fmenol/acr-appro-criteria-split · Datasets at Hugging Face

instruction stringlengths 219 1.08k	procedure stringclasses 840 values	output stringclasses 19 values
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Known or suspected cervicocranial arterial dissection based on clinical or imaging findings. Next imaging study.	Arteriography cervicocerebral	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic elbow pain. Initial imaging.	Computed Tomography arthrography elbow	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New focal neurologic defect, fixed or worsening. Less than 6 hours. Suspected stroke.	Magnetic Resonance Angiography head and neck without and with Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is not specified.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs already performed. Physical examination consistent with vascular compromise. Next imaging study.	Computed Tomography Angiography shoulder with Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Mixed conductive and sensorineural hearing loss. Initial imaging.	Computed Tomography Angiography head with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic shoulder pain. History of prior rotator cuff repair. Suspect rotator cuff disorders or subacromial subdeltoid bursitis. Initial radiographs normal or inconclusive. Next imaging study.	Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected abdominal wall hernia such as umbilical, ventral, incisional, lumbar, or spigelian. Initial imaging.	Ultrasound abdomen	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Clinical suspicion of central venous stenosis or occlusion suggested by swelling (ie, soft tissue edema) of the extremity ipsilateral to the upper or lower extremity hemodialysis access, with or without the development of venous collaterals. Initial imaging to guide interventional radiologic therapy options.	Magnetic Resonance Angiography extremity area of interest without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Pulsatile abdominal mass, suspected abdominal aortic aneurysm. Initial imaging.	Magnetic Resonance Imaging abdomen and pelvis with Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is moderate references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Newly diagnosed. Stage I breast cancer. Asymptomatic. Rule out thoracic metastases. Initial imaging.	Radiography chest	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Noninvasive initial clinical staging of small-cell lung carcinoma.	Computed Tomography head without and with Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Palpable abdominal mass. Suspected intra-abdominal neoplasm. Initial imaging.	Computed Tomography abdomen without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Cirrhotic patient bleeding from esophageal varices and gastric varices not amenable to endoscopic management with a MELD score of 13 and a hepatic wedge pressure of 22 mmHg. Computed Tomography demonstrates a small gastrorenal shunt.	Surgical management	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Unilateral isolated weakness or paralysis of the sternocleidomastoid and trapezius muscles (accessory nerve, CN XI). Initial imaging.	Magnetic Resonance Angiography head and neck with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Asymptomatic patient. Intermediate risk for coronary artery disease. Initial imaging.	Computed Tomography coronary calcium	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Degenerative or atherosclerotic aortic disease. Initial imaging.	Computed Tomography chest and abdomen without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Assessment of complications: GTD and GTN.	Computed Tomography abdomen and pelvis without and with Intravenous contrast	The proposed procedure is may be appropriate (disagreement). The strength of the evidence for this recommendation is expert opinion references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New focal neurologic defect, fixed or worsening. Longer than 6 hours. Suspected stroke.	Magnetic Resonance Angiography head and neck without Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is not specified.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic ankle pain. Ankle radiographs normal or nonspecific, suspected ankle impingement syndrome. Next study.	Computed Tomography ankle with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Ottawa rules can be evaluated without exclusionary criteria. Ottawa rules are negative. No suspected abnormalities in regions not evaluated by the Ottawa rules. Initial imaging.	Magnetic Resonance Imaging foot without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute pelvic pain in the reproductive age group. Gynecological etiology suspected, ß-hCG negative (either serum or urine). Initial imaging.	Computed Tomography pelvis without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Indeterminate, greater than 1 cm liver lesion on initial imaging with Ultrasound Known history of an extrahepatic malignancy.	Liver spleen scan	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Headache with features of intracranial hypertension (eg, papilledema, pulsatile tinnitus, visual symptoms worse on Valsalva). Initial imaging.	Magnetic Resonance Imaging head without and with Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected osteomyelitis or soft tissue infection with implanted extra-articular surgical hardware. Initial radiographs normal or with findings suggestive of osteomyelitis or soft tissue infection with implanted extra-articular surgical hardware. Next imaging study.	Image-guided aspiration area of interest	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Indeterminate renal mass. Contraindication to both iodinated Computed Tomography and gadolinium-based Magnetic Resonance intravenous contrast. Initial imaging.	Radiography intravenous urography	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Second and third trimester vaginal bleeding. Painless bleeding. Initial imaging.	Ultrasound duplex Doppler pelvis	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Low back pain with or without radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging.	Radiography lumbar spine	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Confirmed new-onset heart failure with reduced ejection fraction of uncertain etiology: ischemic versus nonischemic.	Rb-82 Positron Emission Tomography/Computed Tomography heart	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging.	Computed Tomography maxillofacial without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic chest pain; high probability of coronary artery disease. Known ischemic heart disease with no prior definitive treatment. Initial imaging.	Magnetic Resonance Imaging heart function and morphology without and with Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Headache attributed to infection. Initial imaging.	Radiography skull	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected abdominal wall hernia such as umbilical, ventral, incisional, lumbar, or spigelian. Initial imaging.	