 0 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 3 0 0 0 1 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 2 1 1 2 1 1 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 1 4 1 1 1 0 0 0
References Study Quality
41 (32113152) 4
Variant 7: Treated cancer of the paranasal sinuses or nasal cavity. Surveillance imaging or follow-up imaging for suspected or known recurrence.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 1 0 1 0 2 3 11
References Study Quality
105 (25698188) 2
96 (26476381) 4
103 (32608548) 2
104 (31529977) 4
CT neck with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 0 0 0 0 2 2 3 3 8
References Study Quality
96 (26476381) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 0 1 5 4 8
References Study Quality
118 (26715675) 4
136 (25917499) 2
117 (24149172) 2
151 (18486742) 4
150 (21925763) 4
134 (21665394) 2
102 (16343913) 2
US neck May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 2 0 0 2 9 4 1 0 0
References Study Quality
140 (28638103) 2
47 (25131685) 2
65 (25150165) 2
64 (21674359) 2
63 (19688854) 2
MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 1 1 2 9 3 0 0 1
CT maxillofacial with IV contrast May be appropriate Expert Consensus ☢☢ 0.1-1mSv 5 5 0 0 0 3 7 6 0 2 0
CT maxillofacial without IV contrast May be appropriate Expert Consensus ☢☢ 0.1-1mSv 5 5 2 0 2 1 7 5 0 1 0
CT chest with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 9 4 3 1 1
References Study Quality
15 (25239083) 4
21 (21232904) 2
120 (26976351) 2
121 (30409312) 2
122 (22520870) 2
CT chest without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 9 4 1 1 0
References Study Quality
15 (25239083) 4
21 (21232904) 2
122 (22520870) 2
121 (30409312) 2
120 (26976351) 2
FDG-PET/MRI skull base to mid-thigh May be appropriate Limited ☢☢☢ 1-10 mSv 5 5 1 0 1 0 8 7 0 1 0
References Study Quality
137 (25958189) 2
138 (29922943) 4
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 15 2 0 0 1 0 0 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 17 0 0 0 1 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 0 2 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 0 2 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 1 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 0 2 0 0 0 1 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 1 0 1 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 9 4 3 0 0 0 0 1 1
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 2 1 0 0 0 0 1 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 2 1 2 0 0 1 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 1 0 0 1 1 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 2 1 0 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 2 0 0 1 0 1 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 1 0 1 0 1 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 1 2 2 1 0 2 0 0
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 2 2 1 2 0 0 0 0
References Study Quality
41 (32113152) 4
Variant 8: Treated cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Surveillance imaging or follow-up imaging for suspected or known recurrence.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI orbits face neck without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 2 0 0 0 0 2 1 13
References Study Quality
108 (27236737) 4
CT neck with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 8 8 1 0 0 0 0 1 5 4 7
References Study Quality
112 (18337041) 4
111 (22842859) 4
108 (27236737) 4
107 (33866123) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 1 1 3 0 4 2 7
References Study Quality
153 (24900119) 2
114 (31102059) 2
110 (31635766) 4
108 (27236737) 4
US neck May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 2 11 4 1 0 0
References Study Quality
108 (27236737) 4
112 (18337041) 4
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 9 4 3 1 1
References Study Quality
15 (25239083) 4
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 9 4 2 0 0
References Study Quality
15 (25239083) 4
FDG-PET/MRI skull base to mid-thigh May be appropriate Strong ☢☢☢ 1-10 mSv 5 5 1 0 0 0 10 6 0 1 0
References Study Quality
152 (30548894) 2
154 (25841279) 4
137 (25958189) 2
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 8 4 2 0 2 1 1 0 0
References Study Quality
11 (10718426) 2
15 (25239083) 4
18 (10870751) 2
Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 17 1 0 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 0 2 0 0 0 0
MRA neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 0 2 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 0 1 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 0 2 0 1 0 0 0
MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 2 2 0 3 1 0 0 0
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 1 0 0 0 0
MRI orbits face neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 0 0 0 0 1
MRI orbits face neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 3 0 1 0 0 0 0
CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 10 2 2 1 1 2 0 0 0
CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 14 1 2 1 0 0 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 1 0 0 0 0 1 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 0 1 2 0 0 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 2 0 0 2 0 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 16 1 0 1 0 0 0 0 0
CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 3 0 0 1 0 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 2 0 0 0 1 1 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 4 1 0 0 0 0 0 1
CTA neck with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 2 2 2 2 0 0 0 0
References Study Quality
41 (32113152) 4
Appendix Key

A more complete discussion of the items presented below can be found by accessing the supporting documents at the designated hyperlinks.

Appropriateness Category:The panel’s recommendation for a procedure based on the assessment of the risks and benefits of performing the procedure for the specified clinical scenario.

SOE: Strength of Evidence. The assessment of the amount and quality of evidence found in the peer reviewed medical literature for an appropriateness recommendation.

  • References: The citation number and PMID for the reference(s) associated with the recommendation.
  • Study Quality: The assessment of the quality of an individual reference based on the number of study quality elements described in the reference.

RRL: Relative Radiation Level. A population based assessment of the amount of radiation a typical patient may be exposed to during the specified procedure.

Rating: The final rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Median: The median rating (1-9 scale) for the procedure as determined by the panel during rating rounds.

Final tabulations: A histogram showing the number of panel members who rated the procedure as noted in the column heading (ie, 1, 2, 3, etc.).

Additional supporting documents about the AC methodology and processes can be found at www.acr.org/ac.