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Appropriateness Criteria

Variant 1: Renal cell carcinoma. No contraindication to either iodinated CT contrast or gadolinium-based MR intravenous contrast. Staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI abdomen and pelvis without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 1 0 1 3 4 4 3
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
48 (12090319) 4
47 (9888732) 4
33 (12704036) 3
13 (-3195129) 4
5 (30803729) 4
MRI abdomen without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 0 1 0 0 0 5 5 5
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
48 (12090319) 4
47 (9888732) 4
33 (12704036) 3
13 (-3195129) 4
5 (30803729) 4
CT abdomen and pelvis with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 0 2 2 3 5 4
References Study Quality
48 (12090319) 4
47 (9888732) 4
46 (11734949) 3
45 (10350288) 4
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
16 (14512329) 2
15 (15100536) 2
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
44 (21843882) 2
CT abdomen with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 0 0 1 0 1 1 6 4 3
References Study Quality
46 (11734949) 3
45 (10350288) 4
44 (21843882) 2
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
27 (23108238) M
26 (10737472) 2
25 (24321262) 4
24 (18311784) 3
23 (19007371) 3
22 (17286945) M
21 (7954317) 4
20 (24819422) 3
19 (25593113) 3
18 (24566409) 3
17 (2196982) 4
16 (14512329) 2
15 (15100536) 2
14 (16304081) 3
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
CT chest with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 1 0 0 0 1 1 6 2 5
References Study Quality
55 (31955483) 3
54 (27684653) 3
53 (21557795) 2
52 (19450840) 3
51 (25241004) 3
50 (20846691) 3
49 (26880407) 2
13 (-3195129) 4
5 (30803729) 4
Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 0 2 1 2 11 0 0 0 0
References Study Quality
13 (-3195129) 4
54 (27684653) 3
53 (21557795) 2
Bone scan whole body with SPECT or SPECT/CT area of interest May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 2 2 4 2 4 2 0 0 0
References Study Quality
14 (16304081) 3
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 4 4 6 0 1 3 4 1 1 0 0
References Study Quality
57 (33525046) 2
56 (33578374) 4
13 (-3195129) 4
5 (30803729) 4
CT abdomen and pelvis without and with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 5 5 3 3 5 1 0 1 2 1 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
46 (11734949) 3
45 (10350288) 4
44 (21843882) 2
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
16 (14512329) 2
15 (15100536) 2
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
CT abdomen without and with IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 5 5 3 2 5 2 0 1 2 1 0
References Study Quality
46 (11734949) 3
45 (10350288) 4
44 (21843882) 2
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
27 (23108238) M
26 (10737472) 2
25 (24321262) 4
24 (18311784) 3
23 (19007371) 3
22 (17286945) M
21 (7954317) 4
20 (24819422) 3
19 (25593113) 3
18 (24566409) 3
17 (2196982) 4
16 (14512329) 2
15 (15100536) 2
14 (16304081) 3
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
US abdomen Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 6 4 5 0 0 0 1 0 0
References Study Quality
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
13 (-3195129) 4
5 (30803729) 4
US abdomen with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 6 3 6 0 0 0 0 1 0
References Study Quality
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
13 (-3195129) 4
5 (30803729) 4
MRI abdomen and pelvis without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 4 2 6 3 1 0 0 0 0
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
48 (12090319) 4
47 (9888732) 4
33 (12704036) 3
13 (-3195129) 4
5 (30803729) 4
MRI abdomen without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 5 2 5 1 3 0 0 0 0
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
33 (12704036) 3
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 3 3 6 3 1 0 0 0 0
References Study Quality
57 (33525046) 2
56 (33578374) 4
13 (-3195129) 4
5 (30803729) 4
MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 6 2 5 2 0 1 0 0 0
References Study Quality
57 (33525046) 2
56 (33578374) 4
13 (-3195129) 4
5 (30803729) 4
MRU without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 3 4 9 0 0 0 0 0 0
References Study Quality
13 (-3195129) 4
5 (30803729) 4
MRU without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 5 1 6 0 2 2 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
Bone scan whole body Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 1 4 3 3 0 0 1 0
References Study Quality
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
CT abdomen and pelvis without IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 4 5 7 0 0 0 0 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
46 (11734949) 3
45 (10350288) 4
44 (21843882) 2
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
16 (14512329) 2
15 (15100536) 2
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