Magnetic Resonance Imaging pelvis without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Age greater than or equal to 16 years and less than 65 years. Suspected acute blunt cervical spine trauma; imaging not indicated by NEXUS or CCR clinical criteria. Patient meets low-risk criteria. Initial imaging.	Magnetic Resonance Angiography neck without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study.	Ultrasound foot	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Epigastric pain with clinical suspicion for hiatal hernia. Initial imaging.	Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute pelvic pain in the reproductive age group. Nongynecological etiology suspected, ß-hCG negative (either urine or serum). Initial imaging.	Computed Tomography pelvis without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Any etiology. Initial imaging.	Magnetic Resonance Imaging shoulder without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute hand fracture on radiographs. Suspect hand tendon or ligament trauma. Next imaging study.	Computed Tomography hand with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Second trimester anatomy examination. Follow-up imaging.	Magnetic Resonance Imaging fetal without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Known multiorgan system arterial occlusions. Suspected embolic etiology. Next imaging study to determine source.	Ultrasound echocardiography transesophageal	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs show Bankart or Hill-Sachs lesion. Next imaging study.	Magnetic Resonance arthrography shoulder	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Prolonged history of right flank pain, fever, and leukocytosis. Urinalysis positive for blood and infection. Patient appears septic and is hypotensive. Computed Tomography scan shows dilated right ureter and renal pelvis with perinephric stranding. No etiology for ureteral obstruction identified with current imaging.	Retrograde ureteral stenting	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Muscle-invasive bladder cancer with or without cystectomy. Post-treatment surveillance.	Radiography intravenous urography	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected perianal disease. Abscess or fistula. Initial imaging.	Fluoroscopy contrast enema	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New symptomatic VCF. History of prior vertebroplasty or surgery. Initial treatment.	Percutaneous vertebral augmentation	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known breast cancer. Initial determination of tumor size and extent within the breast prior to neoadjuvant chemotherapy. Initial imaging.	Magnetic Resonance Imaging breast without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Oropharyngeal neurogenic dysphagia or oropharyngeal pain (glossopharyngeal nerve, CN IX). Initial imaging.	Computed Tomography maxillofacial without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Chronic wrist pain. Radiographs show old scaphoid fracture. Evaluate for nonunion, malunion, osteonecrosis, or post-traumatic osteoarthritis. Next imaging study.	Magnetic Resonance arthrography wrist	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Vomiting within the first 2 days after birth. Radiographs show a distal bowel obstruction. Next imaging study.	Nuclear medicine gastroesophageal reflux scan	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.	Computed Tomography head without Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: 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.	Computed Tomography cone beam paranasal sinuses without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Hepatocellular cancer: Solitary tumor less than 3 cm, cirrhotic.	Combination locoregional therapy	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected large-vessel vasculitis (LVV). Initial imaging.	Magnetic Resonance Angiography chest abdomen pelvis without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Younger than 5 years of age. Concern for osteomyelitis or septic arthritis involving an extremity. Initial radiographs normal, or with findings suggestive of osteomyelitis. Next imaging study.	Magnetic Resonance Imaging area of interest without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Patient with a 3 week history of pneumonia, fever, dyspnea. Worsening condition despite a full course of broad-spectrum antibiotics. Computed Tomography scan shows a loculated pleural collection with overlying pleural thickening (empyema). Treatment includes antibiotics.	Open decortication	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is moderate references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Initial radiographs showing distal radioulnar joint or carpal malalignment in the absence of fracture. Next imaging study.	Magnetic Resonance Imaging wrist without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.	Computed Tomography head without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute iliofemoral DVT with moderate to severe symptoms present for less than 14 days, otherwise healthy.	Anticoagulation alone	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nonmuscle invasive bladder cancer no symptoms or risk factors. Post-treatment surveillance.	Magnetic Resonance Imaging abdomen and pelvis without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspicion for infection with new or increasing nontraumatic cervical or neck pain or radiculopathy. Initial imaging.	Facet injection/medial branch block cervical spine	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female. Postsurgical excision for breast cancer. Positive margins. Asymptomatic. Initial imaging.	Mammography diagnostic	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Man <40 years of age, transient or episodic hematospermia, and no other symptoms or signs of disease.	Transrectal Ultrasound prostate	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is not specified.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Pleural effusion incidentally detected on incomplete thoracic imaging study. Next imaging study.	Radiography chest	The proposed procedure is may be appropriate (disagreement). The strength of the evidence for this recommendation is expert opinion.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Female. Breast cancer, greater than 2 cm in size, clinical node-positive. Imaging of the axilla after completion of neoadjuvant chemotherapy and prior to surgery.	Magnetic Resonance Imaging breast without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Low back pain with or without radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging.	Discography and post-discography Computed Tomography lumbar spine	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Metastatic prostate cancer treated by systemic therapy (androgen deprivation therapy [ADT], chemotherapy, immunotherapy). Follow-up.	Fluciclovine Positron Emission Tomography/Magnetic Resonance Imaging skull base to mid-thigh	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic ankle pain. Multiple sites of degenerative joint disease in the hindfoot detected by ankle radiographs. Next study.	