Reference	Study Type	Patients/Events	Study Objective(Purpose of Study)	Study Results	Study Quality

1. Friedman T, Quencer KB, Kishore SA, Winokur RS, Madoff DC. Malignant Venous Obstruction: Superior Vena Cava Syndrome and Beyond. Semin Intervent Radiol 2017;34:398-408.	Review/Other-Dx	N/A	Symptom severity, primary malignancy, functional status, and prognosis are all fundamental to the patient workup and dictate both the timing and extent of endovascular intervention.	No results stated in abstract.	4
2. Kalra M, Sen I, Gloviczki P. Endovenous and Operative Treatment of Superior Vena Cava Syndrome. Surg Clin North Am 2018;98:321-35.	Review/Other-Dx	N/A	Etiologic factors, clinical presentation, and diagnostic evaluation of SVC syndrome, and current techniques and results for the endovascular and open surgical treatment of SVC occlusion.	No results stated in abstract.	4
3. Yu JB, Wilson LD, Detterbeck FC. Superior vena cava syndrome--a proposed classification system and algorithm for management. J Thorac Oncol 2008;3:811-4.	Review/Other-Dx	N/A	To discuss Superior Vena Cava Syndrome: A proposed classification system and algorithm for management	No results stated in the abstract	4
4. Ierardi AM, Jannone ML, Petrillo M, et al. Treatment of venous stenosis in oncologic patients. Future Oncol 2018;14:2933-43.	Review/Other-Dx	N/A	Current state of endovascular treatment for both superior vena cava occlusion and iliac compression syndrome in cancer patients.	No results stated in abstract.	4
5. Zhao Y, Yang L, Wang Y, Zhang H, Cui T, Fu P. The diagnostic value of multi-detector CT angiography for catheter-related central venous stenosis in hemodialysis patients. Phlebology. 36(3):217-225, 2021 Apr.	Observational-Dx	219	To compare Multi-detector CT angiography (MDCTA) and digital subtraction angiography (DSA) in diagnosing hemodialysis catheter related-central venous stenosis (CVS)	We analyzed the sensitivity, specificity, accuracy, Cohen’s kappa coefficient (j) and other diagnostic parameters for MDCTA compared to DSA. A total of 1533 vascular segments in 219 patients were analyzed. Among the 280 lesions identified by DSA, 156 were correctly identified by MDCTA. There were 124 false negative and 41 false positive diagnoses. MDCTA had a high specificity (96.73%) but a low sensitivity (55.71%), with a moderate inter-test agreement (j ¼ 0.5930). In stratified analyses of vascular segments, the specificities of MDCTA were 89.93% (superior vena cava), 98.95% (left brachiocephalic vein), 95.33% (right brachiocephalic vein), 99.53% (left subclavian vein), 97.61% (right subclavian vein), 97.13% (left internal jugular vein), and 95.86% (right internal jugular vein), while the sensitivities were 90.00%, 65.52%, 66.67%, 87.50%, 40.00%, 20.00% and 8.11%, respectively. Good to excellent inter-test agreement was observed for the superior vena cava (j ¼ 0.7870), left brachiocephalic vein (j ¼ 0.7300), right brachiocephalic vein (j ¼ 0.6610), and left subclavian vein (j ¼ 0.8700) compared with poor to low agreement for the right subclavian vein (j ¼ 0.3950), left internal jugular vein (j ¼ 0.1890), and right internal jugular vein (j ¼ 0.0500). MDCTA had a high specificity in diagnosing hemodialysis catheter related-CVS. Its sensitivity varied by central venous segments, with better performance in superior vena cava and brachiocephalic veins.	3
6. Choong CK, Pasricha SS, Li X, et al. Dynamic four-dimensional computed tomography for preoperative assessment of lung cancer invasion into adjacent structures . European Journal of Cardio-Thoracic Surgery. 47(2):239-43; discussion 243, 2015 Feb.	Experimental-Dx	8	The 320-slice computed tomography (CT) provides three-dimensional and dynamic imaging resulting in the ability to assessmotion analysis between two adjacent structures (the fourth dimension). Differential movements between two adjacent structures wouldindicate that there is no fixation between the two structures	Dynamic 4D imaging revealed differential movements between the tumour and the adjacent structures in 7 cases, suggestingthe absence of overt malignant invasion. Intraoperative assessments confirmed the findings. In 1 case, a small area of fixation seen ondynamic CT corresponded intraoperatively to superficial invasion of the adventitia of the SVC.	4
7. Akin Y, Cagli K, Okten RS, Keles T, Golbasi Z. Pacemaker-associated superior vena cava syndrome: Role of contrast echocardiography. Echocardiography. 39(4):647-653, 2022 04.	Review/Other-Dx	NA	In this report we present the role of contrast study with transesophageal echocardiography in a patient with suspicion of SVC syndrome but inconclusive CT findings.	No results listed in abstract.	4
8. Sonavane SK, Milner DM, Singh SP, Abdel Aal AK, Shahir KS, Chaturvedi A. Comprehensive Imaging Review of the Superior Vena Cava. [Review]. Radiographics. 35(7):1873-92, 2015 Nov-Dec.	Review/Other-Dx	NA	No purpose listed in abstract.	No results listed in abstract.	4
9. Sundaram B, Kuriakose JW, Stojanovska J, Watcharotone K, Parker RA, Kazerooni EA. Thoracic central venous evaluation: comparison of first-pass direct versus delayed-phase indirect multidetector CT venography. Clinical Imaging. 39(3):412-6, 2015 May-Jun.	Review/Other-Dx	18	To compare first pass and delayed phase thoracic Computed Tomography (CT) venography for the evaluation of suspected central thoracic venous pathology.	18 patients formed the study group, mean age 49.5 years and 28% male. Dual arm injection was successful in 72% of exams. All readers reported more streak artifacts on first pass imaging than delayed imaging (72–94% vs. 27–44% respectively; p < 0.05). First pass imaging had significantly higher measured enhancement across all central venous segments than delayed imaging (mean HU range: 212–906 HU vs. 173–414 HU; p < 0.05), but also had significantly more heterogeneous enhancement (mean SD range 75–1058 HU vs. 67–378 HU; p <0.05). For overall diagnosis, reader agreement, accuracy and confidence levels were higher for delayed phase images (p < 0.05).	4
10. Azizi AH, Shafi I, Shah N, et al. Superior Vena Cava Syndrome. JACC Cardiovasc Interv 2020;13:2896-910.	Review/Other-Tx	N/A	This paper aims to update the practicing interventionalists with the contemporary and the evolving therapeutic approach to SVC syndrome. In addition, the review will focus on endovascular techniques, including catheter-directed thrombolysis (CDT), angioplasty, and stenting, and their associated complications.	Complications associated with SVC revascularization are acceptably low and are mitigated by operator experience and caution. Minor complications are very infrequent and include hematoma and local infection at the puncture site (3.2%). Major complications include pericardial tamponade, SVC rupture, stent migration, in-stent restenosis, pulmonary edema, major bleeding, pulmonary embolism, and cardiac injury; these can be catastrophic, even fatal. The cumulative incidence of these complications is <8% (44). In patients with malignant SVC syndrome, stent placement carries a procedural mortality rate of 2% (55). Pericardial tamponade is arare(0.1%to1.8%)but dreaded and potentially fatal complication, particularly when balloon sizes <16 mm are used (44). Patients who have undergone recent radiation may have an increased risk of SVC rupture and extra caution should be taken in these patients (1). Facilities offering this intervention should have availability of emergency pericardiocentesis equipment and personnel (23,61). SVC rupture or extravasation outside the pericardium can be equally catastrophic, resulting in blood loss into the chest cavity or chest wall with precipitous hypotension, pulmonary compromise, and death. Interventionalists and staff must be prepared to respond. Maintaining wire position across the interventional site is critical, in order to deliver balloons to immediately tamponade the site of disruption and curtail the blood loss. Emergency surgical backup should be summoned. Covered stents or stent-grafts can be used to “repair” or close the site of extravasation. Stent migration can occur as a result of stent shortening, or if the stent is undersized and can be managed with endovascular techniques such as directly snaring the stent or balloon-guide wire assisted snaring (44). SVC stent occlusion is a delayed complication and in patients with malignancy is due to inward growth of tumor or extrinsic compression from the mass. Alternatively, reocclusion can be caused by intimal hyperplasia or thrombus formation (23). Repeat stenting can often be effective in treating restenosis and even reocclusion (32). Pulmonary edema is rare and caused by a precipitous increase in venous return after a stenting. Patients with underlying poor cardiac DECEMBER 28, 2020:2896–910 reserve are more susceptible and should be treated with diuretic agents (44,62). The post-procedure surveillance includes a close clinical follow-up usually every 3 months and a repeat venography if symptoms recur. Patients are advised to call immediately if symptoms recur (23).	4
11. Lacout A, Marcy PY, Thariat J, Lacombe P, El Hajjam M. Radio-anatomy of the superior vena cava syndrome and therapeutic orientations. Diagn Interv Imaging 2012;93:569-77.	Review/Other-Dx	N/A	To specify the characteristics of the stenosis, its aetiology and detects collateral venous routes. Scannography reconstructions provide a true map of the obstacle, indispensable in planning the endovascular treatment.	No results stated in the abstract.	4
12. Measuring Sex, Gender Identity, and Sexual Orientation.	Review/Other-Dx	N/A	Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized.	No abstract available.	4
13. American College of Radiology. ACR Appropriateness Criteria® Radiation Dose Assessment Introduction. Available at: https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/Clinical/Appropriateness-Criteria/ACR-Appropriateness-Criteria-Radiation-Dose-Assessment-Introduction.pdf.	Review/Other-Dx	N/A	To provide evidence-based guidelines on exposure of patients to ionizing radiation.	No abstract available.	4
No of Rows: 13

