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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 positive D-dimer.
Initial imaging. | Ventilation/Perfusion scan lung | 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: Oropharyngeal neurogenic dysphagia or oropharyngeal pain (glossopharyngeal nerve, CN IX).
Initial imaging. | Magnetic Resonance Imaging head 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 or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands).
Initial staging. | Computed Tomography 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: Hepatocellular cancer: Multifocal, bilobar disease, at least 1 tumor greater than 5 cm, cirrhotic. | Liver transplantation | 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: Chronic chest pain; high probability of coronary artery disease.
Known ischemic heart disease with no prior definitive tre... | Ultrasound echocardiography transthoracic stress | 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: Muscle-invasive bladder cancer with or without cystectomy.
Post-treatment surveillance. | Magnetic Resonance Imaging abdomen and pelvis without 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: Esophageal cancer.
Posttreatment imaging.
Suspected or known recurrence. | Magnetic Resonance Imaging 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: Adult younger than 30 years of age.
Female or transfeminine.
Evaluation of unexplained axillary adenopathy.
Silicone breas... | 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: Follow-up for clinically localized renal cell carcinoma; post ablation. | Computed Tomography chest 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: Vomiting within the first 2 days after birth.
Poor feeding or no passage of meconium.
Initial imaging. | Fluoroscopy upper Gastrointestinal series | 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 or confirmed sepsis.
No specific symptoms suggestive of origin, or symptoms cannot be assessed.
Initial imaging. | Radiography chest | 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: Hip arthroplasty patient with trochanteric pain.
Suspect abductor injury, or trochanteric bursitis, or other soft tissue a... | Image-guided anesthetic +/- corticosteroid injection hip joint or surrounding structures | 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: Hepatocellular cancer: Solitary tumor 3 to 5 cm, cirrhotic. | Liver transplantation | 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: Female.
Breast cancer screening.
High-risk, bilateral prophylactic mastectomy, no reconstruction. | Ultrasound breast | 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 skeletally mature child.
Fall or acute twisting trauma to the knee.
No fracture seen on radiographs.
Suspect occu... | Ultrasound knee | 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: Initial staging of pretreatment vulvar cancer: Primary tumor is greater than 4 cm or tumor of any size with more than mini... | Computed Tomography chest abdomen pelvis 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: Assessment of complications: GTD and GTN. | 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: Chronic shoulder pain.
Initial imaging. | Computed Tomography shoulder 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: Surveillance of treated cervical cancer in asymptomatic patients. | Magnetic Resonance Imaging abdomen 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: Child or adult.
Transposition of the great arteries after atrial switch.
Incomplete or inadequate assessment of cardiovasc... | Radiography chest | 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: Planning for endovascular or open repair of thoracoabdominal aorta aneurysm or dissection. | 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 **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: Chorea; suspected Huntington disease.
Initial imaging. | Single Photon Emission Computed Tomography or Single-photon Emission Computed Tomography / Computed Tomography brain perfusion | 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 or adult.
Suspected aortic coarctation with inadequate evaluation after transthoracic echocardiography.
Next imaging... | Magnetic Resonance Angiography chest 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: Adult.
Symptomatic hydronephrosis in a pregnant patient with unknown cause.
Initial imaging. | Ultrasound color Doppler kidneys and bladder retroperitoneal | 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: Adult.
Chronic recurrent vertigo.
Associated with unilateral hearing loss or tinnitus.
Initial imaging. | Computed Tomography 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: Lower gastrointestinal tract bleeding.
Active bleeding in a hemodynamically unstable patient or a patient who has required... | Magnetic Resonance Angiography abdomen and 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: Headache without any of the following “red flags”: sudden onset ("thunderclap"), features of intracranial hypertension or ... | 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: Adult.
Chronic hand pain.
Radiographs normal or remarkable for nonspecific arthritis.
Next imaging study. | Computed Tomography arthrography hand | 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 frac... | Computed Tomography foot without 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: Trismus or malocclusion or gingival hemorrhage or mucosal hemorrhage or loose teeth or fractured teeth or displaced teeth.... | Magnetic Resonance Imaging cervical spine 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: Suspected or confirmed sepsis.
Acute abdominal pain.
Initial imaging. | 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 **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 therapeutic procedure for a patient with bile leak and dilated bile ducts following laparoscopic cholecystectomy. | Surgery | 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: Vaginal Cancer.
Suspected or known recurrence.
Evaluate extent of disease.
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: Suspected Crohn disease, no prior Crohn diagnosis.
Initial Imaging. | Magnetic Resonance enteroclysis | 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: Confirmed new-onset heart failure with reduced ejection fraction of uncertain etiology: ischemic versus nonischemic. | 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: Suspected inflammatory cardiomyopathy.