Ultrasound ankle and hindfoot	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected dementia with Lewy bodies. Initial imaging.	Ioflupane Single Photon Emission Computed Tomography or Single-photon Emission Computed Tomography / Computed Tomography brain	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nontraumatic chest wall pain. Known or suspected malignancy. Secondary evaluation after normal chest radiograph. Next imaging study.	Magnetic Resonance Imaging chest without and with Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Infant with nonbilious vomiting, and otherwise healthy (suspected uncomplicated esophageal reflux). Initial imaging.	Ultrasound abdomen Upper Gastrointestinal tract)	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is moderate references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Malignant or aggressive primary bone tumor. Surveillance for local recurrence.	Magnetic Resonance Imaging area of interest without Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of GTN, including refractory, relapsed, or quiescent GTN.	Computed Tomography head with Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.	Magnetic Resonance Angiography head with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Upper urinary tract urothelial cancer. Pretreatment staging.	Magnetic Resonance Urography without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Traumatic hematuria (microscopic). Initial imaging.	Voiding urosonography	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Anosmia or other abnormalities of the sense of smell (olfactory nerve, CN I). Initial imaging.	Magnetic Resonance Imaging orbits face neck without and with Intravenous contrast	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple different lower cranial nerve palsies or combined lower cranial nerve syndromes (CN IX-XII). Initial imaging.	Ultrasound neck	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of stage IA and IB pure seminoma testicular cancer. Diagnosed by orchiectomy. No clinical suspicion of recurrence.	Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography whole body	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute sinusitis with rapid progression or suspected invasive fungal sinusitis. Initial Imaging.	Magnetic Resonance Imaging orbits face neck with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute nonlocalized abdominal pain and fever. No recent surgery. Initial imaging.	Nuclear medicine scan gallbladder	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Abnormal uterine bleeding. Follow-up imaging when surveillance is appropriate given findings from the initial ultrasound.	Ultrasound pelvis transvaginal	The proposed procedure is usually appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs normal. Physical examination findings consistent with rotator cuff tear. Next imaging study.	Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Prior ischemic infarct. Surveillance imaging.	Magnetic Resonance Angiography neck without and with Intravenous contrast	The proposed procedure is may be appropriate (disagreement). The strength of the evidence for this recommendation is expert opinion references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of asymptomatic patients with treated high-risk endometrial cancer.	Magnetic Resonance Imaging pelvis without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nonischemic visual loss. Chiasm or post-chiasm symptoms. Initial imaging.	Computed Tomography head without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Occupational exposure, screening, and surveillance of lung disease. Initial imaging.	Computed Tomography chest without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Asymptomatic cervical bruit. Initial imaging.	Magnetic Resonance Venography head without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected pulmonary embolism. Low or intermediate pretest probability with a negative D-dimer. Initial Imaging.	Ventilation/Perfusion scan lung	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Lung cancer screening. Patient 50 to 80 years of age and 20 or more packs per year smoking history and currently smoke or have quit within the past 15 years. Initial imaging.	Radiography chest	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study.	Computed Tomography foot with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected chronic mesenteric ischemia. Initial imaging.	Magnetic Resonance Angiography abdomen and pelvis without Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Growth and antepartum surveillance.	Ultrasound echocardiography fetal	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Follow-up after open repair of thoracoabdominal aortic aneurysm or dissection.	Radiography chest	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Suspect stress fracture, excluding vertebrae. Initial imaging.	Magnetic Resonance Imaging area of interest without and with Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known axillary lymph node-positive breast cancer on prior mammography, Ultrasound or Magnetic Resonance Imaging Axillary evaluation after completion of neoadjuvant chemotherapy, axilla previously evaluated. Next imaging study.	Digital breast tomosynthesis diagnostic	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Leukocoria or suspected intraocular mass. Initial imaging.	Magnetic Resonance Imaging head without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Clinically suspected prostate cancer. Negative TRUS-guided biopsy. Initial diagnosis. Next imaging study.	Computed Tomography chest abdomen pelvis without Intravenous contrast	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is expert consensus.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Initial staging of pretreatment ovarian cancer.	Magnetic Resonance Imaging abdomen and pelvis without and with Intravenous contrast	The proposed procedure is may be appropriate. The strength of the evidence for this recommendation is strong references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic elbow pain with mechanical symptoms such as locking, clicking, or limited range of motion. Suspect intra-articular pathology such as osteocartilaginous body, osteochondral lesion, or synovial abnormality. Radiographs normal or nonspecific. Next imaging study.	3-phase bone scan elbow	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.
Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child or adult. Known or suspected anomalous pulmonary venous return with inadequate evaluation after transthoracic echocardiography. Next imaging study.	Ultrasound echocardiography transesophageal	The proposed procedure is usually not appropriate. The strength of the evidence for this recommendation is limited references.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Known or suspected cervicocranial arterial dissection based on clinical or imaging findings. Next imaging study.

