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Appropriateness Criteria

Variant 1: Child. Acute ataxia, no history of recent trauma. Initial imaging.
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] 8 8 1 0 0 0 1 2 2 4 8
References Study Quality
18 (31327588) 3
20 (30932991) 4
19 (30948362) 3
MRI head without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 1 0 2 1 6 4 4
References Study Quality
18 (31327588) 3
20 (30932991) 4
19 (30948362) 3
CT head without IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 7 7 0 0 0 0 5 3 3 2 5
References Study Quality
13 (23683541) 4
18 (31327588) 3
20 (30932991) 4
7 (27789117) 4
28 (26444039) 4
26 (25535060) 2
MRA head and neck without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 1 0 17 0 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
MRA head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 1 17 0 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
MRA neck with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 8 10 0 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
MRA neck without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 0 18 0 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
MRI complete spine without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 2 0 0 2 15 0 0 0 0
References Study Quality
20 (30932991) 4
29 (19898915) 4
MRI complete spine without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 0 7 10 0 0 1 0
References Study Quality
20 (30932991) 4
29 (19898915) 4
CTA head and neck with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 1 3 13 2 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
CTA head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 0 1 11 6 1 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
CTA neck with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 4 4 0 0 1 11 6 1 0 0 0
References Study Quality
20 (30932991) 4
7 (27789117) 4
26 (25535060) 2
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 1 3 2 1 0 0 0 0
MRI chest abdomen pelvis without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 6 10 0 0 2 1 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
MRI chest abdomen pelvis without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 0 2 5 1 0 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
MRV head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 7 2 5 1 1 2 0 0 0
MRV head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 8 11 0 0 0 0 0 0 0
MRV head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 9 10 0 0 0 0 0 0 0
MRV head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 6 4 4 1 1 2 0 0 0
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 5 1 5 0 6 1 0 0 0
References Study Quality
13 (23683541) 4
18 (31327588) 3
20 (30932991) 4
7 (27789117) 4
28 (26444039) 4
26 (25535060) 2
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 4 3 1 4 1 0 0 0
References Study Quality
13 (23683541) 4
18 (31327588) 3
20 (30932991) 4
7 (27789117) 4
28 (26444039) 4
26 (25535060) 2
CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 9 2 4 0 2 1 0 0 0
MIBG scan Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 11 7 0 1 0 0 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
CT chest abdomen pelvis with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 1 1 2 4 0 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
CT chest abdomen pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 14 1 2 0 1 0 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 2 1 0 0 0 0 0 0
References Study Quality
13 (23683541) 4
2 (24716559) 4
CT complete spine with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 2 1 0 0 0 1 0 0
CT complete spine without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 2 2 0 0 0 0 0 0
CT complete spine without IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 2 0 0 0 0 0 0
Variant 2: Child. Acute ataxia, history of recent trauma. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 1 0 4 4 3 2 4
References Study Quality
4 (22595899) 4
26 (25535060) 2
33 (21292802) 4
32 (19863638) 4
CT head without IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 9 9 0 0 0 0 1 0 1 2 14
References Study Quality
7 (27789117) 4
MRA head and neck without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 0 17 2 0 0 0
MRA head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 0 18 1 0 0 0
MRA neck with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 5 13 1 0 0 0
MRA neck without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 0 18 1 0 0 0
CTA head and neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 1 6 4 8 0 0
CTA head with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 0 15 3 1 0 0
CTA neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 0 0 0 15 3 1 0 0
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 0 1 1 0 0 0 0
MRI complete spine without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 9 0 4 0 3 1 1 0 0
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 4 8 0 0 0 0 0 0
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 4 4 4 4 2 0 1 0 0
References Study Quality
4 (22595899) 4
26 (25535060) 2
33 (21292802) 4
32 (19863638) 4
MRV head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 12 0 0 0 0 0 0 0
MRV head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 7 0 0 0 0 0 0 0
MRV head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 7 0 0 0 0 0 0 0
MRV head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 9 10 0 0 0 0 0 0 0
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 7 4 3 0 3 1 0 0 0
References Study Quality
7 (27789117) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 9 2 3 0 3 1 0 0 0
References Study Quality
7 (27789117) 4
CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 9 3 1 2 1 2 0 0 0
CT complete spine with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 3 2 1 2 0 0 0 0
CT complete spine without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 3 2 1 2 0 0 0 0
CT complete spine without IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 3 9 0 0 0 0 0 0
Variant 3: Child. Recurrent ataxia with interval normal neurology examination. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 1 1 6 3 7
References Study Quality
1 (28257643) 4
34 (28043238) 4
25 (22764177) 4
MR spectroscopy head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 1 1 14 2 0 0 0
MRI head without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 2 0 1 0 10 6 0 0 0
References Study Quality
1 (28257643) 4
34 (28043238) 4
25 (22764177) 4
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 6 5 8 0 0 0 0 0 0
MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 9 3 0 0 0 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 8 3 0 1 0 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 4 3 4 1 0 0 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 1 2 1 0 0 0
MRI complete spine without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 4 0 0 1 0 0 0 0
MRV head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 1 0 2 1 1 0 0
MRV head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 17 2 0 0 0 0 0 0 0
MRV head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 18 1 0 0 0 0 0 0 0
MRV head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 1 2 0 2 2 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 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 0 1 0 3 0 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 6 11 1 0 0 0 1 0 0
CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 7 1 4 2 2 1 1 0 0
CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 2 2 1 1 1 1 0 0
CTA neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 8 1 2 2 3 1 1 0 0
CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 12 2 1 1 1 1 0 0 0
CT complete spine with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 2 0 0 0 0 0 0
CT complete spine without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 17 0 1 0 0 0 0 0 0
CT complete spine without IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 16 0 2 0 0 0 0 0 0
Variant 4: Child. Chronic progressive ataxia. Initial imaging.
