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Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0000_5e2f99d7
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
American College of Radiology ACR Appropriateness Criteria® Growth Disturbances–Risk of Fetal Growth Restriction Variant 1: Growth disturbance. Low risk for fetal growth restriction. Initial evaluation. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 US pregnant uterus transabdominal Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 1 0 0 0 0 2 9 References Study Quality 26 (26031399) 3 US pregnant uterus biophysical profile Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 0 4 4 2 3 0 0 0 0 References Study Quality 27 (2404302) 4 US duplex Doppler fetal umbilical artery Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 3 3 5 0 0 1 0 0 0 References Study Quality 31 (2178428) 3 US duplex Doppler maternal uterine artery Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 2 4 4 0 1 1 0 0 0 References Study Quality 28 (26112630) 3 30 (24277892) 3 29 (28712949) 3 US duplex Doppler ductus
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0001_652537e5
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
References Study Quality 28 (26112630) 3 30 (24277892) 3 29 (28712949) 3 US duplex Doppler ductus venosus Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 5 5 2 0 0 0 0 0 0
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0002_edc5c56d
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
US duplex Doppler fetal middle cerebral artery Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 4 6 2 0 0 0 0 0 0 Variant 2: Growth disturbance. High risk for fetal growth restriction. Initial evaluation. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 US pregnant uterus transabdominal Usually appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 0 2 10 US pregnant uterus biophysical profile Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 3 2 3 4 1 References Study Quality 27 (2404302) 4 18 (16319247) 3 32 (-3130664) 4 US duplex Doppler fetal umbilical artery Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 2 3 6 2 0 References Study Quality 35 (7755042) M US duplex Doppler ductus venosus May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 1 9 3 0 0 0 References Study Quality 19 (17267821) 3 US duplex Doppler maternal uterine artery May be
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0003_1bc0b416
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
References Study Quality 19 (17267821) 3 US duplex Doppler maternal uterine artery May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 1 1 0 5 4 0 1 0 References Study Quality 33 (25810352) 3 34 (25346413) 2 US duplex Doppler fetal middle cerebral artery Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 2 6 2 0 1 0 1 0 0
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0004_7b1c5a4a
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
Variant 3: Established fetal growth restriction. Follow-up evaluation. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 US pregnant uterus biophysical profile Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 1 0 2 9 References Study Quality 25 (24931475) 3 32 (-3130664) 4 US pregnant uterus transabdominal Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 0 1 11 References Study Quality 1 (24785859) 4 8 (24839087) 4 11 (23635765) 4 US duplex Doppler fetal umbilical artery Usually appropriate Strong O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 0 1 2 4 5 References Study Quality 44 (28032647) 2 37 (24635223) 3 38 (25603682) 3 39 (25068564) 3 41 (25754212) 4 42 (25545442) 3 43 (25751217) 4 45 (23585420) 2 9 (15302194) 1 18 (16319247) 3 40 (23999424) 3
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0005_b0fa2836
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
US duplex Doppler ductus venosus Usually appropriate Strong O 0 mSv O 0 mSv [ped] 7 7 0 0 0 0 1 3 4 3 2 References Study Quality 47 (25747582) 2 44 (28032647) 2 18 (16319247) 3 49 (27854382) 4 48 (28938063) 4 US duplex Doppler fetal middle cerebral artery Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 0 0 1 3 2 4 0 2 References Study Quality 25 (24931475) 3 40 (23999424) 3 US duplex Doppler maternal uterine artery May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 0 1 5 4 1 1 0 References Study Quality 23 (25098960) 4 36 (25358519) 2
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0006_e12a52c8
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
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.
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx_0007_2983ddb5
Growth_Disturbances–Risk_of_Fetal_Growth_Restriction_Apdx
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.
Sinonasal_Disease_Apdx_0000_d066302b
Sinonasal_Disease_Apdx
American College of Radiology ACR Appropriateness Criteria® Sinonasal Disease Variant 1: Acute (less than 4 weeks) uncomplicated rhinosinusitis. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT cone beam paranasal sinuses without IV contrast Usually not appropriate Limited ☢☢ 0.1-1mSv 3 3 5 3 3 4 1 0 1 0 0 References Study Quality 18 (8259141) 3 17 (26253983) 4 19 (26700263) 3 1 (25833927) 4 CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 4 1 1 1 2 0 0 0 References Study Quality 1 (25833927) 4 CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 3 2 2 0 1 1 0 0 References Study Quality 1 (25833927) 4 CT maxillofacial without IV contrast Usually not appropriate Limited ☢☢ 0.1-1mSv 2 2 7 5 1 2 2 0 0 0 0 References Study Quality 18 (8259141) 3 17 (26253983) 4
Sinonasal_Disease_Apdx_0001_afe4d012
Sinonasal_Disease_Apdx
1 (25833927) 4 Radiography paranasal sinuses Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 8 2 2 4 1 0 0 0 0 References Study Quality 21 (12820855) 2 20 (27481857) 4 1 (25833927) 4 22 (-3194068) 4 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 1 0 1 0 0 0 0 CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 9 3 1 3 0 1 0 0 0 References Study Quality 1 (25833927) 4 CT maxillofacial with IV contrast Usually not appropriate Limited ☢☢ 0.1-1mSv 1 1 11 5 1 0 0 0 0 0 0 References Study Quality 18 (8259141) 3 17 (26253983) 4 1 (25833927) 4 CT maxillofacial without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 15 2 0 0 0 0 0 0 0 References Study Quality 18 (8259141) 3 17 (26253983) 4 1 (25833927) 4 Arteriography craniofacial Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 16 0 1 0 0 0 0 0 0
Sinonasal_Disease_Apdx_0002_f4cf6e5b
Sinonasal_Disease_Apdx
MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 3 1 0 0 0 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 1 0 0 0 0 0 0 MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 9 1 4 2 0 1 0 0 0 References Study Quality 1 (25833927) 4 MRI head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 9 2 3 2 0 1 0 0 0 References Study Quality 1 (25833927) 4 SPECT or SPECT/CT paranasal sinuses Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 2 0 0 0 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 MRI orbits face neck without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 14 2 1 0 0 0 0 0 0 References Study Quality 1 (25833927) 4
Sinonasal_Disease_Apdx_0003_ded1a3d7
Sinonasal_Disease_Apdx