Arteriography cervicocerebral

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic elbow pain. Initial imaging.

Computed Tomography arthrography elbow

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New focal neurologic defect, fixed or worsening. Less than 6 hours. Suspected stroke.

Magnetic Resonance Angiography head and neck without and with Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **not specified**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs already performed. Physical examination consistent with vascular compromise. Next imaging study.

Computed Tomography Angiography shoulder with Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Mixed conductive and sensorineural hearing loss. Initial imaging.

Computed Tomography Angiography head with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic shoulder pain. History of prior rotator cuff repair. Suspect rotator cuff disorders or subacromial subdeltoid bursitis. Initial radiographs normal or inconclusive. Next imaging study.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected abdominal wall hernia such as umbilical, ventral, incisional, lumbar, or spigelian. Initial imaging.

Ultrasound abdomen

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Clinical suspicion of central venous stenosis or occlusion suggested by swelling (ie, soft tissue edema) of the extremity ipsilateral to the upper or lower extremity hemodialysis access, with or without the development of venous collaterals. Initial imaging to guide interventional radiologic therapy options.

Magnetic Resonance Angiography extremity area of interest without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Pulsatile abdominal mass, suspected abdominal aortic aneurysm. Initial imaging.

Magnetic Resonance Imaging abdomen and pelvis with Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **moderate references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Newly diagnosed. Stage I breast cancer. Asymptomatic. Rule out thoracic metastases. Initial imaging.

Radiography chest

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Noninvasive initial clinical staging of small-cell lung carcinoma.

Computed Tomography head without and with Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Palpable abdominal mass. Suspected intra-abdominal neoplasm. Initial imaging.

Computed Tomography abdomen without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Cirrhotic patient bleeding from esophageal varices and gastric varices not amenable to endoscopic management with a MELD score of 13 and a hepatic wedge pressure of 22 mmHg. Computed Tomography demonstrates a small gastrorenal shunt.

Surgical management

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Unilateral isolated weakness or paralysis of the sternocleidomastoid and trapezius muscles (accessory nerve, CN XI). Initial imaging.

Magnetic Resonance Angiography head and neck with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Asymptomatic patient. Intermediate risk for coronary artery disease. Initial imaging.

Computed Tomography coronary calcium

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Degenerative or atherosclerotic aortic disease. Initial imaging.

Computed Tomography chest and abdomen without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Assessment of complications: GTD and GTN.