Ischemic cardiomyopathy already excluded.
Initial imaging. | Arteriography coronary with ventriculography | 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, younger than 30 years of age.
Palpable breast mass.
Initial imaging. | Fluorodeoxyglucose Positron Emission Tomography breast dedicated | 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: Known osteonecrosis with articular collapse by radiographs.
Surgery planned.
Next imaging study. | Magnetic Resonance Imaging area of interest 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: Child or adult.
Known single ventricle physiology.
Postoperative evaluation after stage 3 single ventricle palliation (tot... | Magnetic Resonance Angiography chest 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: Child.
Chronic nonprogressive ataxia.
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: Routine preoperative chest imaging for noncardiothoracic surgery.
History of chronic cardiopulmonary disease or cardiothor... | Computed Tomography chest 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: Multiple gestations.
Dichorionic twins or multichorionic higher order multiples.
Growth and antepartum surveillance. | Ultrasound pregnant uterus biophysical profile | 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: Surveillance.
Regardless of clinical stage of breast cancer at time of original presentation.
Evaluation for local recurre... | Mammography diagnostic | 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: Known high-flow vascular malformation (AVM/AVF).
Surveillance monitoring. | Arteriography cervicocerebral | 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: Chronic dyspnea.
Suspected central airways disease.
Initial imaging. | 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 **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: Mixed conductive and sensorineural hearing loss.
Initial imaging. | Magnetic Resonance Imaging head and internal auditory canal 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: Man <40 years of age, transient or episodic hematospermia, and no other symptoms or signs of disease. | Computed Tomography pelvis with Intravenous contrast | 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: Child, older than 6 months of age.
Concern for DDH.
Initial imaging. | Radiography 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: Age greater than or equal to 16 years.
Blunt trauma meeting criteria for thoracic and lumbar imaging.
Initial imaging. | Computed Tomography thoracic and lumbar spine without 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: Suspected nonischemic dilated and unclassified cardiomyopathy.
Ischemic cardiomyopathy already excluded.
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 **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 or diagnosed cancer of the paranasal sinuses or nasal cavity.
Initial staging. | Computed Tomography 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: Surveillance of stage IA and IB pure seminoma testicular cancer.
Diagnosed by orchiectomy.
No clinical suspicion of recurr... | Radiography chest | 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: Age greater than or equal to 16 years.
Suspected acute cervical spine blunt trauma.
Imaging indicated by NEXUS or CCR clin... | Magnetic Resonance Imaging cervical spine 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: Low back pain with or without radiculopathy.
One or more of the following: low-velocity trauma, osteoporosis, elderly indi... | Computed Tomography lumbar spine 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 Computed Tomography (noncontrast or single-phase) or... | Computed Tomography abdomen with Intravenous contrast multiphase | 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: Known or suspected infective endocarditis.
Additional imaging to direct patient management or treatment. | Arteriography coronary | 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: Congenital hearing loss or total deafness or cochlear implant candidate.
Surgical planning. | Magnetic Resonance Angiography 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: Adult or child older than 5 years of age.
Acute trauma to the foot.
Suspect penetrating trauma with a foreign body.
Radiog... | Computed Tomography foot 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 female, younger than 30 years of age.
Palpable breast mass.
Ultrasound findings are suspicious or highly suggestive ... | Mammography screening | 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: Newly diagnosed.
Clinical stage I-IIA (early stage) breast cancer at presentation.
Evaluation for locoregional disease (in... | Ultrasound axilla | 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: Acute onset flank pain.
Suspicion of stone disease.
No history or remote history of stone disease.
Initial imaging. | Ultrasound kidneys and bladder retroperitoneal | 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: Suspected osteomyelitis.
Initial radiographs normal or with findings suggestive of osteomyelitis.
Next imaging study. | Computed Tomography area of interest 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: Newly diagnosed.
Clinical stage IIB-III (late stage) breast cancer at presentation.
Evaluation for distant disease.
IDC or... | 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: Multiple gestations.
Monochorionic twins.
Second trimester anatomy examination.
Follow-up imaging. | Ultrasound pregnant uterus biophysical profile | 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 extremity joint pain.
Suspect erosive osteoarthritis.
Radiographs normal or inconclusive.
Next imaging study. | Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography whole body | 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: Lower gastrointestinal tract bleeding.
Obscure (nonlocalized) recurrent bleeding in a hemodynamically stable patient (assu... | Red Blood Cells scan with Single Photon Emission Computed Tomography or Single-photon Emission Computed Tomography / Computed Tomography abdomen and pelvis | 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: Known Crohn disease, disease surveillance; monitoring therapy. | 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 **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: Symptomatic patient with a primary shoulder arthroplasty, infection excluded.
