Condition
stringclasses 232
values | Variant
stringlengths 14
869
| Procedure
stringclasses 948
values | Appropriateness Category
stringclasses 4
values | SOE
stringclasses 6
values | References
stringlengths 18
2.57k
| Adult RRL (scale)
int64 0
5
| Adult RRL (dosage)
stringclasses 6
values | Peds RRL (scale)
int64 0
5
| Peds RRL (dosage)
stringclasses 6
values | Rating
int64 1
9
| Median
float64 1
9
⌀ | Assessment - 1
int64 0
24
| Assessment - 2
int64 0
14
| Assessment - 3
int64 0
13
| Assessment - 4
int64 0
15
| Assessment - 5
int64 0
19
| Assessment - 6
int64 0
13
| Assessment - 7
int64 0
20
| Assessment - 8
int64 0
13
| Assessment - 9
int64 0
20
| __index_level_0__
int64 1
12.2k
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sinonasal Disease
|
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.
|
CT maxillofacial without IV contrast
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 25832968, "Study Quality": "4"}, {"PMID": 26001236, "Study Quality": "4"}, {"PMID": 27554662, "Study Quality": "1"}, {"PMID": 28072563, "Study Quality": "4"}, {"PMID": 27643765, "Study Quality": "4"}, {"PMID": 27193478, "Study Quality": "2"}, {"PMID": 26476379, "Study Quality": "4"}, {"PMID": 25412986, "Study Quality": "2"}]}
| 2
|
1-1mSv
| 0
| null | 9
| 9
| 1
| 0
| 0
| 1
| 0
| 0
| 2
| 0
| 13
| 6,092
|
Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
|
Suspected cerebral vasospasm. Initial imaging.
|
CT head perfusion with IV contrast
|
May be appropriate
|
Strong
|
{"References": [{"PMID": 20884748, "Study Quality": "M"}, {"PMID": 29058091, "Study Quality": "2"}, {"PMID": 25468878, "Study Quality": "4"}, {"PMID": 23982597, "Study Quality": "2"}, {"PMID": 21748499, "Study Quality": "4"}, {"PMID": 24200901, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 0
| null | 5
| 5
| 1
| 0
| 0
| 2
| 9
| 7
| 0
| 0
| 0
| 10,033
|
Acutely Limping Child Up To Age 5
|
Child up to age 5. Acute limp. Pain. Localized symptoms. No concern for infection. Initial imaging.
|
CT lower extremity area of interest without IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 15046440, "Study Quality": "3"}]}
| 0
| null | 0
| null | 1
| 1
| 11
| 3
| 0
| 2
| 0
| 0
| 0
| 0
| 0
| 718
|
Noninvasive Clinical Staging of Primary Lung Cancer
|
Noninvasive initial clinical staging of small-cell lung carcinoma.
|
FDG-PET/CT skull base to mid-thigh
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 15140545, "Study Quality": "3"}, {"PMID": 3034008, "Study Quality": "3"}, {"PMID": 15310768, "Study Quality": "2"}, {"PMID": 15258700, "Study Quality": "2"}, {"PMID": 21330566, "Study Quality": "Good"}, {"PMID": 21354739, "Study Quality": "Good"}, {"PMID": 9636830, "Study Quality": "3"}, {"PMID": 23649448, "Study Quality": "4"}, {"PMID": 23307985, "Study Quality": "4"}, {"PMID": 21409347, "Study Quality": "3"}, {"PMID": 19921339, "Study Quality": "3"}, {"PMID": 15057156, "Study Quality": "3"}]}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 9
| 9
| 0
| 0
| 0
| 0
| 0
| 0
| 2
| 2
| 9
| 3,794
|
Suspected Spine Infection
|
Suspected spine infection (such as epidural abscess or discitis osteomyelitis), with recent intervention (such as surgery with or without hardware, pain injection, or stimulator implantation). Initial imaging.
|
WBC scan and sulfur colloid scan complete spine
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 29452617, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 0
| null | 2
| 2
| 10
| 3
| 5
| 0
| 1
| 0
| 1
| 0
| 1
| 9,746
|
Palpable Breast Masses
|
Adult female, 40 years of age or older. Palpable breast mass. Mammography findings are suspicious or highly suggestive of malignancy (BI-RADS 4 or 5). Next imaging study.