Computed Tomography abdomen and pelvis without and with Intravenous contrast

The proposed procedure is **may be appropriate (disagreement)**. The strength of the evidence for this recommendation is **expert opinion references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New focal neurologic defect, fixed or worsening. Longer than 6 hours. Suspected stroke.

Magnetic Resonance Angiography head and neck without Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **not specified**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic ankle pain. Ankle radiographs normal or nonspecific, suspected ankle impingement syndrome. Next study.

Computed Tomography ankle with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Ottawa rules can be evaluated without exclusionary criteria. Ottawa rules are negative. No suspected abnormalities in regions not evaluated by the Ottawa rules. Initial imaging.

Magnetic Resonance Imaging foot without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute pelvic pain in the reproductive age group. Gynecological etiology suspected, ß-hCG negative (either serum or urine). Initial imaging.

Computed Tomography pelvis without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Indeterminate, greater than 1 cm liver lesion on initial imaging with Ultrasound Known history of an extrahepatic malignancy.

Liver spleen scan

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Headache with features of intracranial hypertension (eg, papilledema, pulsatile tinnitus, visual symptoms worse on Valsalva). Initial imaging.

Magnetic Resonance Imaging head without and with Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected osteomyelitis or soft tissue infection with implanted extra-articular surgical hardware. Initial radiographs normal or with findings suggestive of osteomyelitis or soft tissue infection with implanted extra-articular surgical hardware. Next imaging study.

Image-guided aspiration area of interest

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Indeterminate renal mass. Contraindication to both iodinated Computed Tomography and gadolinium-based Magnetic Resonance intravenous contrast. Initial imaging.

Radiography intravenous urography

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Second and third trimester vaginal bleeding. Painless bleeding. Initial imaging.

Ultrasound duplex Doppler pelvis

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Low back pain with or without radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging.

Radiography lumbar spine

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Confirmed new-onset heart failure with reduced ejection fraction of uncertain etiology: ischemic versus nonischemic.

Rb-82 Positron Emission Tomography/Computed Tomography heart

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging.

Computed Tomography maxillofacial without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic chest pain; high probability of coronary artery disease. Known ischemic heart disease with no prior definitive treatment. Initial imaging.

Magnetic Resonance Imaging heart function and morphology without and with Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Headache attributed to infection. Initial imaging.

Radiography skull

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected abdominal wall hernia such as umbilical, ventral, incisional, lumbar, or spigelian. Initial imaging.

Magnetic Resonance Imaging pelvis without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Age greater than or equal to 16 years and less than 65 years. Suspected acute blunt cervical spine trauma; imaging not indicated by NEXUS or CCR clinical criteria. Patient meets low-risk criteria. Initial imaging.

Magnetic Resonance Angiography neck without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study.

Ultrasound foot

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Epigastric pain with clinical suspicion for hiatal hernia. Initial imaging.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute pelvic pain in the reproductive age group. Nongynecological etiology suspected, ß-hCG negative (either urine or serum). Initial imaging.

Computed Tomography pelvis without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Any etiology. Initial imaging.

Magnetic Resonance Imaging shoulder without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute hand fracture on radiographs. Suspect hand tendon or ligament trauma. Next imaging study.

Computed Tomography hand with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Second trimester anatomy examination. Follow-up imaging.

Magnetic Resonance Imaging fetal without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Known multiorgan system arterial occlusions. Suspected embolic etiology. Next imaging study to determine source.

Ultrasound echocardiography transesophageal

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs show Bankart or Hill-Sachs lesion. Next imaging study.

Magnetic Resonance arthrography shoulder

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Prolonged history of right flank pain, fever, and leukocytosis. Urinalysis positive for blood and infection. Patient appears septic and is hypotensive. Computed Tomography scan shows dilated right ureter and renal pelvis with perinephric stranding. No etiology for ureteral obstruction identified with current imaging.

Retrograde ureteral stenting

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Muscle-invasive bladder cancer with or without cystectomy. Post-treatment surveillance.

Radiography intravenous urography

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected perianal disease. Abscess or fistula. Initial imaging.

Fluoroscopy contrast enema

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: New symptomatic VCF. History of prior vertebroplasty or surgery. Initial treatment.

Percutaneous vertebral augmentation

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known breast cancer. Initial determination of tumor size and extent within the breast prior to neoadjuvant chemotherapy. Initial imaging.