CT abdomen without IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 5 4 7 0 0 0 0 0 0
References Study Quality
46 (11734949) 3
45 (10350288) 4
44 (21843882) 2
43 (23325783) 2
42 (30456180) 4
41 (27867332) 3
40 (25304287) 3
39 (11796275) 2
38 (28296683) 3
37 (31607203) 2
36 (25410425) 2
35 (20937417) 2
34 (17082687) 1
33 (12704036) 3
32 (21342488) 3
31 (18937590) 3
30 (11275723) 3
29 (18710440) 3
28 (20148365) 3
27 (23108238) M
26 (10737472) 2
25 (24321262) 4
24 (18311784) 3
23 (19007371) 3
22 (17286945) M
21 (7954317) 4
20 (24819422) 3
19 (25593113) 3
18 (24566409) 3
17 (2196982) 4
16 (14512329) 2
15 (15100536) 2
14 (16304081) 3
13 (-3195129) 4
5 (30803729) 4
3 (30523454) 3
CT chest without and with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 3 5 2 1 0 0 0 0
References Study Quality
55 (31955483) 3
54 (27684653) 3
53 (21557795) 2
52 (19450840) 3
51 (25241004) 3
50 (20846691) 3
49 (26880407) 2
13 (-3195129) 4
5 (30803729) 4
CT chest without IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 6 3 3 1 3 0 0 0 0
References Study Quality
55 (31955483) 3
54 (27684653) 3
53 (21557795) 2
52 (19450840) 3
51 (25241004) 3
50 (20846691) 3
49 (26880407) 2
13 (-3195129) 4
5 (30803729) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 6 0 6 1 3 0 0 0 0
References Study Quality
57 (33525046) 2
56 (33578374) 4
13 (-3195129) 4
5 (30803729) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 6 1 7 1 0 0 0 1 0
References Study Quality
57 (33525046) 2
56 (33578374) 4
13 (-3195129) 4
5 (30803729) 4
CTU without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 4 6 6 0 0 0 0 0 0
References Study Quality
13 (-3195129) 4
5 (30803729) 4
FDG-PET/CT skull base to mid-thigh Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 3 4 9 0 0 0 0 0 0
References Study Quality
59 (30120698) 2
60 (30234688) 2
58 (25210086) 4
13 (-3195129) 4
5 (30803729) 4
Fluoride PET/CT skull base to mid-thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv 3 3 4 3 6 1 2 0 0 0 0
References Study Quality
61 (26202597) 3
13 (-3195129) 4
5 (30803729) 4
Variant 2: Renal cell carcinoma. Contraindication to both iodinated CT and gadolinium-based MR intravenous contrast. Staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI abdomen and pelvis without IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 8 8 0 0 1 0 1 2 3 6 3
References Study Quality
5 (30803729) 4
13 (-3195129) 4
47 (9888732) 4
48 (12090319) 4
MRI abdomen without IV contrast Usually appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 8 8 1 0 0 1 0 0 2 6 6
CT chest without IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 1 0 0 0 1 1 5 4 4
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 4 4 0 2 2 8 3 1 0 0 0
References Study Quality
13 (-3195129) 4
54 (27684653) 3
55 (31955483) 3
MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 4 4 1 3 3 7 2 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
Bone scan whole body May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 5 1 2 4 3 0 0 1 0
References Study Quality
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
Bone scan whole body with SPECT or SPECT/CT area of interest May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 1 1 12 2 0 0 0 0
References Study Quality
14 (16304081) 3
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 1 0 1 0 2 7 3 1 1
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 1 1 0 1 2 5 5 1 0
References Study Quality
16 (14512329) 2
15 (15100536) 2
US abdomen Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 7 4 4 0 0 0 1 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
US abdomen with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 7 5 3 0 0 0 0 1 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
MRI abdomen and pelvis without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 2 2 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
47 (9888732) 4
48 (12090319) 4
MRI abdomen without and 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 and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
MRU without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
MRU without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 8 2 6 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT abdomen and pelvis with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 12 2 1 0 0 0 1 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 0 0 0 0 1 1 0
References Study Quality
15 (15100536) 2
16 (14512329) 2
CT chest with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 1 0 0 0 1 0 0
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
CT chest without and with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 1 1 0 0 0 1 0 0
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 1 1 7 5 2 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT abdomen and pelvis without and with IV contrast Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 12 2 1 0 0 0 1 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen without and with IV contrast Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 13 1 1 0 0 0 1 0 0