|
Sestamibi MBI
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 0
| null | 1
| 1
| 14
| 2
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 5,893
|
Suspected Retroperitoneal Bleed
|
Clinically suspected retroperitoneal bleed. Initial imaging.
|
MRI abdomen and pelvis without IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 22498446, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 3
| 3
| 2
| 1
| 8
| 3
| 1
| 1
| 0
| 0
| 0
| 11,286
|
Acutely Limping Child Up To Age 5
|
Child up to age 5. Acute limp. Symptoms localized to the hip. Concern for infection. Initial imaging.
|
MRI pelvis without and with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 20180105, "Study Quality": "3"}, {"PMID": 17019590, "Study Quality": "4"}, {"PMID": 21129563, "Study Quality": "4"}, {"PMID": 17314640, "Study Quality": "3"}, {"PMID": 19380545, "Study Quality": "3"}, {"PMID": 12368368, "Study Quality": "4"}, {"PMID": 19858750, "Study Quality": "4"}, {"PMID": 26001240, "Study Quality": "4"}, {"PMID": 22268189, "Study Quality": "3"}, {"PMID": 28170361, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 8
| 8
| 1
| 0
| 0
| 0
| 0
| 1
| 5
| 6
| 3
| 735
|
Preprocedural Planning for Transcatheter Aortic Valve Replacement
|
Preintervention planning for transcatheter aortic valve replacement
|
MRA chest with IV contrast
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 31489471, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 6
| 6
| 0
| 0
| 0
| 3
| 5
| 9
| 0
| 0
| 0
| 7,018
|
Liver Lesion — Initial Characterization
|
Indeterminate, greater than 1 cm liver lesion on initial imaging with US. Known history of an extrahepatic malignancy.
|
Octreotide scan with SPECT or SPECT/CT chest and abdomen
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 19713709, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 0
| null | 4
| 4
| 2
| 1
| 1
| 6
| 5
| 1
| 1
| 0
| 0
| 4,467
|
Noninvasive Clinical Staging of Primary Lung Cancer
|
Noninvasive initial clinical staging of non–small-cell lung carcinoma.
|
Bone scan whole body
|
May be appropriate
|
Strong
|
{"References": [{"PMID": 19144446, "Study Quality": "3"}, {"PMID": 21354739, "Study Quality": "Good"}, {"PMID": 21094027, "Study Quality": "Good"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 5
| 5
| 1
| 0
| 1
| 4
| 5
| 2
| 0
| 0
| 0
| 3,781
|
Acute Pyelonephritis
|
Suspected acute pyelonephritis. Complicated patient (eg, recurrent pyelonephritis, diabetes, immune compromise, advanced age, vesicoureteral reflux, or lack of response to initial therapy). Initial imaging.
|
Fluoroscopy antegrade pyelography
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 18203942, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 0
| null | 1
| 1
| 13
| 2
| 1
| 0
| 0
| 0
| 0
| 1
| 0
| 5,728
|
Acute Trauma to the Knee
|
Adult or child 5 years of age or older. Significant trauma to the knee (eg, motor vehicle accident, knee dislocation). Initial imaging.
|
CT knee without and with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 16392612, "Study Quality": "3"}]}
| 1
|
1 mSv
| 2
|
3 mSv
| 1
| 1
| 17
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 2,140
|
Pancreatic Cyst
|
Incidentally detected pancreatic cyst greater than 2.5 cm in size. High-risk stigmata or worrisome features. Initial evaluation.
|
CT abdomen without and with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 27161060, "Study Quality": "3"}, {"PMID": 22520033, "Study Quality": "4"}, {"PMID": 28533111, "Study Quality": "4"}, {"PMID": 28735806, "Study Quality": "4"}, {"PMID": 16327281, "Study Quality": "4"}, {"PMID": 22687371, "Study Quality": "4"}, {"PMID": 25805375, "Study Quality": "4"}, {"PMID": -3141673, "Study Quality": "4"}, {"PMID": 24355035, "Study Quality": "4"}, {"PMID": 22347959, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 5
|
10-30 mSv
| 3
| 3
| 1
| 6
| 5
| 2
| 3
| 0
| 0
| 0
| 0
| 9,677
|
Congenital or Acquired Heart Disease
|
Child or adult. Known single ventricle physiology. Postoperative evaluation after stage 3 single ventricle palliation (total cavopulmonary connection). Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study.