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 Strong O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 2 1 3 5 7
References Study Quality
41 (21701895) 3
46 (19631275) 2
45 (22764178) 4
4 (22595899) 4
39 (22816526) 4
42 (29922574) 3
1 (28257643) 4
44 (27126632) 4
40 (20378176) 4
47 (30086112) 4
43 (27423800) 4
11 (27142713) 2
28 (26444039) 4
5 (23622410) 4
25 (22764177) 4
MRI head without IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 1 0 3 6 8
References Study Quality
41 (21701895) 3
46 (19631275) 2
45 (22764178) 4
4 (22595899) 4
39 (22816526) 4
42 (29922574) 3
1 (28257643) 4
44 (27126632) 4
40 (20378176) 4
47 (30086112) 4
43 (27423800) 4
11 (27142713) 2
28 (26444039) 4
5 (23622410) 4
25 (22764177) 4
MRI complete spine without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 0 0 15 3 0 0 0
MRI complete spine without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 0 1 13 3 1 0 0
CT head without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 1 0 0 2 13 2 1 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 7 3 2 0 7 0 0 0 0
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 8 4 1 1 2 2 0 0 0
MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 8 3 1 2 2 2 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 1 0 2 1 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 9 3 1 1 2 2 0 0 0
MRV head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 0 1 3 1 0 0 0
MRV head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 0 0 1 2 0 0 0
MRV head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 0 0 1 2 0 0 0
MRV head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 0 0 2 2 0 0 0
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 6 3 2 2 3 2 0 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 8 2 1 1 4 2 0 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 11 1 1 2 2 1 0 0 0
CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 11 1 1 2 2 1 0 0 0
CTA neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 1 1 2 2 1 0 0 0
CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 0 2 2 0 0 0 0
CT complete spine with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 2 0 0 0 0 0 0
CT complete spine without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 17 0 1 0 0 0 0 0 0
CT complete spine without IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 0 2 0 1 0 0 0 0
Variant 5: Child. Chronic nonprogressive ataxia. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI head without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 1 0 0 1 3 13
References Study Quality
4 (22595899) 4
52 (27785688) 3
43 (27423800) 4
6 (26413479) 3
32 (19863638) 4
50 (26132530) 4
MRI complete spine without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 0 0 16 2 0 0 0
References Study Quality
44 (27126632) 4
CT head without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 6 6 0 0 0 2 7 9 1 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
MR spectroscopy head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 2 3 2 0 0 0 1 0
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 1 0 2 2 0 0 0
MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 1 1 2 1 0 0 0
MRA neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 1 0 2 1 0 0 0
MRA neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 1 1 2 1 0 0 0
MRI complete spine without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 5 5 3 5 1 0 0 0 0
References Study Quality
44 (27126632) 4
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 5 5 2 0 6 0 1 0 0
References Study Quality
4 (22595899) 4
52 (27785688) 3
43 (27423800) 4
6 (26413479) 3
32 (19863638) 4
50 (26132530) 4
MRV head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 0 0 3 1 0 0 0
MRV head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 3 0 0 1 2 0 0 0
MRV head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 0 0 1 2 0 0 0
MRV head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 3 0 1 2 1 0 0 0
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 7 2 2 3 4 0 0 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 2 2 2 2 0 0 0 0
References Study Quality
14 (26940752) 4
28 (26444039) 4
CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 11 3 1 0 2 1 0 0 0
CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 11 3 1 1 1 1 0 0 0
CTA neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 2 2 1 1 1 0 0 0
CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 1 0 2 1 0 0 0
CT complete spine with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 16 2 0 0 0 0 0 0 0
CT complete spine without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 17 1 0 0 0 0 0 0 0
CT complete spine without IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 15 1 1 0 1 0 0 0 0
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.