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Appropriateness Criteria

Variant 1: Adult. Asymptomatic unilateral hydronephrosis with unknown cause. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRU without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 1 3 8 1 2
References Study Quality
13 (31237781) 2
14 (25102294) 2
MAG3 renal scan Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 7 7 0 0 1 0 1 1 7 2 3
References Study Quality
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
CTU without and with IV contrast Usually appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 7 7 0 1 0 4 1 0 7 1 1
US color Doppler kidneys and bladder retroperitoneal May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 4 4 0 0 7 3 4 1 0 0 0
MRU without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 6 5 2 1 0 0
References Study Quality
15 (20729416) 4
CT abdomen and pelvis with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 1 0 5 3 3 0 3 0 0
CT abdomen and pelvis without IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 1 1 8 5 0 0 0 0
DTPA renal scan May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 1 0 1 1 9 0 3 0 0
References Study Quality
13 (31237781) 2
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
US abdomen Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 2 2 5 1 3 1 1 0 0
Fluoroscopy voiding cystourethrography Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 8 4 2 0 1 0 0 0 0
Fluoroscopy antegrade pyelography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 7 4 2 1 1 0 0 0 0
Radiography abdomen and pelvis Usually not appropriate ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 n/a 0 0 0 0 0 0 0 0 0
Radiography intravenous urography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 6 4 2 1 1 0 1 0 0
MRI abdomen and pelvis without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 1 1 7 2 3 1 0 0 0
MRI abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 3 2 7 3 0 0 0 0 0
MRI abdomen without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 5 4 3 1 0 0 2 0 0
MRI abdomen without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 5 2 5 1 0 2 0 0 0
CT abdomen with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 3 2 0 1 1 1 0 0
CT abdomen without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 6 3 2 1 1 1 1 0 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 3 3 7 0 7 0 1 0 0 0 0
CT abdomen without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 8 2 2 0 1 1 1 0 0
Variant 2: Adult. Asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRU without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 2 0 2 7 3 1
References Study Quality
13 (31237781) 2
14 (25102294) 2
MAG3 renal scan Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 7 7 0 0 1 0 0 0 9 2 3
References Study Quality
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
2 (29287975) 4
MRU without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 3 6 5 0 0 0
References Study Quality
15 (20729416) 4
CT abdomen and pelvis with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 6 3 2 2 2 0 0
CT abdomen and pelvis without IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 1 1 2 5 6 0 0 0
DTPA renal scan May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 1 2 1 6 3 2 0 0
References Study Quality
13 (31237781) 2
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
CTU without and with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 5 5 1 1 2 2 0 1 4 4 0
US abdomen Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 2 3 5 3 2 0 0 0 0
US color Doppler kidneys and bladder retroperitoneal Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 0 0 8 2 5 0 0 0 0
Fluoroscopy voiding cystourethrography Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 2 2 7 2 3 1 1 0 1 0 0
Fluoroscopy antegrade pyelography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 3 3 4 3 4 2 1 0 1 0 0
Radiography abdomen and pelvis Usually not appropriate ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 n/a 0 0 0 0 0 0 0 0 0
Radiography intravenous urography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 7 3 1 1 2 0 1 0 0
MRI abdomen and pelvis without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 1 0 7 1 3 2 1 0 0
MRI abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 4 2 8 0 1 0 0 0 0
MRI abdomen without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 3 6 2 1 2 0 1 0 0
MRI abdomen without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 3 4 4 2 1 1 0 0 0
CT abdomen with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 6 4 2 0 2 1 0 0 0
