Variant 1: 58-year-old woman with stage IA follicular lymphoma (grade 1 or 2) involving multiple 2 cm lymph nodes in the right cervical neck.
Variant 2: 67-year-old man with stage IIA follicular lymphoma (grade 2) involving the right inguinal and right internal iliac nodes (2-3 cm in size).
Variant 3: 35-year-old woman with stage IA follicular lymphoma (grade 1) involving a single 2.8 cm lymph node in the axilla that was removed at the biopsy with no evidence of residual adenopathy.
Variant 4: 80-year-old symptomatic woman with stage IIB bulky (12 cm) follicular lymphoma involving the mesentery and para-aortics.
Variant 5: 50-year-old man with chemotherapy- and immunotherapy-refractory stage IV follicular lymphoma with a 6 cm para-aortic nodal mass causing significant back pain.
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.