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Appropriateness Criteria

Variant 1: Adult. Primary brain tumor screening. Genetic risk factors.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 1 0 0 1 3 2 10
References Study Quality
24 (28620005) 4
25 (34633580) 4
MRI complete spine without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 1 2 3 8 1 0 0 0
References Study Quality
21 (34806136) 4
24 (28620005) 4
MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 9 5 0 0 0
References Study Quality
26 (28572266) 4
25 (34633580) 4
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 0 0 0 0 0
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 0 1 0 1 0 0 1
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 0 2 0 0 0 1 0
MRI functional (fMRI) head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 0 0 0 0 0
MRI head perfusion with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 0 0 0 1 0 0
MRI head perfusion without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 0 0 0 1 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 3 1 0 0 0 0 0 0
MRI head without IV contrast with DTI Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 0 2 0 1 0 0 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 1 0 1 0 0 2 0 0
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 0 0 0 0 2 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 1 1 0 0 0 0 0
DOTATATE PET/CT brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 11 1 1 2 0 0 1 1 0
References Study Quality
22 (35961372) 4
23 (30777201) 2
DOTATATE PET/MRI brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 11 1 1 2 0 0 1 1 0
References Study Quality
22 (35961372) 4
23 (30777201) 2
FDG-PET/CT brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 0 0 0 0 1 0 0
FDG-PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 1 0 0 0 0 1 0 0
Fluciclovine PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 1 0 0 1 0 0 0 0
Fluciclovine PET/CT brain Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv 1 1 15 1 0 0 1 0 0 0 0
Variant 2: Adult. Secondary or metastatic brain tumor screening. Extracranial malignancy.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 1 0 0 1 0 0 2 2 11
References Study Quality
32 (32065345) 4
31 (29799956) 2
30 (37245883) 4
29 (-3197191) 4
MRI complete spine without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 2 0 2 5 7 0 0 0
MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 1 2 11 1 0 0 0
References Study Quality
29 (-3197191) 4
30 (37245883) 4
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 0 2 1 0 0 0 0
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 0 0 1 0 0 1
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 3 0 0 0 0 0 0
MRI functional (fMRI) head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 1 0 0 0 0 0
MRI head perfusion with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 0 0 0 1 0 0
MRI head perfusion without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 0 2 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 3 1 0 0 0 0 0 0
MRI head without IV contrast with DTI Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 2 0 0 2 1 0 0 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 3 1 0 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 11 3 1 0 0 1 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 2 1 2 0 0 0 0 0
DOTATATE PET/CT brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 11 3 2 0 0 0 0 0 0
References Study Quality
11 (35854930) 4
DOTATATE PET/MRI brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 11 3 2 0 0 0 0 0 0
References Study Quality
11 (35854930) 4
FDG-PET/CT brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 0 0 2 0 1 0 0
FDG-PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 13 1 0 0 2 0 1 0 0
Fluciclovine PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 1 0 1 0 1 0 0 0
Fluciclovine PET/CT brain Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv 1 1 14 1 0 1 0 1 0 0 0
Variant 3: Adult. Suspected intra-axial brain tumor based on prior imaging. Pretreatment evaluation.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head perfusion with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 5 3 6 2 0
References Study Quality
51 (37105676) 2
50 (36549990) 2
49 (37246748) 2
48 (32678438) 2
47 (29098571) 1
46 (37010573) 2
45 (31371360) 2
44 (30777220) 2
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 1 0 0 0 0 1 1 1 12
References Study Quality
56 (32048719) 4
55 (36334295) 1
54 (26250565) 4
53 (33802292) 4
52 (36381650) 4
33 (28486641) 4
MR spectroscopy head without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 1 0 0 4 6 2 2 1 0
References Study Quality
41 (33811494) Good
40 (26471274) Good
39 (29459844) 4
38 (35655732) 4