[ped] 1 1 14 2 1 0 0 0 0 0 0 References Study Quality 1 (25833927) 4 MRI orbits face neck without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 14 1 2 0 0 0 0 0 0 References Study Quality 1 (25833927) 4 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 MRI head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 9 2 3 1 0 1 0 1 0 References Study Quality
Sinonasal_Disease_Apdx_0004_461a1d10
Sinonasal_Disease_Apdx
1 (25833927) 4 MRI orbits face neck with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 9 1 2 3 0 1 1 0 0 References Study Quality 1 (25833927) 4 Variant 2: Acute rhinosinusitis with suspected orbital or intracranial complication. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT maxillofacial with IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 9 9 0 0 0 0 0 0 3 6 8 References Study Quality 23 (11889374) 3 17 (26253983) 4 MRI orbits face neck without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 2 2 13 References Study Quality 17 (26253983) 4 MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 8 8 0 0 0 0 1 3 3 3 7 References Study Quality 23 (11889374) 3 17 (26253983) 4 CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 6 6 0 0 0 4 3 5 5 0 0 References Study Quality
Sinonasal_Disease_Apdx_0005_e5cdb66e
Sinonasal_Disease_Apdx
mSv ☢☢☢ 0.3- 3 mSv [ped] 6 6 0 0 0 4 3 5 5 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 6 (28341385) 4
Sinonasal_Disease_Apdx_0006_4b5a84f8
Sinonasal_Disease_Apdx
CT maxillofacial without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢ 0.1-1mSv 5 5 0 3 1 2 8 3 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 0 5 6 5 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 MRI orbits face neck without IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 0 0 0 3 5 4 3 2 0 References Study Quality 17 (26253983) 4 CT cone beam paranasal sinuses without IV contrast Usually not appropriate Limited ☢☢ 0.1-1mSv 3 3 7 2 5 1 1 1 0 0 0 References Study Quality 25 (24449524) 3 19 (26700263) 3 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 8 1 2 4 0 2 0 0 0 CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 4 2 2 1 0 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 6 (28341385) 4
Sinonasal_Disease_Apdx_0007_58d0de5d
Sinonasal_Disease_Apdx
[ped] 2 2 8 4 2 2 1 0 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 6 (28341385) 4 CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 11 1 2 2 1 0 0 0 0
Sinonasal_Disease_Apdx_0008_d40e3bfa
Sinonasal_Disease_Apdx
References Study Quality 23 (11889374) 3 17 (26253983) 4 6 (28341385) 4 CT maxillofacial without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 12 1 1 2 1 0 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4 Arteriography craniofacial Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 0 0 2 0 1 0 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 9 1 3 2 1 1 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 9 2 4 1 0 1 0 0 0 SPECT or SPECT/CT paranasal sinuses Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 14 0 3 0 0 0 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 1 2 0 0 1 0 0 0 Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 12 1 2 0 1 1 0 0 0
Sinonasal_Disease_Apdx_0009_b5660076
Sinonasal_Disease_Apdx
appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 12 1 2 0 1 1 0 0 0 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 9 1 5 0 0 2 0 0 0 MRI head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 1 2 2 1 0 0 0 0 References Study Quality 23 (11889374) 3 17 (26253983) 4
Sinonasal_Disease_Apdx_0010_a1bd0b1d
Sinonasal_Disease_Apdx
MRI orbits face neck with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 0 2 2 0 1 0 0 0 References Study Quality 17 (26253983) 4 Variant 3: Acute recurrent sinusitis or chronic rhinosinusitis or noninvasive fungal sinusitis or sinonasal polyposis. Possible surgical candidate for these indications or other non-neoplastic indications, including suspected silent sinus syndrome or suspected mucocele, or deviated nasal septum. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT maxillofacial without IV contrast Usually appropriate Strong ☢☢ 0.1-1mSv 9 9 1 0 0 1 0 0 2 0 13 References Study Quality 26 (25832968) 4 31 (26001236) 4 35 (27554662) 1 36 (28072563) 4 32 (27643765) 4 37 (27193478) 2 2 (26476379) 4 38 (25412986) 2 CT maxillofacial with IV contrast May be appropriate Strong ☢☢ 0.1-1mSv 5 5 0 0 0 3 8 2 4 0 0 References Study Quality 26 (25832968) 4 31 (26001236) 4 35 (27554662) 1
Sinonasal_Disease_Apdx_0011_90f1d486
Sinonasal_Disease_Apdx
References Study Quality 26 (25832968) 4 31 (26001236) 4 35 (27554662) 1 36 (28072563) 4 32 (27643765) 4 37 (27193478) 2 2 (26476379) 4
Sinonasal_Disease_Apdx_0012_64b3ac06
Sinonasal_Disease_Apdx
38 (25412986) 2 CT cone beam paranasal sinuses without IV contrast May be appropriate Strong ☢☢ 0.1-1mSv 5 5 0 0 2 1 12 2 0 0 0 References Study Quality 25 (24449524) 3 19 (26700263) 3 34 (28747616) 2 33 (25765366) 2 MRI orbits face neck without and with IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 3 0 1 2 8 3 0 0 0 References Study Quality 40 (19379610) 2 39 (2294574) 4 24 (29685531) 4 MRI orbits face neck without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 4 4 3 0 0 6 8 0 0 0 0 References Study Quality 40 (19379610) 2 39 (2294574) 4 24 (29685531) 4 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 3 3 6 2 5 1 1 2 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 8 1 3 3 0 2 0 0 0 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped]
Sinonasal_Disease_Apdx_0013_036d81a8
Sinonasal_Disease_Apdx
appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 1 1 0 0 2 0 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 11 2 4 0 0 0 0 0 0
Sinonasal_Disease_Apdx_0014_db18deeb
Sinonasal_Disease_Apdx
CT maxillofacial without and with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv 1 1 12 2 2 0 1 0 0 0 0 References Study Quality 26 (25832968) 4 31 (26001236) 4 35 (27554662) 1 36 (28072563) 4 32 (27643765) 4 37 (27193478) 2 2 (26476379) 4 38 (25412986) 2 Arteriography craniofacial Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 16 0 1 0 0 0 0 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 1 0 0 0 0 0 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 0 0 0 0 0 0 MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 3 0 0 0 0 0 0 0 SPECT or SPECT/CT paranasal sinuses Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 14 1 0 0 1 1 0 0 0 References Study Quality
Sinonasal_Disease_Apdx_0015_11910055
Sinonasal_Disease_Apdx
mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 14 1 0 0 1 1 0 0 0 References Study Quality 42 (19401044) 3 FDG-PET/CT skull base to mid- thigh Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 14 2 1 0 0 0 0 0 0 Radiography paranasal sinuses Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 9 3 2 1 1 0 1 0 0
Sinonasal_Disease_Apdx_0016_84cce857
Sinonasal_Disease_Apdx
References Study Quality 41 (8327669) 4 2 (26476379) 4 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 MRI orbits face neck with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 0 1 3 0 0 0 0 0 References Study Quality 40 (19379610) 2 39 (2294574) 4 24 (29685531) 4 Variant 4: Acute sinusitis with rapid progression or suspected invasive fungal sinusitis. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 MRI orbits face neck without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 2 3 12 References Study Quality 45 (22006778) 2 46 (29774383) 4 5 (28438285) 4 4 (26476380) 4 CT maxillofacial with IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 8 8 0 0 0 0 2 0 6 3 6