|
MRA chest without IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": -3194076, "Study Quality": "4"}, {"PMID": 12234957, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 7
| 7
| 1
| 0
| 1
| 0
| 5
| 1
| 10
| 3
| 1
| 8,917
|
Post Treatment Follow-up and Active Surveillance of Renal Cell Carcinoma
|
Follow-up for clinically localized renal cell carcinoma; post ablation.
|
FDG-PET/CT skull base to mid-thigh
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 26996777, "Study Quality": "3"}, {"PMID": 23665399, "Study Quality": "4"}, {"PMID": 28596261, "Study Quality": "4"}, {"PMID": 30803729, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 2
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 909
|
Dizziness and Ataxia
|
Adult. Chronic recurrent vertigo. Associated with unilateral hearing loss or tinnitus. Initial imaging.
|
CTA head and neck with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 18
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 4,682
|
Suspected Spine Trauma
|
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.
|
MRI cervical spine without IV contrast
|
Usually not appropriate
|
Strong
|
{"References": [{"PMID": 25997715, "Study Quality": "4"}, {"PMID": 25769487, "Study Quality": "3"}, {"PMID": 24731570, "Study Quality": "3"}, {"PMID": 24033302, "Study Quality": "3"}, {"PMID": 27893647, "Study Quality": "2"}, {"PMID": 21619408, "Study Quality": "M"}, {"PMID": 20336892, "Study Quality": "4"}, {"PMID": 20065765, "Study Quality": "M"}, {"PMID": 18188119, "Study Quality": "M"}, {"PMID": 18073599, "Study Quality": "4"}, {"PMID": 18469647, "Study Quality": "3"}, {"PMID": 18404054, "Study Quality": "4"}, {"PMID": 16374279, "Study Quality": "2"}, {"PMID": 27438681, "Study Quality": "2"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 15
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 496
|
Staging and Follow-up of Vulvar Cancer
|
Initial staging of pretreatment vulvar cancer
|
CT abdomen and pelvis without IV contrast
|
May be appropriate (Disagreement)
|
Expert Opinion
|
{"References": [{"PMID": 16445651, "Study Quality": "3"}, {"PMID": -3165329, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 5
| 5
| 1
| 4
| 3
| 4
| 1
| 0
| 1
| 1
| 0
| 9,311
|
Diffuse Lung Disease
|
Confirmed diffuse lung disease. Suspected acute exacerbation or acute deterioration. Initial Imaging.
|
Radiography chest
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 8153310, "Study Quality": "2"}, {"PMID": 1535900, "Study Quality": "4"}, {"PMID": 2717730, "Study Quality": "2"}, {"PMID": 25810444, "Study Quality": "2"}, {"PMID": 23293132, "Study Quality": "3"}, {"PMID": 24953093, "Study Quality": "2"}, {"PMID": 24038345, "Study Quality": "2"}, {"PMID": 19997848, "Study Quality": "2"}, {"PMID": 21622551, "Study Quality": "2"}, {"PMID": 2928513, "Study Quality": "4"}, {"PMID": 2217770, "Study Quality": "4"}, {"PMID": 2006262, "Study Quality": "2"}, {"PMID": 1959296, "Study Quality": "2"}, {"PMID": 22098943, "Study Quality": "4"}, {"PMID": 30344228, "Study Quality": "2"}]}
| 1
|
1 mSv
| 1
|
03 mSv
| 8
| 8
| 0
| 0
| 0
| 0
| 0
| 0
| 6
| 2
| 4
| 10,269
|
Orbits, Vision, and Visual Loss
|
Ophthalmoplegia or diplopia. Initial imaging.
|
MRI head without and with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 22284056, "Study Quality": "4"}, {"PMID": 19016810, "Study Quality": "4"}, {"PMID": 15531324, "Study Quality": "4"}, {"PMID": 27448831, "Study Quality": "3"}, {"PMID": 27768791, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 9
| 9
| 0
| 0
| 0
| 0
| 0
| 0
| 3
| 4
| 10
| 5,497
|
Lower Extremity Arterial Revascularization-Post-Therapy Imaging
|
Previous infrainguinal endovascular therapy or bypass. Asymptomatic. Surveillance.
|
MRA lower extremity without and with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 21618851, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 3
| 3
| 0
| 6
| 8
| 1
| 0
| 0
| 0
| 0
| 0
| 8,385
|
Head Trauma-Child
|
Child. Minor acute blunt head trauma. Very low risk for clinically important brain injury per PECARN criteria. Excluding suspected abusive head trauma. Initial imaging.