MRI complete spine without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 12 2 0 0 0
MRI functional (fMRI) head without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 2 6 3 2 2 1
References Study Quality
4 (34060940) Good
42 (32653026) 2
43 (28980887) Good
MRI head perfusion without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 0 7 4 5 0 0
References Study Quality
51 (37105676) 2
50 (36549990) 2
49 (37246748) 2
48 (32678438) 2
47 (29098571) 1
46 (37010573) 2
45 (31371360) 2
44 (30777220) 2
MRI head without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 1 0 0 2 4 5 2 2 0
References Study Quality
59 (37468750) 1
58 (28751449) 2
57 (35198981) Good
33 (28486641) 4
MRI head without IV contrast with DTI May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 0 4 7 3 0 2
References Study Quality
2 (31494311) 2
3 (31192130) 4
60 (35626069) 4
61 (30277427) 2
Fluciclovine PET/MRI brain May be appropriate Strong ☢☢☢ 1-10 mSv 5 5 0 1 0 4 9 2 0 0 0
References Study Quality
37 (29730279) 2
35 (30519867) 4
9 (37341842) 1
8 (36549916) 2
Fluciclovine PET/CT brain May be appropriate Strong ☢☢☢☢ 10-30 mSv 5 5 0 1 0 5 8 2 0 0 0
References Study Quality
8 (36549916) 2
9 (37341842) 1
37 (29730279) 2
35 (30519867) 4
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 1 0 0 1 0 0 1
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 1 3 0 1 0 1 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 2 2 0 0 1 0 0 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 12 3 1 0 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 12 3 1 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 12 1 2 2 0 0 0 0 0
DOTATATE PET/CT brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 9 4 3 0 0 0 0 0 0
References Study Quality
34 (35695763) 4
DOTATATE PET/MRI brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 2 2 8 4 4 0 0 0 0 0 0
References Study Quality
34 (35695763) 4
FDG-PET/CT brain Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 3 3 1 0 0 0 0 0
References Study Quality
36 (31426864) 2
35 (30519867) 4
FDG-PET/MRI brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 2 2 7 3 4 1 1 0 0 0 0
References Study Quality
36 (31426864) 2
35 (30519867) 4
Variant 4: Adult. Suspected extra-axial brain tumor on prior imaging. Pretreatment evaluation.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 1 0 0 0 2 1 12
References Study Quality
63 (27432671) 4
62 (33459822) 4
MRI complete spine without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 1 1 7 6 0 0 0
References Study Quality
64 (37535461) 4
MRI functional (fMRI) head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 4 4 3 1 2 4 4 1 0 1 0
References Study Quality
70 (25957723) 2
MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 14 0 0 0 0
References Study Quality
32 (32065345) 4
62 (33459822) 4
63 (27432671) 4
DOTATATE PET/CT brain May be appropriate Strong ☢☢☢ 1-10 mSv 6 6 0 0 1 1 4 6 3 1 0
References Study Quality
69 (32442855) 4
68 (28450556) 2
67 (37287577) 4
66 (35885570) 4
65 (35275019) 2
DOTATATE PET/MRI brain May be appropriate Strong ☢☢☢ 1-10 mSv 6 6 0 0 1 1 5 5 3 1 0
References Study Quality
69 (32442855) 4
68 (28450556) 2
67 (37287577) 4
66 (35885570) 4
65 (35275019) 2
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 1 0 2 0 0 0 0
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 1 1 1 1 0 0 0 1
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 2 0 1 0 0 0 0
MRI head perfusion with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 5 1 3 1 6 0 0 0 0
References Study Quality
72 (35155210) 2
71 (33504729) 4
MRI head perfusion without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 5 1 4 3 3 0 0 0 0
References Study Quality
72 (35155210) 2
71 (33504729) 4
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
MRI head without IV contrast with DTI Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 5 1 3 0 6 1 0 0 0
References Study Quality
70 (25957723) 2
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 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 12 2 2 0 0 0 0 0 0
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 5 3 4 3 1 0 0 0 0
References Study Quality
62 (33459822) 4
63 (27432671) 4
FDG-PET/CT brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 3 1 0 0 2 0 0 0
FDG-PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 11 2 1 0 0 2 0 0 0
Fluciclovine PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 11 2 2 0 0 1 0 0 0
Fluciclovine PET/CT brain Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv 1 1 11 2 2 0 0 1 0 0 0
Variant 5: Adult. Known history of brain tumor. Posttreatment surveillance.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head perfusion with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 4 4 4 3 1
References Study Quality
