American College of Radiology
ACR Appropriateness Criteria®

Post-Treatment Follow-up and Active Surveillance of Clinically Localized Renal Cell Cancer

Variant 1: Follow-up for clinically localized renal cell cancer; post radical or partial nephrectomy.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
CT abdomen with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 1 0 2 5 3 6
References Study Quality
6 (23665399) 4
10 (9507823) 4
11 (15201737) 2
14 (10893575) 2
15 (7776446) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
22 (21843882) 2
MRI abdomen without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 8 8 0 0 1 0 1 1 2 6 6
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
26 (20429759) 2
CT abdomen without and with IV contrast Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 7 7 0 1 1 0 2 3 4 1 5
References Study Quality
6 (23665399) 4
11 (15201737) 2
10 (9507823) 4
14 (10893575) 2
15 (7776446) 2
16 (9836544) 4
22 (21843882) 2
21 (9146581) 2
20 (23764074) 4
CT abdomen and pelvis with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 1 0 1 4 4 2 4 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
10 (9507823) 4
11 (15201737) 2
14 (10893575) 2
15 (7776446) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
22 (21843882) 2
CT abdomen and pelvis without and with IV contrast May be appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 6 6 1 0 0 1 3 9 2 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
10 (9507823) 4
11 (15201737) 2
14 (10893575) 2
15 (7776446) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
22 (21843882) 2
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 0 0 1 0 6 8 2 0 0
References Study Quality
6 (23665399) 4
7 (25616710) 4
18 (26880407) 2
25 (20846691) 3
MRI abdomen without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 6 6 0 0 1 2 5 5 4 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
26 (20429759) 2
Radiography chest May be appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 6 6 0 0 1 1 2 7 4 2 0
References Study Quality
19 (24096433) 2
18 (26880407) 2
8 (26617405) 4
7 (25616710) 4
6 (23665399) 4
US abdomen with IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 2 6 9 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
28 (23092215) 2
29 (27569091) 2
30 (20204642) 2
31 (21107560) 2
32 (25404183) 3
33 (24665032) 2
CT abdomen without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 3 5 5 3 1 0 0
References Study Quality
6 (23665399) 4
10 (9507823) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
15 (7776446) 2
20 (23764074) 4
21 (9146581) 2
22 (21843882) 2
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 0 1 1 7 4 2 1 1
References Study Quality
6 (23665399) 4
7 (25616710) 4
18 (26880407) 2
25 (20846691) 3
MRI abdomen and pelvis without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 1 2 2 5 5 1 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
26 (20429759) 2
MRI abdomen and pelvis without and with IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 6 2 0 1 0 2 7 5 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
26 (20429759) 2
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 1 0 2 9 4 1 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
10 (9507823) 4
11 (15201737) 2
14 (10893575) 2
15 (7776446) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
22 (21843882) 2
FDG-PET/CT skull base to mid-thigh May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 4 4 1 0 0 9 6 0 1 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
36 (27824726) Good
37 (26202597) 3
38 (26996777) 3
US kidney retroperitoneal May be appropriate Limited O 0 mSv O 0 mSv [ped] 4 4 0 0 1 11 4 1 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
9 (26567050) 2
CT chest without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 1 10 1 0 0 0 0 0
References Study Quality
6 (23665399) 4
7 (25616710) 4
18 (26880407) 2
25 (20846691) 3
Tc-99m bone scan whole body Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 7 1 0 0 1 0 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
34 (4060382) 3
35 (11696720) 3
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 11 4 1 0 0 0 0 1 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 0 0 0 0 0 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography intravenous urography Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 3 1 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 15 1 0 1 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 14 2 0 0 0 0 0 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography abdomen Usually not appropriate Limited ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography skeletal survey Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 1 0 1 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Variant 2: Follow-up for clinically localized renal cell cancer; post ablation.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
CT abdomen without and with IV contrast Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 9 9 0 0 0 0 0 1 0 5 10
References Study Quality
6 (23665399) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
MRI abdomen without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 1 0 6 9
References Study Quality
20 (23764074) 4
53 (27401340) 4
54 (26797360) 2
55 (20173161) 2
CT abdomen with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 7 7 0 0 1 1 1 3 7 2 1
References Study Quality
20 (23764074) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
21 (9146581) 2
6 (23665399) 4
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
CT abdomen and pelvis without and with IV contrast May be appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 6 6 0 1 0 0 4 10 1 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 1 0 0 1 3 7 4 0 1
References Study Quality
6 (23665399) 4
7 (25616710) 4
18 (26880407) 2
25 (20846691) 3
MRI abdomen without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 1 3 3 5 3 1 0
References Study Quality
20 (23764074) 4
53 (27401340) 4
54 (26797360) 2
55 (20173161) 2
MRI abdomen and pelvis without and with IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 1 1 1 2 11 0 1 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
20 (23764074) 4
23 (9888732) 4
24 (12090319) 4
53 (27401340) 4
54 (26797360) 2
55 (20173161) 2
Radiography chest May be appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 6 6 0 0 1 1 2 5 6 2 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
8 (26617405) 4
18 (26880407) 2
19 (24096433) 2
US abdomen with IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 1 0 9 6 0 1
References Study Quality
33 (24665032) 2
32 (25404183) 3
31 (21107560) 2
30 (20204642) 2
29 (27569091) 2
28 (23092215) 2
CT abdomen and pelvis with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 1 0 1 9 5 0 1 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 1 0 2 6 5 2 0 0
References Study Quality
7 (25616710) 4
6 (23665399) 4
18 (26880407) 2
25 (20846691) 3
MRI abdomen and pelvis without IV contrast May be appropriate Moderate O 0 mSv O 0 mSv [ped] 5 5 0 1 1 1 13 1 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
20 (23764074) 4
23 (9888732) 4
24 (12090319) 4
53 (27401340) 4
54 (26797360) 2
55 (20173161) 2
CT abdomen without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 0 5 6 1 3 1 0 0
References Study Quality
6 (23665399) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 0 4 3 3 4 2 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
11 (15201737) 2
14 (10893575) 2
16 (9836544) 4
20 (23764074) 4
21 (9146581) 2
50 (20227295) 4
51 (26154677) 2
52 (24345460) 3
US kidney retroperitoneal May be appropriate Limited O 0 mSv O 0 mSv [ped] 4 4 0 2 6 3 2 2 1 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT chest without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 5 1 9 0 1 1 0 0 0
References Study Quality
6 (23665399) 4
7 (25616710) 4
18 (26880407) 2
25 (20846691) 3
Tc-99m bone scan whole body Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 6 2 1 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
34 (4060382) 3
35 (11696720) 3
FDG-PET/CT skull base to mid-thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 2 2 2 2 1 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 2 1 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 2 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography intravenous urography 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
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 3 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 4 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography abdomen Usually not appropriate Limited ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 15 1 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography skeletal survey Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 15 1 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Variant 3: Follow-up for clinically localized renal cell cancer; active surveillance.