|
MRI head without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 27488722, "Study Quality": "3"}, {"PMID": 26584662, "Study Quality": "3"}, {"PMID": 24927811, "Study Quality": "4"}, {"PMID": 24431418, "Study Quality": "3"}, {"PMID": 19758692, "Study Quality": "2"}, {"PMID": 24635987, "Study Quality": "1"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 13
| 1
| 1
| 1
| 3
| 0
| 0
| 0
| 0
| 7,120
|
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
|
Clinically suspected prostate cancer. No prior biopsy (biopsy naïve). Initial diagnosis. Initial imaging.
|
CT chest abdomen pelvis without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 5
|
10-30 mSv
| 1
| 1
| 10
| 3
| 0
| 0
| 0
| 0
| 1
| 0
| 0
| 1,206
|
Hearing Loss and/or Vertigo
|
Congenital hearing loss or total deafness or cochlear implant candidate. Surgical planning.
|
CT head with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 26810296, "Study Quality": "3"}, {"PMID": 25573134, "Study Quality": "3"}, {"PMID": 25208295, "Study Quality": "4"}, {"PMID": 24232063, "Study Quality": "3"}, {"PMID": 306012, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 3
|
3-3 mSv
| 1
| 1
| 8
| 2
| 5
| 0
| 0
| 0
| 0
| 0
| 0
| 5,667
|
Liver Lesion — Initial Characterization
|
Indeterminate, greater than 1 cm liver lesion on initial imaging with CT (noncontrast or single-phase) or noncontrast MRI. Normal liver. No suspicion or evidence of extrahepatic malignancy or underlying liver disease.
|
MRI abdomen without and with IV contrast
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 19459531, "Study Quality": "2"}, {"PMID": 18580333, "Study Quality": "1"}, {"PMID": 21597893, "Study Quality": "2"}, {"PMID": 20578020, "Study Quality": "2"}, {"PMID": 23776623, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 8
| 8
| 0
| 0
| 1
| 0
| 0
| 0
| 2
| 7
| 7
| 4,448
|
Hematuria
|
Microhematuria. Patients with risk factors, without any of the following
|
CT abdomen and pelvis without and with IV contrast
|
May be appropriate
|
Expert Consensus
|
{"References": [{"PMID": 17222650, "Study Quality": "3"}, {"PMID": 19058939, "Study Quality": "M"}]}
| 4
|
10-30 mSv
| 5
|
10-30 mSv
| 5
| 5
| 0
| 0
| 2
| 6
| 8
| 1
| 0
| 0
| 0
| 5,817
|
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
|
Clinically suspected prostate cancer. No prior biopsy (biopsy naïve). Initial diagnosis. Initial imaging.
|
MRI whole body without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 9
| 3
| 0
| 1
| 1
| 0
| 0
| 0
| 0
| 1,195
|
Cranial Neuropathy
|
Unilateral isolated weakness or paralysis of the tongue (hypoglossal nerve, CN XII). Initial imaging.
|
MRA head and neck without IV contrast
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 19770343, "Study Quality": "4"}, {"PMID": 24458034, "Study Quality": "3"}, {"PMID": 18635617, "Study Quality": "2"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 2
| 0
| 2
| 4
| 11
| 1
| 0
| 0
| 0
| 6,500
|
Hearing Loss and/or Vertigo
|
Acquired conductive hearing loss in absence of clinically evident mass in the middle ear. Initial imaging.
|
CT head without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 27430449, "Study Quality": "4"}, {"PMID": 26491893, "Study Quality": "4"}, {"PMID": 24625612, "Study Quality": "2"}, {"PMID": 24162764, "Study Quality": "2"}, {"PMID": 21739095, "Study Quality": "4"}, {"PMID": 12563123, "Study Quality": "2"}, {"PMID": 16424241, "Study Quality": "2"}, {"PMID": 19733309, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 10
| 4
| 0
| 1
| 0
| 0
| 0
| 0
| 0
| 5,616
|
Supplemental Breast Cancer Screening Based on Breast Density
|
Supplemental breast cancer screening. Intermediate-risk females with dense breasts.