Sinonasal_Disease_Apdx_0017_f1654ae7
Sinonasal_Disease_Apdx
CT maxillofacial with IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 8 8 0 0 0 0 2 0 6 3 6 References Study Quality 43 (18029900) 4 23 (11889374) 3
Sinonasal_Disease_Apdx_0018_2dac22fb
Sinonasal_Disease_Apdx
5 (28438285) 4 6 (28341385) 4 4 (26476380) 4 44 (25882281) 1 CT maxillofacial without IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 7 7 0 0 0 1 2 1 8 1 4 References Study Quality 43 (18029900) 4 23 (11889374) 3 5 (28438285) 4 6 (28341385) 4 4 (26476380) 4 44 (25882281) 1 MRI head without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 6 6 0 0 0 1 6 7 3 0 0 References Study Quality 43 (18029900) 4 5 (28438285) 4 6 (28341385) 4 CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 0 1 3 9 4 0 0 0 References Study Quality 43 (18029900) 4 23 (11889374) 3 6 (28341385) 4 MRI head without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 1 0 1 4 7 4 0 0 0 References Study Quality 43 (18029900) 4 5 (28438285) 4
Sinonasal_Disease_Apdx_0019_3710783e
Sinonasal_Disease_Apdx
6 (28341385) 4 MRI orbits face neck without IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 5 5 5 1 1 0 References Study Quality 45 (22006778) 2 46 (29774383) 4 5 (28438285) 4 4 (26476380) 4 CT cone beam paranasal sinuses without IV contrast Usually not appropriate Limited ☢☢ 0.1-1mSv 2 2 8 1 3 2 3 0 0 0 0 References Study Quality 25 (24449524) 3 19 (26700263) 3 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 3 1 0 1 0 0 0 0 CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 9 3 2 3 0 0 0 0 0 References Study Quality 43 (18029900) 4 23 (11889374) 3 6 (28341385) 4 CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 0 4 1 0 0 0 0 0 References Study Quality 43 (18029900) 4 23 (11889374) 3 6 (28341385) 4 CT maxillofacial without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10
Sinonasal_Disease_Apdx_0020_618a93f9
Sinonasal_Disease_Apdx
CT maxillofacial without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 10 2 2 1 2 0 0 0 0 References Study Quality
Sinonasal_Disease_Apdx_0021_82797a84
Sinonasal_Disease_Apdx
43 (18029900) 4 23 (11889374) 3 5 (28438285) 4 6 (28341385) 4 4 (26476380) 4 44 (25882281) 1 Arteriography craniofacial Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 12 1 1 1 0 0 2 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 0 2 2 1 0 1 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 2 2 1 0 0 1 0 0 SPECT or SPECT/CT paranasal sinuses Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 0 0 1 0 0 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 Radiography paranasal sinuses Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 11 3 1 1 0 1 0 0 0 References Study Quality 47 (28599686) 2 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 0 4 1 0 0 1 0 0
Sinonasal_Disease_Apdx_0022_40d3b692
Sinonasal_Disease_Apdx
appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 0 4 1 0 0 1 0 0 MRI head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 3 0 1 2 0 0 0 0 References Study Quality 43 (18029900) 4 5 (28438285) 4 6 (28341385) 4
Sinonasal_Disease_Apdx_0023_cf83ea6a
Sinonasal_Disease_Apdx
MRI orbits face neck with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 3 0 1 2 0 0 0 0 References Study Quality 45 (22006778) 2 46 (29774383) 4 5 (28438285) 4 4 (26476380) 4 Variant 5: Suspected sinonasal mass. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 MRI orbits face neck without and with IV contrast Usually appropriate Strong O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 1 0 16 References Study Quality 24 (29685531) 4 52 (31939885) 1 8 (29696477) 4 9 (29217745) 1 7 (26830408) 4 53 (26359585) 2 CT maxillofacial with IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 7 7 0 0 0 1 1 0 8 1 6 References Study Quality 51 (28391267) 2 7 (26830408) 4 CT maxillofacial without IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 7 7 1 0 1 0 1 4 3 3 4 References Study Quality 51 (28391267) 2
Sinonasal_Disease_Apdx_0024_1d648312
Sinonasal_Disease_Apdx
7 (26830408) 4 MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 6 6 1 0 0 1 1 8 4 2 0 CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 1 0 0 4 10 2 0 0 0 References Study Quality 51 (28391267) 2 MRI head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 2 0 0 5 9 1 0 0 0 MRI orbits face neck without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 0 3 7 6 0 1 0 References Study Quality 24 (29685531) 4 52 (31939885) 1 8 (29696477) 4 9 (29217745) 1 7 (26830408) 4 53 (26359585) 2 CT head without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 8 2 1 4 0 1 1 0 0 References Study Quality 51 (28391267) 2 CTA head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 10 0 1 3 1 2 0 0 0 References Study Quality 43 (18029900) 4 48 (17213441) 4 49 (15794546) 4 50 (12487677) 4
Sinonasal_Disease_Apdx_0025_c2d5bef9
Sinonasal_Disease_Apdx
CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 11 1 5 0 0 0 0 0 0 References Study Quality 51 (28391267) 2 CT maxillofacial without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 11 3 0 1 1 1 0 0 0 References Study Quality 51 (28391267) 2 7 (26830408) 4 Arteriography craniofacial Usually not appropriate Limited ☢☢☢ 1-10 mSv 1 1 12 1 1 1 0 2 0 0 0 References Study Quality 43 (18029900) 4 48 (17213441) 4 49 (15794546) 4 50 (12487677) 4 MRA head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 1 3 1 1 1 0 0 0 References Study Quality 43 (18029900) 4 48 (17213441) 4 49 (15794546) 4 50 (12487677) 4 MRA head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 0 2 2 1 2 0 0 0 References Study Quality 43 (18029900) 4 48 (17213441) 4 49 (15794546) 4 50 (12487677) 4
Sinonasal_Disease_Apdx_0026_4c61af1c
Sinonasal_Disease_Apdx
SPECT or SPECT/CT paranasal sinuses Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 1 3 1 0 0 0 0 0 References Study Quality 7 (26830408) 4 Radiography paranasal sinuses Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 14 2 0 0 1 0 0 0 0 References Study Quality 51 (28391267) 2 CT cone beam paranasal sinuses without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 9 1 2 2 2 0 1 0 0 MRA head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 0 2 2 1 1 0 0 0 References Study Quality 43 (18029900) 4 48 (17213441) 4 49 (15794546) 4 50 (12487677) 4 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 2 0 2 0 0 0 1 0 MRI orbits face neck with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv
Sinonasal_Disease_Apdx_0027_e5d7b84c
Sinonasal_Disease_Apdx
MRI orbits face neck with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 1 1 13 0 1 0 1 1 0 1 0 References Study Quality 24 (29685531) 4 52 (31939885) 1 8 (29696477) 4 9 (29217745) 1 7 (26830408) 4
Sinonasal_Disease_Apdx_0028_9c51e1ea
Sinonasal_Disease_Apdx