Study Quality Category	Study Quality Definition	Criteria for Diagnostic Studies	Criteria for Therapeutic Studies
Category 1	The study is well-designed and accounts for common biases.	The source has all 8 diagnostic study quality elements present.	The source has 5 or 6 therapeutic study quality elements
Category 2	The study is moderately well-designed and accounts for most common biases.	The source has 6 or 7 diagnostic study quality elements	The source has 3 or 4 therapeutic study quality elements
Category 3	There are important study design limitations.	The source has 3, 4, or 5 diagnostic study quality elements	The source has 1 or 2 therapeutic study quality elements
Category 4	The study is not useful as primary evidence. The article may not be a clinical study or the study design is invalid, or conclusions are based on expert consensus. For example: The study does not meet the criteria for or is not a hypothesis-based clinical study (e.g., a book chapter or case report or case series description); The study may synthesize and draw conclusions about several studies such as a literature review article or book chapter but is not primary evidence; The study is an expert opinion or consensus document.	The source has 0, 1, or 2 diagnostic study quality elements present.	The source has zero (0) therapeutic study quality elements.
Meta-analysis	Good quality – the study design, methods, analysis, and results are valid and the conclusion is supported. Inadequate quality – the study design, analysis, and results lack the methodological rigor to be considered a good meta-analysis study.	n/a	n/a

Appropriateness Criteria

Definitions of Study Quality Categories