Procedure Appropriateness Category SOE Adult RRL Peds RRL Rating Median Final Tabulations
1 2 3 4 5 6 7 8 9
MRI abdomen without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 1 0 2 1 3 9
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
66 (22826399) 3
CT abdomen with IV contrast Usually appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 8 8 0 0 0 1 1 2 1 4 7
References Study Quality
2 (28596261) 4
6 (23665399) 4
59 (25698065) 1
63 (27331922) Good
65 (25794069) 3
CT abdomen without and with IV contrast Usually appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 7 7 0 0 2 0 0 3 4 2 5
References Study Quality
2 (28596261) 4
6 (23665399) 4
59 (25698065) 1
63 (27331922) Good
65 (25794069) 3
US abdomen with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 1 0 4 3 4 1 3
References Study Quality
68 (24475802) 3
69 (28429490) 3
54 (26797360) 2
CT abdomen and pelvis with IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 6 6 1 0 0 0 6 8 2 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
5 (21766302) Good
23 (9888732) 4
24 (12090319) 4
59 (25698065) 1
58 (22564495) 3
57 (21353376) 2
56 (25781204) 4
62 (21167561) 3
63 (27331922) Good
65 (25794069) 3
CT abdomen and pelvis without and with IV contrast May be appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 6 6 1 0 0 1 2 10 2 1 0
References Study Quality
2 (28596261) 4
5 (21766302) Good
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
59 (25698065) 1
58 (22564495) 3
57 (21353376) 2
56 (25781204) 4
63 (27331922) Good
62 (21167561) 3
65 (25794069) 3
MRI abdomen without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 6 6 0 0 0 0 4 5 5 2 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
66 (22826399) 3
MRI abdomen and pelvis without and with IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 1 0 1 0 3 10 2 0 0
References Study Quality
2 (28596261) 4
5 (21766302) Good
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
63 (27331922) Good
62 (21167561) 3
59 (25698065) 1
58 (22564495) 3
57 (21353376) 2
56 (25781204) 4
66 (22826399) 3
US kidney retroperitoneal May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 3 4 8 2 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
59 (25698065) 1
63 (27331922) Good
67 (18806171) 2
CT abdomen without IV contrast May be appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 1 0 2 11 3 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
59 (25698065) 1
63 (27331922) Good
65 (25794069) 3
CT chest with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 1 0 0 1 9 4 2 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
18 (26880407) 2
CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 5 5 0 2 1 3 5 4 1 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
18 (26880407) 2
MRI abdomen and pelvis without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 1 0 0 1 13 2 0 0 0
References Study Quality
2 (28596261) 4
5 (21766302) Good
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
57 (21353376) 2
56 (25781204) 4
59 (25698065) 1
58 (22564495) 3
62 (21167561) 3
63 (27331922) Good
66 (22826399) 3
Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 0 0 1 2 9 2 2 1 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
8 (26617405) 4
57 (21353376) 2
58 (22564495) 3
62 (21167561) 3
CT abdomen and pelvis without IV contrast May be appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 4 4 1 0 0 11 4 1 0 0 0
References Study Quality
2 (28596261) 4
5 (21766302) Good
6 (23665399) 4
7 (25616710) 4
23 (9888732) 4
24 (12090319) 4
59 (25698065) 1
58 (22564495) 3
57 (21353376) 2
56 (25781204) 4
62 (21167561) 3
63 (27331922) Good
65 (25794069) 3
CT chest without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 3 3 4 4 5 0 1 1 1 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
18 (26880407) 2
FDG-PET/CT skull base to mid-thigh Usually not appropriate Moderate ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 3 3 6 2 5 1 2 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
36 (27824726) Good
Tc-99m bone scan whole body Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 2 2 7 6 3 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
34 (4060382) 3
35 (11696720) 3
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 13 2 1 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 2 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3-10 mSv [ped] 1 1 13 3 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography intravenous urography Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3-3 mSv [ped] 1 1 14 2 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 3 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 4 0 0 0 0 0 0 1
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography abdomen Usually not appropriate Limited ☢☢ 0.1-1mSv ☢☢ 0.03-0.3 mSv [ped] 1 1 15 1 0 0 0 0 0 0 0
References Study Quality
2 (28596261) 4
6 (23665399) 4
7 (25616710) 4
Radiography skeletal survey 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
2 (28596261) 4
6 (23665399) 4
7 (25616710) 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.