76 (27502247) Good
72 (35155210) 2
71 (33504729) 4
56 (32048719) 4
54 (26250565) 4
48 (32678438) 2
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 1 0 0 0 0 0 2 0 13
References Study Quality
63 (27432671) 4
62 (33459822) 4
56 (32048719) 4
55 (36334295) 1
54 (26250565) 4
53 (33802292) 4
33 (28486641) 4
MRI complete spine without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 2 0 1 4 7 1 1 0 0
MRI head perfusion without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 0 7 4 1 4 0
References Study Quality
76 (27502247) Good
72 (35155210) 2
71 (33504729) 4
56 (32048719) 4
54 (26250565) 4
48 (32678438) 2
MRI head without IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 2 1 0 2 3 7 0 1 0
References Study Quality
63 (27432671) 4
62 (33459822) 4
56 (32048719) 4
54 (26250565) 4
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 4 1 0 0 0 0 0 0
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 2 1 1 2 0 0 0 0
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 4 0 0 1 0 0 0 0
MRI functional (fMRI) head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 2 0 1 2 0 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 3 1 0 0 0 0 0 0
MRI head without IV contrast with DTI Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 0 0 2 1 0 0 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 1 0 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 14 1 1 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 12 1 2 0 1 0 0 0 0
DOTATATE PET/CT brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 7 2 6 1 0 0 0 0 0
DOTATATE PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 3 3 7 1 6 1 1 0 0 0 0
FDG-PET/CT brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 4 2 0 0 0 0 0 0
FDG-PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 10 4 2 0 0 0 0 0 0
Fluciclovine PET/MRI brain Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 10 3 3 0 0 0 0 0 0
Fluciclovine PET/CT brain Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv 1 1 10 3 3 0 0 0 0 0 0
Variant 6: Adult. Known history of brain tumor. New or enlarging lesion on posttreatment surveillance. Next imaging study.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head perfusion with IV contrast Usually appropriate Moderate O 0 mSv O 0 mSv [ped] 7 7 0 0 0 1 2 0 8 4 1
References Study Quality
1 (28332014) 4
80 (27187209) 4
76 (27502247) Good
MRI head perfusion without IV contrast Usually appropriate Moderate O 0 mSv O 0 mSv [ped] 7 7 0 0 0 1 3 2 7 2 1
References Study Quality
1 (28332014) 4
76 (27502247) Good
80 (27187209) 4
MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 1 0 0 0 2 2 11
References Study Quality
74 (37774317) 4
MR spectroscopy head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 1 7 4 2 1 0
References Study Quality
1 (28332014) 4
MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 4 9 2 0 0 0
References Study Quality
54 (26250565) 4
56 (32048719) 4
MRI head without IV contrast with DTI May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 1 1 1 5 8 0 0 0 0
References Study Quality
40 (26471274) Good
81 (26450533) 2
DOTATATE PET/CT brain May be appropriate Strong ☢☢☢ 1-10 mSv 6 6 0 0 1 1 6 4 3 1 0
References Study Quality
11 (35854930) 4
15 (35661809) 2
66 (35885570) 4
69 (32442855) 4
77 (31868239) 2
78 (31898311) 4
DOTATATE PET/MRI brain May be appropriate Strong ☢☢☢ 1-10 mSv 6 6 0 0 1 1 6 4 3 1 0
References Study Quality
11 (35854930) 4
15 (35661809) 2
66 (35885570) 4
69 (32442855) 4
77 (31868239) 2
78 (31898311) 4
FDG-PET/CT brain May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 2 6 3 5 0 0
References Study Quality
7 (28341716) 2
35 (30519867) 4
76 (27502247) Good
FDG-PET/MRI brain May be appropriate Strong ☢☢☢ 1-10 mSv 6 6 0 0 0 2 6 3 5 0 0
References Study Quality
7 (28341716) 2
35 (30519867) 4
76 (27502247) Good
MRI complete spine with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 0 0 0 1 0 0
MRI complete spine without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 1 0 1 0 1 0 0
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 0 1 0 0 0 0
MRI functional (fMRI) head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 1 0 1 1 1 0 0 0
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 0 0 0 0
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 1 0 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 14 1 1 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 12 1 1 2 0 0 0 0 0
Fluciclovine PET/MRI brain Usually not appropriate Limited ☢☢☢ 1-10 mSv 3 3 5 1 3 2 4 1 0 0 0
References Study Quality
10 (37055222) 4
79 (36577872) 4
Fluciclovine PET/CT brain Usually not appropriate Limited ☢☢☢☢ 10-30 mSv 3 3 5 1 3 2 4 1 0 0 0
References Study Quality
10 (37055222) 4
79 (36577872) 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.