Magnetic Resonance Imaging breast without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Oropharyngeal neurogenic dysphagia or oropharyngeal pain (glossopharyngeal nerve, CN IX). Initial imaging.

Computed Tomography maxillofacial without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Chronic wrist pain. Radiographs show old scaphoid fracture. Evaluate for nonunion, malunion, osteonecrosis, or post-traumatic osteoarthritis. Next imaging study.

Magnetic Resonance arthrography wrist

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Vomiting within the first 2 days after birth. Radiographs show a distal bowel obstruction. Next imaging study.

Nuclear medicine gastroesophageal reflux scan

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.

Computed Tomography head without Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: 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.

Computed Tomography cone beam paranasal sinuses without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Hepatocellular cancer: Solitary tumor less than 3 cm, cirrhotic.

Combination locoregional therapy

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected large-vessel vasculitis (LVV). Initial imaging.

Magnetic Resonance Angiography chest abdomen pelvis without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Younger than 5 years of age. Concern for osteomyelitis or septic arthritis involving an extremity. Initial radiographs normal, or with findings suggestive of osteomyelitis. Next imaging study.

Magnetic Resonance Imaging area of interest without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Patient with a 3 week history of pneumonia, fever, dyspnea. Worsening condition despite a full course of broad-spectrum antibiotics. Computed Tomography scan shows a loculated pleural collection with overlying pleural thickening (empyema). Treatment includes antibiotics.

Open decortication

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **moderate references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Initial radiographs showing distal radioulnar joint or carpal malalignment in the absence of fracture. Next imaging study.

Magnetic Resonance Imaging wrist without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.

Computed Tomography head without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute iliofemoral DVT with moderate to severe symptoms present for less than 14 days, otherwise healthy.

Anticoagulation alone

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nonmuscle invasive bladder cancer no symptoms or risk factors. Post-treatment surveillance.

Magnetic Resonance Imaging abdomen and pelvis without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspicion for infection with new or increasing nontraumatic cervical or neck pain or radiculopathy. Initial imaging.

Facet injection/medial branch block cervical spine

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female. Postsurgical excision for breast cancer. Positive margins. Asymptomatic. Initial imaging.

Mammography diagnostic

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Man <40 years of age, transient or episodic hematospermia, and no other symptoms or signs of disease.

Transrectal Ultrasound prostate

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **not specified**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Pleural effusion incidentally detected on incomplete thoracic imaging study. Next imaging study.

Radiography chest

The proposed procedure is **may be appropriate (disagreement)**. The strength of the evidence for this recommendation is **expert opinion**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Female. Breast cancer, greater than 2 cm in size, clinical node-positive. Imaging of the axilla after completion of neoadjuvant chemotherapy and prior to surgery.

Magnetic Resonance Imaging breast without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Low back pain with or without radiculopathy. One or more of the following: low-velocity trauma, osteoporosis, elderly individual, or chronic steroid use. Initial imaging.

Discography and post-discography Computed Tomography lumbar spine

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Metastatic prostate cancer treated by systemic therapy (androgen deprivation therapy [ADT], chemotherapy, immunotherapy). Follow-up.

Fluciclovine Positron Emission Tomography/Magnetic Resonance Imaging skull base to mid-thigh

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic ankle pain. Multiple sites of degenerative joint disease in the hindfoot detected by ankle radiographs. Next study.

Ultrasound ankle and hindfoot

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected dementia with Lewy bodies. Initial imaging.

Ioflupane Single Photon Emission Computed Tomography or Single-photon Emission Computed Tomography / Computed Tomography brain

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nontraumatic chest wall pain. Known or suspected malignancy. Secondary evaluation after normal chest radiograph. Next imaging study.

Magnetic Resonance Imaging chest without and with Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Infant with nonbilious vomiting, and otherwise healthy (suspected uncomplicated esophageal reflux). Initial imaging.

Ultrasound abdomen Upper Gastrointestinal tract)

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **moderate references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Malignant or aggressive primary bone tumor. Surveillance for local recurrence.

Magnetic Resonance Imaging area of interest without Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of GTN, including refractory, relapsed, or quiescent GTN.

Computed Tomography head with Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Clinical presentation suggestive of acute stroke, not a candidate for emergent intervention. Initial imaging.

Magnetic Resonance Angiography head with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Upper urinary tract urothelial cancer. Pretreatment staging.

Magnetic Resonance Urography without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Traumatic hematuria (microscopic). Initial imaging.