53 (26359585) 2 Variant 6: Suspected CSF leak. Initial Imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT maxillofacial without IV contrast Usually appropriate Strong ☢☢ 0.1-1mSv 9 9 1 0 1 0 0 0 4 0 11 References Study Quality 57 (10319986) 3 58 (12087336) 3 12 (27890184) 4 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 62 (18079188) 4 MRI orbits face neck without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 6 6 0 0 0 0 6 7 3 1 0 References Study Quality 11 (18710972) 4 58 (12087336) 3 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 60 (17970620) 2 63 (19723768) 3 65 (19762462) 4
Sinonasal_Disease_Apdx_0029_b69f95ed
Sinonasal_Disease_Apdx
MRI head without IV contrast May be appropriate Strong O 0 mSv O 0 mSv [ped] 5 5 0 0 1 4 5 6 0 1 0 References Study Quality 11 (18710972) 4 58 (12087336) 3 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 63 (19723768) 3 MRI head without and with IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 4 0 1 4 5 3 0 0 0 References Study Quality 11 (18710972) 4 58 (12087336) 3 64 (31685104) 4 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 63 (19723768) 3 CT head cisternography May be appropriate Strong ☢☢☢ 1-10 mSv 5 5 0 0 1 1 9 3 2 0 1 References Study Quality 57 (10319986) 3 58 (12087336) 3 12 (27890184) 4 13 (26370330) 4 55 (16145599) 2
Sinonasal_Disease_Apdx_0030_cb491a96
Sinonasal_Disease_Apdx
56 (2287375) 4 59 (9369519) 2 60 (17970620) 2 DTPA cisternography May be appropriate Limited ☢☢☢ 1-10 mSv 5 5 1 0 1 3 8 4 0 0 0 References Study Quality 58 (12087336) 3 12 (27890184) 4 13 (26370330) 4 MRI orbits face neck without and with IV contrast May be appropriate (Disagreement) Expert Opinion O 0 mSv O 0 mSv [ped] 5 5 2 0 1 2 5 3 2 2 0 References Study Quality 11 (18710972) 4 58 (12087336) 3 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 60 (17970620) 2 63 (19723768) 3 65 (19762462) 4 SPECT or SPECT/CT paranasal sinuses May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 4 4 5 1 0 4 6 1 0 0 0 References Study Quality 13 (26370330) 4 66 (23871275) 4 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 3 0 0 2 0 0 0 0
Sinonasal_Disease_Apdx_0031_d5fcd9b6
Sinonasal_Disease_Apdx
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 1 1 1 0 0 0 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 12 3 2 0 0 0 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 2 0 0 0 0 0 0 CT maxillofacial with IV contrast Usually not appropriate Strong ☢☢ 0.1-1mSv 1 1 11 2 4 0 0 0 0 0 0 References Study Quality 57 (10319986) 3 58 (12087336) 3 12 (27890184) 4 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 62 (18079188) 4 CT maxillofacial without and with IV contrast Usually not appropriate Strong ☢☢☢ 1-10 mSv 1 1 12 1 4 0 0 0 0 0 0 References Study Quality 57 (10319986) 3 58 (12087336) 3 12 (27890184) 4 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 62 (18079188) 4 Arteriography craniofacial Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 1 0 1 0 0 0 0 0
Sinonasal_Disease_Apdx_0032_3fd149fd
Sinonasal_Disease_Apdx
MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 1 1 0 0 0 0 0 0 Radiography paranasal sinuses Usually not appropriate Expert Consensus ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 15 1 0 0 0 1 0 0 0 CT cone beam paranasal sinuses without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 11 1 0 1 2 1 1 0 0 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 2 0 1 0 0 0 0 0 MRI head with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 1 1 13 1 0 1 2 0 0 0 0 References Study Quality 58 (12087336) 3 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 63 (19723768) 3
Sinonasal_Disease_Apdx_0033_fc902933
Sinonasal_Disease_Apdx
12 (27890184) 4 14 (27738899) 2 13 (26370330) 4 55 (16145599) 2 61 (9576647) 2 63 (19723768) 3 MRI orbits face neck with IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 1 1 12 1 2 1 1 0 0 0 0 References Study Quality 11 (18710972) 4 58 (12087336) 3 12 (27890184) 4 14 (27738899) 2 13 (26370330) 4
Sinonasal_Disease_Apdx_0035_e12a52c8
Sinonasal_Disease_Apdx
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.
Sinonasal_Disease_Apdx_0036_2983ddb5
Sinonasal_Disease_Apdx
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.
Vision_Loss_Apdx_0000_34a15bdc
Vision_Loss_Apdx
American College of Radiology ACR Appropriateness Criteria® Vision Loss Variant 1: Adult. Acute posttraumatic visual defect. Suspect orbital injury. Initial imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT orbits without IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 9 9 0 0 1 0 1 1 2 3 10 References Study Quality 30 (26208419) 4 29 (25397707) 4 24 (22964404) 4 20 (25086804) 4 CT maxillofacial without IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 9 9 1 0 0 1 0 2 2 3 9 References Study Quality 30 (26208419) 4 29 (25397707) 4 24 (22964404) 4 20 (25086804) 4 CT head without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 1 0 1 2 10 3 1 0 0 References Study Quality 34 (28455003) 4 35 (29503015) 2
Vision_Loss_Apdx_0001_a9d2b3f0
Vision_Loss_Apdx
MRI orbits without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 6 2 7 3 0 0 0 0 0 References Study Quality 13 (25086805) 4 27 (25882280) 2 29 (25397707) 4 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 4 0 0 1 1 0 0 0 CT orbits with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 10 1 3 2 0 1 0 1 0 CT orbits without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 16 1 1 0 0 0 0 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 13 0 3 0 1 1 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 0 2 1 1 1 0 0 0 CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 2 1 0 1 1 1 0 0
Vision_Loss_Apdx_0002_b5477d8c
Vision_Loss_Apdx
appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 2 1 0 1 1 1 0 0 CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 11 0 4 1 1 1 0 0 0 CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 12 0 4 0 1 1 0 0 0 Arteriography cerebral Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 1 0 0 1 0 0 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 1 0 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 0 2 0 0 0 0
Vision_Loss_Apdx_0003_5bfffed5
Vision_Loss_Apdx
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 1 0 0 0 0 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 0 0 2 0 0 0 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 11 2 2 1 1 1 0 0 0 MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 1 1 0 0 Radiography orbit Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 1 1 14 0 2 0 1 1 0 0 0 References Study Quality 24 (22964404) 4 30 (26208419) 4 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 1 0 0 0 0 MRI orbits without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 0 1 1 1 1 0 0 1 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv
Vision_Loss_Apdx_0004_3366af9a
Vision_Loss_Apdx
MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 2 1 0 1 1 0 0 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 1 0 1 0 0 0 Radiography face Usually not appropriate Limited ☢ <0.1 mSv 1 1 13 1 2 0 1 1 0 0 0 References Study Quality 24 (22964404) 4 30 (26208419) 4 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 0 4 0 0 1 1 0 0
Vision_Loss_Apdx_0005_0d167e76
Vision_Loss_Apdx