|
Mammography with IV contrast
|
May be appropriate
|
Strong
|
{"References": [{"PMID": 24928280, "Study Quality": "3"}, {"PMID": 24986697, "Study Quality": "3"}, {"PMID": 27097789, "Study Quality": "3"}, {"PMID": 24696228, "Study Quality": "2"}]}
| 2
|
1-1mSv
| 0
| null | 5
| 5
| 0
| 0
| 1
| 2
| 10
| 3
| 1
| 0
| 0
| 10,465
|
Sinonasal Disease
|
Acute (less than 4 weeks) uncomplicated rhinosinusitis. Initial Imaging.
|
CT maxillofacial with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 8259141, "Study Quality": "3"}, {"PMID": 26253983, "Study Quality": "4"}, {"PMID": 25833927, "Study Quality": "4"}]}
| 2
|
1-1mSv
| 0
| null | 1
| 1
| 11
| 5
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 6,062
|
Management of Uterine Fibroids
|
Reproductive age patient with uterine fibroids desiring pregnancy and experiencing reproductive dysfunction. Initial therapy.
|
MR-guided high-frequency focused ultrasound ablation
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 21570071, "Study Quality": "4"}, {"PMID": 21611041, "Study Quality": "4"}, {"PMID": 17292361, "Study Quality": "4"}]}
| 0
| null | 0
| null | 5
| 5
| 0
| 0
| 0
| 3
| 6
| 1
| 1
| 0
| 0
| 6,334
|
Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot)
|
Suspected soft tissue infection. History of puncture wound with possible retained foreign body. Radiographs normal. Next imaging study.
|
CT area of interest without and with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 24951233, "Study Quality": "4"}, {"PMID": 33136481, "Study Quality": "4"}]}
| 0
| null | 0
| null | 7
| 7
| 0
| 0
| 1
| 1
| 4
| 1
| 5
| 1
| 1
| 7,729
|
Sepsis
|
Suspected or confirmed sepsis. Cough or dyspnea or chest pain. Initial imaging.
|
CT chest without IV contrast
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 32971451, "Study Quality": "2"}, {"PMID": 25468363, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 6
| 6
| 0
| 1
| 0
| 1
| 8
| 10
| 1
| 1
| 1
| 11,782
|
Radiologic Management of Biliary Obstruction
|
Initial therapeutic procedure for a patient with dilated bile ducts and coagulopathy (INR >2.0 or platelet count <60 K).
|
Permanent biliary metallic stent
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 0
| null | 0
| null | 1
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 288
|
Chronic Knee Pain
|
Adult or child greater than or equal to 5 years of age. Chronic knee pain. Initial knee radiograph negative or demonstrates joint effusion. Next imaging procedure.
|
CT knee without IV contrast
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 25442030, "Study Quality": "4"}]}
| 1
|
1 mSv
| 2
|
3 mSv
| 5
| 5
| 0
| 1
| 0
| 1
| 11
| 4
| 0
| 0
| 0
| 2,818
|
Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded)
|
Suspected nonischemic dilated and unclassified cardiomyopathy. Ischemic cardiomyopathy already excluded. Initial imaging.
|
MRI chest without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 26272522, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 8
| 3
| 3
| 0
| 0
| 0
| 1
| 0
| 0
| 6,911
|
Chronic Shoulder Pain
|
Chronic shoulder pain. Suspect adhesive capsulitis. Initial radiographs normal or inconclusive. Next imaging study.
|
MRI shoulder without IV contrast
|
Usually appropriate
|
Moderate
|
{"References": [{"PMID": 23082152, "Study Quality": "4"}, {"PMID": 28410478, "Study Quality": "2"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 8
| 8
| 1
| 0
| 0
| 0
| 2
| 2
| 1
| 5
| 6
| 8,298
|
Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix
|
Initial systemic staging of pretreatment cervical cancer; assessment of lymph node and distant metastases (N/M staging).
|
MRI abdomen without IV contrast
|
May be appropriate
|
Expert Consensus
|
{"References": [{"PMID": 32636272, "Study Quality": "4"}, {"PMID": 18201753, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 0
| 0
| 0
| 1
| 8
| 1
| 0
| 1
| 0
| 3,954
|
Suspected Spine Trauma-Child
|
Child, 3 to 16 years of age, acute cervical spine trauma, at least one risk factor with reliable clinical examination (based on PECARN or NEXUS). Initial imaging.