CT abdomen without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 5 4 2 2 1 1 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 5 5 0 0 0 0 0 0
CT abdomen without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 3 2 0 1 2 0 0 0
Variant 3: Adult. Symptomatic hydronephrosis with unknown cause. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
US color Doppler kidneys and bladder retroperitoneal Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 1 0 1 0 0 4 5 1 3
References Study Quality
41 (23503878) 3
40 (27154825) 3
39 (25219987) 3
38 (26177650) 3
37 (24578772) 3
36 (29427476) Good
35 (33051735) 3
33 (25254610) 3
25 (28611874) 1
22 (29663580) 2
17 (30853305) 4
16 (34304393) 3
MRU without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 1 0 3 3 5 2 1
References Study Quality
29 (25249333) 4
28 (29399012) 3
17 (30853305) 4
14 (25102294) 2
13 (31237781) 2
MAG3 renal scan Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 7 7 0 0 1 0 1 2 5 4 2
References Study Quality
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
2 (29287975) 4
CTU without and with IV contrast Usually appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 7 7 0 0 0 1 4 2 4 3 1
References Study Quality
28 (29399012) 3
US abdomen May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 3 5 1 1 2 2 1 0 0
MRI abdomen and pelvis without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 4 4 0 1 4 3 3 3 1 0 0
MRI abdomen and pelvis without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 4 4 1 2 4 3 4 0 1 0 0
MRU without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 5 3 5 2 0 0
References Study Quality
31 (23532422) 3
30 (23290346) 2
29 (25249333) 4
17 (30853305) 4
15 (20729416) 4
CT abdomen and pelvis with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 0 1 9 2 3 0 0
References Study Quality
22 (29663580) 2
21 (24440589) 3
20 (29675722) 3
19 (27369294) 2
18 (34773812) 2
17 (30853305) 4
16 (34304393) 3
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 0 1 3 4 5 1 1
References Study Quality
27 (27533351) 3
26 (31958894) 3
25 (28611874) 1
24 (31535518) 4
23 (26747219) 3
22 (29663580) 2
21 (24440589) 3
19 (27369294) 2
18 (34773812) 2
17 (30853305) 4
16 (34304393) 3
DTPA renal scan May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 5 5 0 1 2 1 9 2 0 0 0
References Study Quality
13 (31237781) 2
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
Fluoroscopy voiding cystourethrography Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 2 2 7 2 3 1 1 0 1 0 0
Fluoroscopy antegrade pyelography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 6 3 2 1 2 0 1 0 0
Radiography abdomen and pelvis Usually not appropriate ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 n/a 0 0 0 0 0 0 0 0 0
Radiography intravenous urography Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 7 2 1 1 2 1 1 0 0
References Study Quality
6 (28461996) 4
MRI abdomen without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 6 3 6 0 0 0 0 0 0
MRI abdomen without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 3 3 4 3 4 1 1 2 0 0 0
CT abdomen with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 2 2 2 2 2 0 0 0
CT abdomen without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 2 2 3 1 2 0 0 0
CT abdomen and pelvis without and with IV contrast Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 3 3 0 2 8 1 0 3 1 0 0
References Study Quality
23 (26747219) 3
22 (29663580) 2
21 (24440589) 3
20 (29675722) 3
19 (27369294) 2
18 (34773812) 2
17 (30853305) 4
16 (34304393) 3
CT abdomen without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 5 3 0 0 0 0 0 0
Variant 4: Adult. Asymptomatic hydronephrosis in a pregnant patient with unknown cause. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
US color Doppler kidneys and bladder retroperitoneal Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 3 4 8
References Study Quality
5 (33754607) 4
17 (30853305) 4
4 (23455540) 3
43 (33328069) 4
US abdomen May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 6 6 0 0 0 1 3 7 4 0 0
MRI abdomen and pelvis without IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 1 0 3 4 5 0 2 0 0
MRU without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 10 1 2 0 0
References Study Quality
15 (20729416) 4
Fluoroscopy voiding cystourethrography Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 11 1 2 0 0 1 0 0 0
Fluoroscopy antegrade pyelography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 11 1 2 0 0 1 0 0 0
Radiography abdomen and pelvis Usually not appropriate ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 n/a 0 0 0 0 0 0 0 0 0
Radiography intravenous urography Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 10 1 2 1 1 0 0 0 0