References Study Quality
16 (14512329) 2
15 (15100536) 2
CTU without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 14 0 2 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
FDG-PET/CT skull base to mid-thigh Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 3 3 8 2 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
60 (30234688) 2
59 (30120698) 2
58 (25210086) 4
Fluoride PET/CT skull base to mid-thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv 3 3 6 2 5 1 0 0 2 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
61 (26202597) 3
Variant 3: Renal cell carcinoma. Contraindication only to iodinated CT intravenous contrast. Staging.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI abdomen and pelvis without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 1 0 0 0 1 5 6 3
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
48 (12090319) 4
47 (9888732) 4
33 (12704036) 3
13 (-3195129) 4
5 (30803729) 4
MRI abdomen without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 1 0 0 1 0 4 8 2
References Study Quality
33 (12704036) 3
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
CT chest without IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 0 1 0 0 1 1 8 4 1
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 4 4 0 1 1 8 5 1 0 0 0
References Study Quality
13 (-3195129) 4
55 (31955483) 3
54 (27684653) 3
Bone scan whole body with SPECT or SPECT/CT area of interest May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 1 1 13 1 0 0 0 0
References Study Quality
14 (16304081) 3
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 1 1 2 1 10 1 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 1 1 1 4 8 1 0 0
References Study Quality
15 (15100536) 2
16 (14512329) 2
US abdomen Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 8 2 5 0 0 0 1 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
US abdomen with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 2 2 8 3 4 0 0 0 0 1 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
73 (28073200) 3
72 (33006090) 2
71 (7347111) 3
70 (6252674) 3
MRI abdomen and pelvis without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 3 1 6 1 4 1 0 0 0
References Study Quality
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
48 (12090319) 4
47 (9888732) 4
33 (12704036) 3
13 (-3195129) 4
5 (30803729) 4
MRI abdomen without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 4 1 5 4 1 0 1 0 0
References Study Quality
33 (12704036) 3
69 (29724245) 2
68 (18076946) 3
67 (11832712) 3
66 (15665685) 2
65 (31741596) 3
64 (15615960) 2
63 (15100535) 2
62 (14684543) 3
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 1 1 7 6 1 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 5 2 7 1 0 0 1 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
MRU without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 8 2 5 1 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
MRU without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 8 2 6 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
Bone scan whole body Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 2 3 2 4 0 0 1 0
References Study Quality
13 (-3195129) 4
12 (11696720) 3
11 (4060382) 3
5 (30803729) 4
CT abdomen and pelvis with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 2 0 0 0 0 1 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 12 2 1 0 0 0 1 0 0
References Study Quality
15 (15100536) 2
16 (14512329) 2
CT chest with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 12 1 2 0 0 0 1 0 0
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
CT chest without and with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 12 1 2 0 0 0 1 0 0
References Study Quality
75 (17487856) 3
74 (15577678) 4
64 (15615960) 2
63 (15100535) 2
49 (26880407) 2
34 (17082687) 1
13 (-3195129) 4
5 (30803729) 4
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 3 3 5 2 5 1 2 0 0 0 1
References Study Quality
5 (30803729) 4
13 (-3195129) 4
CT abdomen and pelvis without and with IV contrast Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 13 2 0 0 0 0 1 0 0
References Study Quality
48 (12090319) 4
47 (9888732) 4
16 (14512329) 2
15 (15100536) 2
CT abdomen without and with IV contrast Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 12 1 2 0 0 0 1 0 0
References Study Quality
15 (15100536) 2
16 (14512329) 2
CTU without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 14 1 1 0 0 0 0 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
FDG-PET/CT skull base to mid-thigh Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 4 7 1 0 0 0 0 0
References Study Quality
60 (30234688) 2
59 (30120698) 2
58 (25210086) 4
13 (-3195129) 4
5 (30803729) 4
Fluoride PET/CT skull base to mid-thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv 3 3 5 3 4 1 1 1 1 0 0
References Study Quality
5 (30803729) 4
13 (-3195129) 4
61 (26202597) 3
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.