Voiding urosonography

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Anosmia or other abnormalities of the sense of smell (olfactory nerve, CN I). Initial imaging.

Magnetic Resonance Imaging orbits face neck without and with Intravenous contrast

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple different lower cranial nerve palsies or combined lower cranial nerve syndromes (CN IX-XII). Initial imaging.

Ultrasound neck

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of stage IA and IB pure seminoma testicular cancer. Diagnosed by orchiectomy. No clinical suspicion of recurrence.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography whole body

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute sinusitis with rapid progression or suspected invasive fungal sinusitis. Initial Imaging.

Magnetic Resonance Imaging orbits face neck with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Acute nonlocalized abdominal pain and fever. No recent surgery. Initial imaging.

Nuclear medicine scan gallbladder

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Abnormal uterine bleeding. Follow-up imaging when surveillance is appropriate given findings from the initial ultrasound.

Ultrasound pelvis transvaginal

The proposed procedure is **usually appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Traumatic shoulder pain. Radiographs normal. Physical examination findings consistent with rotator cuff tear. Next imaging study.

Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography skull base to mid-thigh

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Prior ischemic infarct. Surveillance imaging.

Magnetic Resonance Angiography neck without and with Intravenous contrast

The proposed procedure is **may be appropriate (disagreement)**. The strength of the evidence for this recommendation is **expert opinion references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Surveillance of asymptomatic patients with treated high-risk endometrial cancer.

Magnetic Resonance Imaging pelvis without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Nonischemic visual loss. Chiasm or post-chiasm symptoms. Initial imaging.

Computed Tomography head without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Occupational exposure, screening, and surveillance of lung disease. Initial imaging.

Computed Tomography chest without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Asymptomatic cervical bruit. Initial imaging.

Magnetic Resonance Venography head without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected pulmonary embolism. Low or intermediate pretest probability with a negative D-dimer. Initial Imaging.

Ventilation/Perfusion scan lung

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Lung cancer screening. Patient 50 to 80 years of age and 20 or more packs per year smoking history and currently smoke or have quit within the past 15 years. Initial imaging.

Radiography chest

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult or child older than 5 years of age. Acute trauma to the foot. Suspect Lisfranc injury, tendon injury, or occult fracture or dislocation. Radiographs are normal or equivocal. Next imaging study.

Computed Tomography foot with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Suspected chronic mesenteric ischemia. Initial imaging.

Magnetic Resonance Angiography abdomen and pelvis without Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Growth and antepartum surveillance.

Ultrasound echocardiography fetal

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Follow-up after open repair of thoracoabdominal aortic aneurysm or dissection.

Radiography chest

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult. Suspect stress fracture, excluding vertebrae. Initial imaging.

Magnetic Resonance Imaging area of interest without and with Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Adult female or male or transfeminine (male-to-female) or transmasculine (female-to-male). Known axillary lymph node-positive breast cancer on prior mammography, Ultrasound or Magnetic Resonance Imaging Axillary evaluation after completion of neoadjuvant chemotherapy, axilla previously evaluated. Next imaging study.

Digital breast tomosynthesis diagnostic

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child. Leukocoria or suspected intraocular mass. Initial imaging.

Magnetic Resonance Imaging head without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Clinically suspected prostate cancer. Negative TRUS-guided biopsy. Initial diagnosis. Next imaging study.

Computed Tomography chest abdomen pelvis without Intravenous contrast

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **expert consensus**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Initial staging of pretreatment ovarian cancer.

Magnetic Resonance Imaging abdomen and pelvis without and with Intravenous contrast

The proposed procedure is **may be appropriate**. The strength of the evidence for this recommendation is **strong references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Chronic elbow pain with mechanical symptoms such as locking, clicking, or limited range of motion. Suspect intra-articular pathology such as osteocartilaginous body, osteochondral lesion, or synovial abnormality. Radiographs normal or nonspecific. Next imaging study.

3-phase bone scan elbow

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.

Act like a medical doctor with a 30 years experience in Radiology and Medical Imaging. Assess the appropriateness of carrying out the proposed procedure on a patient with the following information: Child or adult. Known or suspected anomalous pulmonary venous return with inadequate evaluation after transthoracic echocardiography. Next imaging study.

Ultrasound echocardiography transesophageal

The proposed procedure is **usually not appropriate**. The strength of the evidence for this recommendation is **limited references**.