References Study Quality
6 (28461996) 4
MRI abdomen and pelvis without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 9 2 1 1 0 0 2 0 0
References Study Quality
42 (31429682) 4
MRI abdomen without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 2 0 1 0 1 1 0 0
References Study Quality
42 (31429682) 4
MRI abdomen without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 6 7 1 0 0 0 1 0 0
MRU without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 3 0 0 0 0 0 0 0
References Study Quality
42 (31429682) 4
CT abdomen and pelvis with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 1 2 2 0 1 0 0 0
CT abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 0 3 2 0 1 0 0 0
CT abdomen with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 0 4 0 0 1 0 0 0
CT abdomen without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 10 1 3 0 0 1 0 0 0
DTPA renal scan Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 6 2 2 3 1 1 0 0 0
References Study Quality
13 (31237781) 2
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
MAG3 renal scan Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 5 3 2 3 1 1 0 0 0
References Study Quality
10 (25444983) 2
11 (24591488) 4
CT abdomen and pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 9 1 2 2 0 1 0 0 0
CT abdomen without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 10 1 3 0 0 1 0 0 0
CTU without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 9 1 2 1 1 1 0 0 0
Variant 5: Adult. Symptomatic hydronephrosis in a pregnant patient with unknown cause. Initial imaging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
US color Doppler kidneys and bladder retroperitoneal Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 1 1 1 2 10
References Study Quality
49 (32666258) 3
48 (27231677) 4
47 (26941870) 3
46 (24496359) 3
45 (34515254) 3
43 (33328069) 4
17 (30853305) 4
9 (28516385) 4
6 (28461996) 4
5 (33754607) 4
4 (23455540) 3
MRU without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 0 2 2 3 6 2 0
References Study Quality
6 (28461996) 4
15 (20729416) 4
17 (30853305) 4
29 (25249333) 4
30 (23290346) 2
44 (14665888) 4
US abdomen May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 6 6 0 0 0 2 2 10 1 0 0
MRI abdomen and pelvis without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 1 6 3 1 4 0 0
References Study Quality
17 (30853305) 4
CT abdomen and pelvis without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 1 1 5 4 4 0 0 0 0
References Study Quality
6 (28461996) 4
17 (30853305) 4
Fluoroscopy voiding cystourethrography Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 11 1 2 0 0 1 0 0 0
Fluoroscopy antegrade pyelography Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 10 1 3 0 0 1 0 0 0
Radiography abdomen and pelvis Usually not appropriate ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 n/a 0 0 0 0 0 0 0 0 0
Radiography intravenous urography Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 1 1 1 1 0 0 0 0
References Study Quality
6 (28461996) 4
MRI abdomen and pelvis without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 3 2 0 0 0 0 0 0
References Study Quality
42 (31429682) 4
MRI abdomen without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 3 1 0 0 0 0 0 0
References Study Quality
42 (31429682) 4
MRI abdomen without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 4 6 4 0 0 0 1 0 0
References Study Quality
17 (30853305) 4
MRU without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 7 4 1 1 0 0 2 0 0
References Study Quality
42 (31429682) 4
CT abdomen and pelvis with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 8 1 4 1 0 1 0 0 0
References Study Quality
6 (28461996) 4
17 (30853305) 4
CT abdomen with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 2 3 0 0 1 0 0 0
CT abdomen without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 9 2 3 0 0 1 0 0 0
DTPA renal scan Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 4 2 2 4 1 1 1 0 0
References Study Quality
13 (31237781) 2
12 (8917195) 4
11 (24591488) 4
10 (25444983) 2
MAG3 renal scan Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 2 2 5 3 6 1 0 0 0 0 0
References Study Quality
10 (25444983) 2
11 (24591488) 4
CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 3 3 0 0 1 1 0 0
References Study Quality
6 (28461996) 4
17 (30853305) 4
CT abdomen without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 9 2 3 0 0 1 0 0 0
CTU without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 5 4 3 1 0 1 1 0 0
References Study Quality
6 (28461996) 4
17 (30853305) 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.