Variant 2: Adult. Acute vision loss. Infection or inflammatory disorder suspected. Initial imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT orbits with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 9 9 1 0 0 1 0 2 3 2 9 References Study Quality 12 (30310941) 4 37 (18936033) 4 39 (23053380) 4 CT maxillofacial with IV contrast Usually appropriate Limited ☢☢ 0.1-1mSv 9 9 0 0 1 0 0 0 1 1 15 References Study Quality 12 (30310941) 4 37 (18936033) 4 39 (23053380) 4 MRI orbits without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 1 2 3 12 References Study Quality 12 (30310941) 4 35 (29503015) 2 38 (18842758) 4 MRI head without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 6 6 0 0 0 1 8 7 2 0 0 References Study Quality 44 (27010526) 2 41 (30978149) 4
Vision_Loss_Apdx_0006_d6011061
Vision_Loss_Apdx
CT orbits without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 4 4 3 2 3 4 4 1 1 0 0 References Study Quality 40 (36830848) 4 MRI orbits without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 8 0 6 2 1 1 0 0 0 References Study Quality 12 (30310941) 4 CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 2 2 9 3 6 0 0 0 0 0 0 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 2 1 1 1 1 0 0 0 CT orbits without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 2 2 0 0 0 0 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 12 1 1 1 2 1 0 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 13 0 1 2 1 0 1 0 0 CT head without and with IV contrast Usually not appropriate Expert
Vision_Loss_Apdx_0007_f409e730
Vision_Loss_Apdx
[ped] 1 1 13 0 1 2 1 0 1 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 0 2 0 1 1 0 1 0 CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 1 0 1 1 0 0 0 CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 13 1 1 1 1 0 0 1 0 Arteriography cerebral Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 17 0 0 0 1 0 0 0 0
Vision_Loss_Apdx_0008_13233f4c
Vision_Loss_Apdx
MRA head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 3 1 2 0 1 0 0 0 References Study Quality 41 (30978149) 4 42 (30115678) 2 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 0 0 2 0 0 0 MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 2 0 0 1 0 0 0 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 1 0 0 1 1 0 0 MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 1 3 1 0 2 0 0 0 MRV head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 3 1 0 0 0 1 0 0 References Study Quality 45 (32154332) 4 CTV head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 2 1 0 0 2 0 0 0 MRV head without and with IV contrast Usually not
Vision_Loss_Apdx_0009_899971bf
Vision_Loss_Apdx
mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 2 1 0 0 2 0 0 0 MRV head without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 13 2 1 0 1 1 0 0 0 References Study Quality 45 (32154332) 4 MRA head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 3 2 2 0 1 0 0 0 References Study Quality 42 (30115678) 2 41 (30978149) 4 MRV head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 2 4 0 0 0 0 0 0
Vision_Loss_Apdx_0010_cd5a04f0
Vision_Loss_Apdx
References Study Quality 44 (27010526) 2 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 0 2 0 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 1 0 1 1 0 0 0 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 10 3 1 2 0 0 1 1 0 Variant 3: Adult. Chronic or progressive unilateral vision loss. Intraorbital mass-like lesion suspected or vascular lesion suspected. Initial imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 MRI orbits without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 1 2 15 References Study Quality 46 (25195185) 4 50 (26518678) 4 CT orbits with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 1 1 1 13 2 0 0 0 References Study Quality 48 (24614543) 4 50 (26518678) 4
Vision_Loss_Apdx_0011_6c28e039
Vision_Loss_Apdx
3 mSv [ped] 5 5 0 1 1 1 13 2 0 0 0 References Study Quality 48 (24614543) 4 50 (26518678) 4 52 (24108560) 4 MRI head without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 1 0 1 5 10 1 0 0 0 CTA head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 12 0 1 1 2 1 0 1 0 References Study Quality
Vision_Loss_Apdx_0012_12cbdbf1
Vision_Loss_Apdx
48 (24614543) 4 CT orbits without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 16 1 1 0 0 0 0 0 0 References Study Quality 46 (25195185) 4 50 (26518678) 4 52 (24108560) 4 CT orbits without and with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 13 1 3 0 1 0 0 0 0 References Study Quality 50 (26518678) 4 52 (24108560) 4 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 0 0 2 0 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 0 1 1 1 1 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 13 0 3 0 0 0 2 0 0 CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 11 4 1 1 0 1 0 0 0 CT maxillofacial without IV contrast Usually not appropriate Expert
Vision_Loss_Apdx_0013_fd6206d5
Vision_Loss_Apdx
CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 13 1 2 0 0 2 0 0 0 CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 13 1 1 0 1 1 0 0 1 Arteriography cerebral Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 0 1 0 0 1 0 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 0 0 1 0 0
Vision_Loss_Apdx_0014_d02d068b
Vision_Loss_Apdx
MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 0 0 1 0 1 0 MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 0 1 0 1 0 0 0 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 0 0 1 0 0 1 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 2 0 1 0 0 0 FDG-PET/CT skull base to mid- thigh Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 17 0 0 0 0 1 0 0 0 References Study Quality 50 (26518678) 4 53 (31939615) 4 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 0 0 1 1 1 0 0 MRI orbits without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 2 4 0 0 0 0 0 0 References Study Quality 46 (25195185) 4 50 (26518678) 4 MRI head with IV contrast Usually not
Vision_Loss_Apdx_0015_d31dfaba
Vision_Loss_Apdx
References Study Quality 46 (25195185) 4 50 (26518678) 4 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 1 0 0 0 2 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 0 0 1 1 0 1 0 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 0 3 1 0 0 1 1 0 Variant 4: Adult. Acute vision loss, retinal structural abnormality suspected. Initial imaging.
Vision_Loss_Apdx_0016_8960cd35
Vision_Loss_Apdx
Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 0 0 1 0 0 0 1 0 CT orbits with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 1 0 0 1 2 0 0 0 CT orbits without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 0 1 1 1 1 0 0 0 CT orbits without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 1 0 0 1 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 16 1 0 0 1 0 0 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 1 0 1 0 1 1 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped]
Vision_Loss_Apdx_0017_fc8f36a2
Vision_Loss_Apdx
contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 1 0 0 0 0 0 1 0 CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 15 1 0 0 2 0 0 0 0 CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 15 1 0 1 1 0 0 0 0 CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 15 1 0 1 0 0 1 0 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 1 0 0 0 0 0 1 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 1 0 0 0 0 0 1
Vision_Loss_Apdx_0018_2810e5ba
Vision_Loss_Apdx