Suspected loosening.
Additional imaging foll... | Magnetic Resonance Imaging shoulder 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: Recent pneumonia with suspected parapneumonic effusion or empyema.
Initial imaging. | Computed Tomography chest 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: Adult or child 5 years of age or older.
Acute trauma to the knee.
Mechanism unknown.
Focal patellar tenderness, effusion, ... | Radiography knee | 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: Major blunt trauma.
Hemodynamically stable.
Suspected urinary system, including urethra trauma.
Initial imaging. | Ultrasound abdomen and pelvis | 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 up to age 5.
Acute limp.
Nonlocalized symptoms.
Concern for infection.
Initial imaging. | Radiography pelvis | 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: Age greater than or equal to 16 years and less than 65 years.
Suspected acute blunt cervical spine trauma; imaging not ind... | Computed Tomography myelography 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 of any age.
Female or transfeminine.
Evaluation of silicone breast implants.
Asymptomatic.
Initial imaging at 5 to 6... | Magnetic Resonance Imaging breast 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: Suspected normal pressure hydrocephalus. | Magnetic Resonance spectroscopy head without Intravenous contrast | 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: Adult.
Presenting with shortness of breath, or hemothorax, or hemoptysis.
Patient has history of epistaxis and family hist... | Computed Tomography Angiography pulmonary arteries 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: Hepatocellular cancer: Solitary tumor less than 3 cm, cirrhotic. | Percutaneous ablation liver | 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: Palpable thyroid nodule.
Not goiter.
Euthyroid.
Initial imaging. | Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography whole body | 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: Clinically suspected prostate cancer.
No prior biopsy (biopsy naïve).
Initial diagnosis.
Initial imaging. | Prostate-Specific Membrane Antigen 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: Lung cancer screening.
Patient of any age with less than 20 packs per year history of smoking, and no additional risk fact... | 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: Child.
With one or more clinical signs concerning for septic arthritis.
Initial radiographs normal or demonstrating possib... | Bone scan whole body | 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: Parkinson disease.
Typical clinical features.
Responsive to levodopa. | Tc-99m Hexamethylpropyleneamine Oxime Single Photon Emission Computed Tomography head | 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: Acute head trauma, mild (GCS 13–15), imaging not indicated by clinical decision rule.
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 **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 recurrent sinusitis or chronic rhinosinusitis or noninvasive fungal sinusitis or sinonasal polyposis.
Possible surgi... | Computed Tomography 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: Unilateral isolated weakness or paralysis of the sternocleidomastoid and trapezius muscles (accessory nerve, CN XI).
Initi... | Computed Tomography neck 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 physical abuse.
Child ≤24 months of age.
Neurological or visceral injuries not clinically suspected.
Initial ima... | Computed Tomography head without and with Intravenous contrast | 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: Indeterminate, greater than 1 cm liver lesion on initial imaging with Computed Tomography (noncontrast or single-phase) or... | Image-guided biopsy liver | 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: Acquired conductive hearing loss in absence of clinically evident mass in the middle ear.
Initial imaging. | Computed Tomography 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: Adult or child.
Secondary hyperparathyroidism.
Initial imaging. | Computed Tomography neck 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: Surveillance of stage IA and IB nonseminoma testicular cancer.
Diagnosed by orchiectomy.
No clinical suspicion of recurren... | Computed Tomography abdomen and pelvis 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.
Nonspecific dizziness without vertigo, ataxia, or other neurologic deficits.
Initial imaging. | Magnetic Resonance Imaging cervical and thoracic spine 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.
Nontraumatic acute vision loss without papilledema.
Initial imaging. | Magnetic Resonance Imaging complete spine 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.
No prior biopsy (biopsy naïve).
Initial diagnosis.
Initial imaging. | Transrectal Ultrasound prostate | 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 chest 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: Known or suspected infective endocarditis.
Additional imaging to direct patient management or treatment. | Computed Tomography chest 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: Acute respiratory illness in immunocompromised patients.
Abnormal chest radiograph, multiple, diffuse, or confluent opacit... | Computed Tomography chest without 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: Unilateral isolated weakness of the mastication muscles, paralysis of the mastication muscles, sensory abnormalities of th... | Magnetic Resonance Angiography head 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.
Secondary headache.
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: Adult.
Prior ischemic infarct.
Surveillance imaging. | Magnetic Resonance Angiography head without 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: Age greater than or equal to 16 years.
Suspected acute cervical spine blunt trauma.
Imaging indicated by NEXUS or CCR clin... | Magnetic Resonance Angiography neck without and with Intravenous contrast | The proposed procedure is **usually not appropriate**.
The strength of the evidence for this recommendation is **expert consensus**. |
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