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Appropriateness Criteria

Variant 1: Adult. Noninvasive imaging surveillance following treatment of stage I-III non–small-cell lung cancer. Routine surveillance.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
CT chest with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 9 9 1 0 0 0 0 1 3 2 11
References Study Quality
19 (28225653) 4
18 (34051381) 2
17 (21892108) Good
16 (22859511) 2
15 (23127371) 4
14 (28881918) 4
13 (23649451) 4
12 (34481037) 4
11 (-3196828) 4
CT chest without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 0 1 4 4 4
References Study Quality
5 (31829901) 4
20 (23996838) 4
Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 5 6 5 0 0 0 0 0 0
References Study Quality
8 (30292847) 1
37 (24139896) 2
MRI chest without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 8 1 4 2 2 0 1 0 0
References Study Quality
34 (21928189) 4
33 (22434450) 4
32 (18374761) 2
MRI chest without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 9 4 2 0 2 0 1 0 0
References Study Quality
34 (21928189) 4
33 (22434450) 4
32 (18374761) 2
MRI head without and with IV contrast Usually not appropriate Moderate O 0 mSv O 0 mSv [ped] 2 2 6 5 4 0 1 0 0 0 0
References Study Quality
5 (31829901) 4
35 (24606446) Good
36 (23860613) 4
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 4 8 4 0 0 0 0 0 0
Bone scan whole body Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 3 2 1 1 0 1 0 0
CT abdomen and pelvis with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 3 5 1 2 1 1 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
CT abdomen and pelvis without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 9 3 2 1 2 1 0 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 6 5 4 1 0 0 0 0 0
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 8 5 1 1 2 1 0 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 3 2 0 0 2 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 1 3 3 0 1 0 0 0
CT neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 8 1 5 2 0 2 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 3 2 1 0 1 1 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 9 2 4 1 0 1 1 0 0
CTA chest with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 5 4 7 0 0 0 0 0 0
CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 9 1 4 0 2 1 0 1 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 11 1 2 1 2 1 0 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
CT chest abdomen pelvis with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 4 6 2 0 0 0 0 0
References Study Quality
5 (31829901) 4
11 (-3196828) 4
CT chest abdomen pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 5 2 1 1 1 1 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 6 2 4 2 2 1 1 0 0
References Study Quality
3 (35545176) 4
5 (31829901) 4
FDG-PET/CT skull base to mid-thigh Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 3 3 7 0 3 0 0 0 0
References Study Quality
29 (32909168) 2
28 (20005529) 2
27 (19398291) 2
26 (23317944) 2
25 (25012832) 2
24 (19046631) 2
23 (22914804) 2
22 (17257962) 2
21 (22051278) 2
8 (30292847) 1
5 (31829901) 4
4 (22305958) 4
3 (35545176) 4
Variant 2: Adult. Noninvasive imaging surveillance following treatment of stage I-III small-cell lung cancer. Routine surveillance.
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] 7 7 0 1 0 0 0 0 8 4 3
References Study Quality
5 (31829901) 4
50 (23307984) 4
MRI head without IV contrast Usually appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 7 7 0 1 0 1 3 2 6 3 0
CT chest with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 1 0 1 0 2 0 2 4 8
References Study Quality
46 (25310425) 4
45 (30323087) 4
44 (23649448) 4
42 (34902832) 4
CT chest abdomen pelvis with IV contrast May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 2 10 2 1 1 0
References Study Quality
45 (30323087) 4
44 (23649448) 4
43 (32723523) 4
FDG-PET/CT skull base to mid-thigh May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 5 3 7 0 1 0 0
References Study Quality
51 (25613535) 2
50 (23307984) 4
49 (23307985) 4
48 (19921339) 3
47 (21409347) 3
39 (27726427) 4
Radiography chest Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 7 4 4 0 1 0 0 0 0
References Study Quality
5 (31829901) 4
52 (19819917) 4
53 (12527585) 4
MRI chest without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 9 5 2 0 0 0 0 0 0
MRI chest without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 9 3 1 2 2 1 0 0 0
References Study Quality
34 (21928189) 4
33 (22434450) 4
32 (18374761) 2
Bone scan whole body Usually not appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 6 1 3 4 4 0 0 0 0
References Study Quality
40 (-3196830) 4
41 (21354739) Good
CT abdomen and pelvis with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 5 5 5 1 0 0 0 0 0
References Study Quality
5 (31829901) 4
42 (34902832) 4
CT abdomen and pelvis without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 5 2 1 1 1 1 0 0
References Study Quality
5 (31829901) 4
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 5 3 1 0 0 0 0 0
CT chest without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 2 3 6 0 3 2 0 0 0
References Study Quality
5 (31829901) 4
39 (27726427) 4
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 6 3 2 1 4 0 0 0 0
References Study Quality
42 (34902832) 4
CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 8 4 2 0 1 1 0 0 0
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 6 4 3 1 4 0 0 0 0
References Study Quality
42 (34902832) 4
CT neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 9 2 3 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] 2 2 9 2 3 1 2 0 1 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 8 3 3 0 2 0 2 0 0
CTA chest with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 6 2 8 0 0 0 0 0 0
CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 8 4 4 0 0 0 0 0 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 8 2 3 1 2 2 0 0 0
References Study Quality
5 (31829901) 4
CT chest abdomen pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 5 7 3 1 0 0 0 0 0
References Study Quality
5 (31829901) 4
CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 2 5 3 3 3 1 0 1 0
References Study Quality
42 (34902832) 4
Variant 3: Adult. Posttreatment evaluation of stage I-III non–small-cell lung cancer. Suspected recurrence or progression.