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 1 0 0 0 0 0 1 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 0 1 0 0 0 0 1 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 0 1 1 0 0 1 0 MRI head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 0 0 1 2 0 0 1 0 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 1 0 0 0 1 0 0 MRI orbits without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 12 2 1 2 1 0 0 0 0 References Study Quality 56 (28506603) 4 MRI orbits without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 0 1 1 1 2 0 0 0 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 0 1 1 0 0 1 0
Vision_Loss_Apdx_0019_2397a846
Vision_Loss_Apdx
appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 0 1 1 0 0 1 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 0 0 1 0 0 0 0 1 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 1 0 0 0 0 0 0 Variant 5: Adult. Acute or chronic vision loss, optic nerve abnormality suspected. Initial imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 MRI orbits without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 1 2 15
Vision_Loss_Apdx_0020_6e6adfa9
Vision_Loss_Apdx
References Study Quality 72 (11545635) 4 71 (35439224) 4 70 (29683029) 4 69 (31756609) 2 64 (33584521) 4 63 (33766824) 4 62 (35091465) 4 60 (36062458) 4 52 (24108560) 4 75 (34851430) 4 74 (28495949) 3 73 (29563953) 4 68 (34281903) 4 MRI head without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 1 14 3 0 0 0 References Study Quality 68 (34281903) 4 67 (33737263) 3 66 (36017841) 2 65 (31435862) 4 CT orbits without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 2 3 3 1 1 0 0 0 References Study Quality 52 (24108560) 4 MRI head without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 9 0 3 2 3 1 0 0 0 References Study Quality 69 (31756609) 2
Vision_Loss_Apdx_0021_b64cc91e
Vision_Loss_Apdx
CTA head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 1 0 0 0 1 0 0 0 CT orbits with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 2 1 0 0 0 0 0 0 References Study Quality 52 (24108560) 4 CT orbits without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 16 1 1 0 0 0 0 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 1 1 0 1 0 1 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 1 0 0 1 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 14 1 1 0 0 1 1 0 0 CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 16 0 1 0 0 1 0 0 0 CT maxillofacial with IV contrast Usually not appropriate
Vision_Loss_Apdx_0022_b1b1f106
Vision_Loss_Apdx
10 mSv [ped] 1 1 16 0 1 0 0 1 0 0 0 CT maxillofacial with IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 15 0 1 0 0 1 1 0 0 CT maxillofacial without IV contrast Usually not appropriate Expert Consensus ☢☢ 0.1-1mSv 1 1 15 1 1 0 0 1 0 0 0 CT maxillofacial without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 1 1 14 1 1 0 0 1 0 1 0 MRA head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 0 1 0 1 1 0 0 0 MRA head without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 0 0 1 1 0 0 0
Vision_Loss_Apdx_0023_479f7281
Vision_Loss_Apdx
MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 1 0 0 0 0 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 2 0 0 0 1 0 0 0 MRA head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 1 0 0 0 0 MRI orbits without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 11 1 2 1 2 1 0 0 0 References Study Quality 74 (28495949) 3 73 (29563953) 4 72 (11545635) 4 64 (33584521) 4 62 (35091465) 4 60 (36062458) 4 52 (24108560) 4 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 2 0 0 0 2 0 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 1 0 0 0 1 0 0 0 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 1 0 0 0 0
Vision_Loss_Apdx_0024_45529ac5
Vision_Loss_Apdx
appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 1 0 0 0 0 Variant 6: Adult. Bitemporal hemianopia or junctional scotoma. Sellar or parasellar mass suspected. Initial imaging. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 MRI sella without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 9 9 0 0 0 0 0 0 0 1 17 References Study Quality
Vision_Loss_Apdx_0025_cc4b7719
Vision_Loss_Apdx
78 (25248586) 4 79 (36799985) 4 MRI head without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 0 0 1 9 6 0 1 1 References Study Quality 79 (36799985) 4 CTA head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 9 1 3 1 3 1 0 0 0 References Study Quality 76 (23891029) 4 CT sella without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 9 2 2 2 1 1 1 0 0 References Study Quality 2 (22284056) 4 79 (36799985) 4 CT orbits with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 0 1 1 0 0 0 CT orbits without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 1 1 0 0 0 0 CT orbits without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 0 1 1 0 1 1 0 0 CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv
Vision_Loss_Apdx_0026_7441d589
Vision_Loss_Apdx
CT head with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 16 0 0 2 0 0 0 0 0 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 15 0 1 0 0 0 1 1 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 1 0 1 1 0 0 0
Vision_Loss_Apdx_0027_a4af69f0
Vision_Loss_Apdx
CTA head and neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 1 1 0 0 1 0 0 0 Arteriography cerebral Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 15 0 2 0 1 0 0 0 0 MRA head without IV contrast Usually not appropriate Moderate O 0 mSv O 0 mSv [ped] 1 1 10 0 4 1 3 0 0 0 0 References Study Quality 76 (23891029) 4 80 (24103356) 4 81 (28887618) Good MRA head without and with IV contrast Usually not appropriate Moderate O 0 mSv O 0 mSv [ped] 1 1 12 0 4 1 1 0 0 0 0 References Study Quality 76 (23891029) 4 80 (24103356) 4 81 (28887618) Good MRA head and neck without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 3 0 0 0 0 0 0 MRA head and neck without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 3 0 0 0 0 0 0 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv
Vision_Loss_Apdx_0028_2ece8450
Vision_Loss_Apdx
MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 15 1 1 0 1 0 0 0 0 MRA head with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 0 4 1 3 0 0 0 0 References Study Quality 76 (23891029) 4 80 (24103356) 4 MRI orbits without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 12 2 1 1 0 1 0 1 0
Vision_Loss_Apdx_0029_6259bfc9
Vision_Loss_Apdx
MRI orbits without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 0 2 0 0 1 1 0 0 CT sella without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 14 2 2 0 0 0 0 0 0 CT sella with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 12 2 4 0 0 0 0 0 0 MRI sella with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 2 0 1 0 0 0 0 MRI sella without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 1 1 10 2 4 0 1 0 1 0 0 References Study Quality 62 (35091465) 4 79 (36799985) 4 MRI head with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 16 2 0 0 0 0 0 0 0 MRA head and neck with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 14 1 3 0 0 0 0 0 0 MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv
Vision_Loss_Apdx_0030_22d228e8
Vision_Loss_Apdx
MRI orbits with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 13 1 1 1 0 1 0 1 0
Vision_Loss_Apdx_0031_e12a52c8
Vision_Loss_Apdx
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.
Vision_Loss_Apdx_0032_2983ddb5
Vision_Loss_Apdx
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.
Lung_Cancer_Surveillance_After_Therapy_Apdx_0000_f93b5b9f
Lung_Cancer_Surveillance_After_Therapy_Apdx
American College of Radiology ACR Appropriateness Criteria® Lung Cancer: Surveillance After Therapy Variant 1: Adult. Noninvasive imaging surveillance following treatment of stage I-III non–small-cell lung cancer. Routine surveillance. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT chest with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 9 9 1 0 0 0 0 1 3 2 11 References Study Quality 15 (23127371) 4 16 (22859511) 2 19 (28225653) 4 14 (28881918) 4 13 (23649451) 4 11 (-3196828) 4 12 (34481037) 4 17 (21892108) Good 18 (34051381) 2 CT chest without IV contrast May be appropriate (Disagreement) Expert Opinion ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 3 0 1 4 4 4 References Study Quality 5 (31829901) 4 20 (23996838) 4 CT abdomen and pelvis with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 5 3 5 1 2 1 1 0 0
Lung_Cancer_Surveillance_After_Therapy_Apdx_0001_53b74534
Lung_Cancer_Surveillance_After_Therapy_Apdx
References Study Quality 5 (31829901) 4 3 (35545176) 4 CT chest abdomen pelvis with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 4 4 6 2 0 0 0 0 0 References Study Quality 5 (31829901) 4 11 (-3196828) 4 CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 6 2 4 2 2 1 1 0 0 References Study Quality 5 (31829901) 4 3 (35545176) 4 CT neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 3 3 8 1 5 2 0 2 0 0 0 MRI chest without and with IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 3 3 8 1 4 2 2 0 1 0 0 References Study Quality 33 (22434450) 4 32 (18374761) 2 34 (21928189) 4 FDG-PET/CT skull base to mid- thigh Usually not appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 3 3 7 0 3 0 0 0 0 References Study Quality 29 (32909168) 2 5 (31829901) 4 8 (30292847) 1 3 (35545176) 4 26 (23317944) 2
Lung_Cancer_Surveillance_After_Therapy_Apdx_0002_29f3979f
Lung_Cancer_Surveillance_After_Therapy_Apdx
21 (22051278) 2 27 (19398291) 2 4 (22305958) 4 23 (22914804) 2 22 (17257962) 2 24 (19046631) 2 25 (25012832) 2 28 (20005529) 2 CT abdomen and pelvis without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 9 3 2 1 2 1 0 0 0 References Study Quality 5 (31829901) 4 3 (35545176) 4 CTA chest with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 5 4 7 0 0 0 0 0 0 CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 6 5 4 1 0 0 0 0 0 CT chest abdomen pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 7 5 2 1 1 1 1 0 0 References Study Quality 5 (31829901) 4 3 (35545176) 4 CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 5 1 1 2 1 0 0 0 References Study Quality 5 (31829901) 4 3 (35545176) 4
Lung_Cancer_Surveillance_After_Therapy_Apdx_0003_7398a7a8
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 9 2 4 1 0 1 1 0 0 MRI chest without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 9 4 2 0 2 0 1 0 0 References Study Quality 33 (22434450) 4 32 (18374761) 2 34 (21928189) 4 MRI head without IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 2 2 4 8 4 0 0 0 0 0 0 MRI head without and with IV contrast Usually not appropriate Moderate O 0 mSv O 0 mSv [ped] 2 2 6 5 4 0 1 0 0 0 0 References Study Quality 5 (31829901) 4 35 (24606446) Good 36 (23860613) 4 Radiography chest Usually not appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 5 6 5 0 0 0 0 0 0 References Study Quality 37 (24139896) 2 8 (30292847) 1 CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 9 1 4 0 2 1 0 1 0 CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped]
Lung_Cancer_Surveillance_After_Therapy_Apdx_0004_1ef73e86
Lung_Cancer_Surveillance_After_Therapy_Apdx
and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 1 1 11 1 2 1 2 1 0 0 0 References Study Quality 5 (31829901) 4 3 (35545176) 4
Lung_Cancer_Surveillance_After_Therapy_Apdx_0005_f7348dd4
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 1 1 10 1 3 3 0 1 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 9 3 2 0 0 2 0 0 0 CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 10 3 2 1 0 1 1 0 0 Bone scan whole body Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 1 1 10 3 2 1 1 0 1 0 0 Variant 2: Adult. Noninvasive imaging surveillance following treatment of stage I-III small-cell lung cancer. Routine surveillance. Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT chest with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 8 8 1 0 1 0 2 0 2 4 8 References Study Quality 46 (25310425) 4 44 (23649448) 4 45 (30323087) 4 42 (34902832) 4 MRI head without IV contrast Usually
Lung_Cancer_Surveillance_After_Therapy_Apdx_0006_eac4319a
Lung_Cancer_Surveillance_After_Therapy_Apdx
44 (23649448) 4 45 (30323087) 4 42 (34902832) 4 MRI head without IV contrast Usually appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 7 7 0 1 0 1 3 2 6 3 0 MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 0 1 0 0 0 0 8 4 3 References Study Quality 5 (31829901) 4 50 (23307984) 4
Lung_Cancer_Surveillance_After_Therapy_Apdx_0007_7ba615ce
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT chest abdomen pelvis with IV contrast May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 2 10 2 1 1 0 References Study Quality 44 (23649448) 4 45 (30323087) 4 43 (32723523) 4 FDG-PET/CT skull base to mid- thigh May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 5 3 7 0 1 0 0 References Study Quality 49 (23307985) 4 47 (21409347) 3 48 (19921339) 3 39 (27726427) 4 50 (23307984) 4 51 (25613535) 2 CTA chest with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 6 2 8 0 0 0 0 0 0 CT chest without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 2 3 6 0 3 2 0 0 0 References Study Quality 39 (27726427) 4 5 (31829901) 4 CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 2 5 3 3 3 1 0 1 0 References Study Quality 42 (34902832) 4 Bone scan whole body Usually not appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv
Lung_Cancer_Surveillance_After_Therapy_Apdx_0008_da75934b
Lung_Cancer_Surveillance_After_Therapy_Apdx
42 (34902832) 4 Bone scan whole body Usually not appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 6 1 3 4 4 0 0 0 0 References Study Quality
Lung_Cancer_Surveillance_After_Therapy_Apdx_0009_2a622fe8
Lung_Cancer_Surveillance_After_Therapy_Apdx
41 (21354739) Good 40 (-3196830) 4 CT abdomen and pelvis with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 5 5 5 1 0 0 0 0 0 References Study Quality 5 (31829901) 4 42 (34902832) 4 CT abdomen and pelvis without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 7 5 2 1 1 1 1 0 0 References Study Quality 5 (31829901) 4 CT abdomen and pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 8 2 3 1 2 2 0 0 0 References Study Quality 5 (31829901) 4 CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 7 5 3 1 0 0 0 0 0 CT chest abdomen pelvis without and with IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 5 7 3 1 0 0 0 0 0 References Study Quality 5 (31829901) 4 CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped]
Lung_Cancer_Surveillance_After_Therapy_Apdx_0010_7eb96856
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT head with IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 6 3 2 1 4 0 0 0 0 References Study Quality 42 (34902832) 4 CT head without IV contrast Usually not appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 6 4 3 1 4 0 0 0 0
Lung_Cancer_Surveillance_After_Therapy_Apdx_0011_d24f0cfd
Lung_Cancer_Surveillance_After_Therapy_Apdx
References Study Quality 42 (34902832) 4 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 8 4 2 0 1 1 0 0 0 CT neck with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 9 2 3 1 2 0 1 0 0 CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 2 2 8 3 3 0 2 0 2 0 0 CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 9 2 3 1 2 0 1 0 0 MRI chest without IV contrast Usually not appropriate Limited O 0 mSv O 0 mSv [ped] 2 2 9 3 1 2 2 1 0 0 0 References Study Quality 33 (22434450) 4 32 (18374761) 2 34 (21928189) 4 Radiography chest Usually not appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 2 2 7 4 4 0 1 0 0 0 0 References Study Quality 5 (31829901) 4 52 (19819917) 4 53 (12527585) 4 CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10
Lung_Cancer_Surveillance_After_Therapy_Apdx_0012_71896b86
Lung_Cancer_Surveillance_After_Therapy_Apdx
CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 8 4 4 0 0 0 0 0 0 MRI chest without and with IV contrast Usually not appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 1 1 9 5 2 0 0 0 0 0 0 Variant 3: Adult. Posttreatment evaluation of stage I-III non–small-cell lung cancer. Suspected recurrence or progression.