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] 7 7 1 0 1 0 0 0 7 2 5
References Study Quality
6 (-3196827) 4
64 (23649440) 4
CT chest with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 9 9 1 0 0 0 1 0 4 3 9
References Study Quality
9 (31841793) 2
8 (30292847) 1
37 (24139896) 2
63 (26291011) 2
62 (33731050) 1
61 (11978336) 1
60 (15620991) Good
CT chest without IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 0 1 0 1 3 1 4 3 3
References Study Quality
20 (23996838) 4
19 (28225653) 4
18 (34051381) 2
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 1 0 1 0 1 5 1 4 5
References Study Quality
66 (23927734) 4
65 (9159703) 4
58 (20547021) 2
55 (23811122) 2
54 (22727222) 4
42 (34902832) 4
41 (21354739) Good
23 (22914804) 2
21 (22051278) 2
8 (30292847) 1
6 (-3196827) 4
Radiography chest May be appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 1 1 1 1 8 4 0 0 0
References Study Quality
8 (30292847) 1
37 (24139896) 2
MRI chest without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 2 0 4 9 1 0 0 0
References Study Quality
67 (23593186) 2
MRI head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 9 3 2 0 0
Bone scan whole body May be appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 1 1 4 5 7 0 0 0 0
References Study Quality
41 (21354739) Good
59 (18300765) 4
CT abdomen and pelvis with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 1 0 0 5 6 4 0 0 0
CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 0 0 3 8 4 1 0 0
References Study Quality
64 (23649440) 4
CT neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 1 4 2 8 2 1 0 0
CTA chest with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 3 12 1 0 0 0
CT chest abdomen pelvis with IV contrast May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 0 4 5 2 5 0
References Study Quality
20 (23996838) 4
MRI chest without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 3 4 6 1 3 0 1 0 0
References Study Quality
34 (21928189) 4
33 (22434450) 4
32 (18374761) 2
68 (30856554) 2
CT abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 3 10 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] 2 2 5 5 5 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] 2 2 4 6 4 1 0 1 0 0 0
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 2 5 3 5 1 1 1 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 3 5 3 1 0 2 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 3 4 4 4 2 0 1 0 0
CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 6 5 4 1 0 0 0 0 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 5 7 3 1 0 0 0 0 0
CT chest abdomen pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 4 6 5 1 0 0 0 0 0
CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 2 2 6 2 4 1 1 0 0
References Study Quality
46 (25310425) 4
Variant 4: Adult. Posttreatment evaluation of stage I-III small-cell lung cancer. Suspected recurrence or progression.
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 0 0 0 1 0 0 3 8 4
References Study Quality
42 (34902832) 4
50 (23307984) 4
78 (18311784) 3
CT chest with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 1 0 7 4 4
References Study Quality
5 (31829901) 4
42 (34902832) 4
CT chest abdomen pelvis with IV contrast Usually appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 0 1 5 5 5
References Study Quality
73 (28778345) 2
43 (32723523) 4
FDG-PET/CT skull base to mid-thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 1 0 0 2 4 1 5 5
References Study Quality
39 (27726427) 4
51 (25613535) 2
77 (26837337) 2
76 (24081215) Good
75 (24777290) 2
74 (15258700) 2
Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 1 1 0 3 7 3 0 1 0
References Study Quality
37 (24139896) 2
52 (19819917) 4
MRI chest without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 4 4 2 3 3 3 5 1 1 0 0
MRI head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 2 10 4 0 0 0
Bone scan whole body May be appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 2 1 12 1 0 0 0
References Study Quality
40 (-3196830) 4
41 (21354739) Good
CT abdomen and pelvis with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 1 13 0 1 0 1
References Study Quality
6 (-3196827) 4
42 (34902832) 4
43 (32723523) 4
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 1 9 6 0 0 0
References Study Quality
5 (31829901) 4
CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 0 0 1 9 5 1 0 0
References Study Quality
42 (34902832) 4
43 (32723523) 4
CT head without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 4 4 3 3 3 7 1 0 1 0 0
References Study Quality
42 (34902832) 4
CT neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 1 0 1 11 3 0 0 0
CTA chest with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 5 8 3 0 0 0
CT chest abdomen pelvis without IV contrast May be appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 2 0 1 9 4 0 0 0
MRI chest without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 2 5 4 5 2 0 0 0 0
References Study Quality
68 (30856554) 2
CT abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 3 8 4 0 0 1 0 0 0
CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 4 5 7 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] 2 2 4 6 4 0 0 2 0 0 0
CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 6 4 4 2 0 0 2 0 0
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 2 3 6 6 0 0 1 0 0
CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 8 2 4 2 1 0 1 0 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 3 2 2 2 0 1 0 1
References Study Quality
42 (34902832) 4
43 (32723523) 4
CT chest abdomen pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 5 4 6 0 0 1 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.