Lung_Cancer_Surveillance_After_Therapy_Apdx_0013_4792a5a3
Lung_Cancer_Surveillance_After_Therapy_Apdx
Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT chest with IV contrast Usually appropriate Strong ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 9 9 1 0 0 0 1 0 4 3 9 References Study Quality 37 (24139896) 2 61 (11978336) 1 60 (15620991) Good 62 (33731050) 1 8 (30292847) 1 63 (26291011) 2 9 (31841793) 2 FDG-PET/CT skull base to mid- thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 8 8 1 0 1 0 1 5 1 4 5 References Study Quality 54 (22727222) 4 65 (9159703) 4 41 (21354739) Good 8 (30292847) 1 42 (34902832) 4 58 (20547021) 2 21 (22051278) 2 23 (22914804) 2 55 (23811122) 2 6 (-3196827) 4 66 (23927734) 4 CT chest without IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 7 7 0 1 0 1 3 1 4 3 3 References Study Quality
Lung_Cancer_Surveillance_After_Therapy_Apdx_0014_2353b9f8
Lung_Cancer_Surveillance_After_Therapy_Apdx
19 (28225653) 4 20 (23996838) 4 18 (34051381) 2 MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 7 7 1 0 1 0 0 0 7 2 5 References Study Quality 64 (23649440) 4 6 (-3196827) 4 CT chest abdomen pelvis with IV contrast May be appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 6 6 0 0 0 0 4 5 2 5 0 References Study Quality 20 (23996838) 4 CT abdomen and pelvis with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 1 0 0 5 6 4 0 0 0 CTA chest with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 3 12 1 0 0 0 CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 0 0 3 8 4 1 0 0 References Study Quality 64 (23649440) 4 CT neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 1 4 2 8 2 1 0 0 MRI chest without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv
Lung_Cancer_Surveillance_After_Therapy_Apdx_0015_6bbd7449
Lung_Cancer_Surveillance_After_Therapy_Apdx
MRI chest without and with IV contrast May be appropriate Limited O 0 mSv O 0 mSv [ped] 5 5 0 2 0 4 9 1 0 0 0 References Study Quality 67 (23593186) 2 MRI head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 1 0 1 9 3 2 0 0
Lung_Cancer_Surveillance_After_Therapy_Apdx_0016_06e4eba8
Lung_Cancer_Surveillance_After_Therapy_Apdx
Radiography chest May be appropriate Strong ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 1 1 1 1 8 4 0 0 0 References Study Quality 37 (24139896) 2 8 (30292847) 1 Bone scan whole body May be appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 4 4 1 1 4 5 7 0 0 0 0 References Study Quality 41 (21354739) Good 59 (18300765) 4 CT chest abdomen pelvis without IV contrast Usually not appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 2 2 6 2 4 1 1 0 0 References Study Quality 46 (25310425) 4 CT head without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 3 3 2 5 3 5 1 1 1 0 0 CT neck without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 3 3 3 4 4 4 2 0 1 0 0 CT neck without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 3 3 4 3 5 3 1 0 2 0 0 MRI chest without IV contrast Usually not appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 3 4 6 1 3 0 1 0 0
Lung_Cancer_Surveillance_After_Therapy_Apdx_0017_d30ed7a0
Lung_Cancer_Surveillance_After_Therapy_Apdx
appropriate Strong O 0 mSv O 0 mSv [ped] 3 3 3 4 6 1 3 0 1 0 0 References Study Quality 33 (22434450) 4 32 (18374761) 2 34 (21928189) 4 68 (30856554) 2
Lung_Cancer_Surveillance_After_Therapy_Apdx_0018_c5a0d258
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT abdomen and pelvis without IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 3 10 2 1 0 0 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 7 3 1 0 0 0 0 0 CT chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 5 5 5 1 0 0 0 0 0 CT chest abdomen pelvis without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢☢ 10-30 mSv [ped] 2 2 4 6 5 1 0 0 0 0 0 CT head without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 2 2 4 6 4 1 0 1 0 0 0 CTA chest without and with IV contrast Usually not appropriate Expert Consensus ☢☢☢ 1-10 mSv 2 2 6 5 4 1 0 0 0 0 0 Variant 4: Adult. Posttreatment evaluation of stage I-III small-cell lung cancer. Suspected recurrence or progression. Procedure Appropriateness
Lung_Cancer_Surveillance_After_Therapy_Apdx_0019_2546ea32
Lung_Cancer_Surveillance_After_Therapy_Apdx
Procedure Appropriateness Category SOE Adults RRL Peds RRL Rating Median Final Tabulations 1 2 3 4 5 6 7 8 9 CT chest with IV contrast Usually appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 8 8 0 0 0 0 1 0 7 4 4 References Study Quality 5 (31829901) 4 42 (34902832) 4 CT chest abdomen pelvis with IV contrast Usually appropriate Limited ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 8 8 0 0 0 0 0 1 5 5 5 References Study Quality 43 (32723523) 4
Lung_Cancer_Surveillance_After_Therapy_Apdx_0020_c4359161
Lung_Cancer_Surveillance_After_Therapy_Apdx
73 (28778345) 2 MRI head without and with IV contrast Usually appropriate Limited O 0 mSv O 0 mSv [ped] 8 8 0 0 0 1 0 0 3 8 4 References Study Quality 78 (18311784) 3 50 (23307984) 4 42 (34902832) 4 FDG-PET/CT skull base to mid- thigh Usually appropriate Strong ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 8 8 0 1 0 0 2 4 1 5 5 References Study Quality 74 (15258700) 2 39 (27726427) 4 77 (26837337) 2 51 (25613535) 2 76 (24081215) Good 75 (24777290) 2 CT abdomen and pelvis with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 1 13 0 1 0 1 References Study Quality 43 (32723523) 4 42 (34902832) 4 6 (-3196827) 4 CTA chest with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 5 8 3 0 0 0 CT chest without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 0 1 9 6 0 0 0 References Study Quality 5 (31829901) 4
Lung_Cancer_Surveillance_After_Therapy_Apdx_0021_12d708cd
Lung_Cancer_Surveillance_After_Therapy_Apdx
CT chest abdomen pelvis without IV contrast May be appropriate Expert Consensus ☢☢☢☢ 10-30 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 2 0 1 9 4 0 0 0 CT head with IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 0 0 1 9 5 1 0 0 References Study Quality 43 (32723523) 4 42 (34902832) 4 CT neck with IV contrast May be appropriate Expert Consensus ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 5 5 0 1 0 1 11 3 0 0 0 MRI head without IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 5 5 0 0 0 2 10 4 0 0 0 Bone scan whole body May be appropriate Moderate ☢☢☢ 1-10 mSv ☢☢☢☢ 3- 10 mSv [ped] 5 5 0 0 2 1 12 1 0 0 0 References Study Quality 41 (21354739) Good 40 (-3196830) 4 Radiography chest May be appropriate Limited ☢ <0.1 mSv ☢ <0.03 mSv [ped] 5 5 1 1 0 3 7 3 0 1 0 References Study Quality 37 (24139896) 2 52 (19819917) 4 CT head without IV contrast May be appropriate Limited ☢☢☢ 1-10 mSv ☢☢☢ 0.3- 3 mSv [ped] 4 4 3 3 3 7 1 0 1 0 0 References Study Quality
Lung_Cancer_Surveillance_After_Therapy_Apdx_0022_2cdbf417
Lung_Cancer_Surveillance_After_Therapy_Apdx
mSv ☢☢☢ 0.3- 3 mSv [ped] 4 4 3 3 3 7 1 0 1 0 0 References Study Quality 42 (34902832) 4 MRI chest without and with IV contrast May be appropriate Expert Consensus O 0 mSv O 0 mSv [ped] 4 4 2 3 3 3 5 1 1 0 0
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