|
CT cervical spine without and with IV contrast
|
Usually not appropriate
|
Strong
|
{"References": [{"PMID": 27043893, "Study Quality": "2"}, {"PMID": 23114489, "Study Quality": "4"}, {"PMID": 23511151, "Study Quality": "3"}, {"PMID": 22531194, "Study Quality": "2"}, {"PMID": 18073623, "Study Quality": "4"}, {"PMID": 15920400, "Study Quality": "M"}, {"PMID": 19741398, "Study Quality": "4"}, {"PMID": 20889081, "Study Quality": "4"}, {"PMID": 18301348, "Study Quality": "4"}, {"PMID": 19396479, "Study Quality": "3"}, {"PMID": 24528980, "Study Quality": "3"}, {"PMID": 15920399, "Study Quality": "3"}, {"PMID": 15920398, "Study Quality": "3"}, {"PMID": 23584614, "Study Quality": "3"}, {"PMID": 25033993, "Study Quality": "2"}, {"PMID": 23453711, "Study Quality": "3"}, {"PMID": 16374279, "Study Quality": "2"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 19
| 4
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 8,223
|
Gestational Trophoblastic Disease
|
Assessment of complications
|
CT chest with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 25126425, "Study Quality": "4"}, {"PMID": 22085657, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 7
| 7
| 0
| 0
| 1
| 0
| 5
| 2
| 3
| 3
| 2
| 9,142
|
Left Lower Quadrant Pain
|
Left lower quadrant pain. Initial imaging.
|
US abdomen transabdominal
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 25816854, "Study Quality": "4"}, {"PMID": 31930228, "Study Quality": "4"}, {"PMID": 21365197, "Study Quality": "2"}, {"PMID": 30616263, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 1
| 0
| 4
| 3
| 5
| 4
| 0
| 0
| 0
| 388
|
Post-Treatment Surveillance of Bladder Cancer
|
Nonmuscle invasive bladder cancer with symptoms or risk factors. Post-treatment surveillance.
|
FDG-PET/CT skull base to mid-thigh
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 3
| 3
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 836
|
Multiple Gestations
|
Multiple gestations. Monochorionic twins. Second trimester anatomy examination. Follow-up imaging.
|
MRI fetal without IV contrast
|
May be appropriate
|
Expert Consensus
|
{"References": []}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 0
| 0
| 0
| 5
| 2
| 4
| 0
| 0
| 0
| 4,049
|
Pulmonary Arteriovenous Malformation (PAVM)
|
Adult. Presenting with a transient ischemic attack, or seizures, or brain abscess, or altered sensorium. Chest radiography reveals a lung nodule. Suspected pulmonary arteriovenous malformation (PAVM). Next imaging study.
|
Radiography chest
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 14742303, "Study Quality": "3"}, {"PMID": 29141890, "Study Quality": "4"}]}
| 1
|
1 mSv
| 1
|
03 mSv
| 2
| 2
| 9
| 3
| 3
| 3
| 1
| 0
| 1
| 0
| 0
| 7,443
|
Radiologic Management of Biliary Obstruction
|
Initial therapeutic procedure for a patient with hilar biliary obstruction from malignant etiology (eg, Klatskin tumor).
|
Endoscopic US-guided biliary drainage (EUS-BD)
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 25264761, "Study Quality": "2"}, {"PMID": 25024600, "Study Quality": "4"}, {"PMID": 23711555, "Study Quality": "4"}, {"PMID": 26379410, "Study Quality": "4"}]}
| 0
| null | 0
| null | 3
| 3
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 280
|
Headache
|
Headache with features of intracranial hypotension (eg, positional, worse when upright, better when lying down). Initial imaging.
|
MRI thoracic spine with IV contrast
|
May be appropriate (Disagreement)
|
Expert Opinion
|
{"References": []}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 5
| 1
| 0
| 0
| 8
| 4
| 0
| 0
| 0
| 5,149
|
Myelopathy
|
Acute onset myelopathy. Initial imaging.
|
CTA spine area of interest with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 29500319, "Study Quality": "4"}, {"PMID": 19967536, "Study Quality": "2"}]}
| 0
| null | 0
| null | 3
| 3
| 4
| 4
| 1
| 5
| 2
| 0
| 0
| 0
| 0
| 5,303
|
Radiologic Management of Gastric Varices
|
Cirrhotic patient bleeding from small, low flow gastric varices and moderate ascites with a MELD score of 18. MRI does not demonstrate a gastrorenal shunt.
|
Partial splenic embolization
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 23939627, "Study Quality": "2"}, {"PMID": 21618687, "Study Quality": "4"}]}
| 0
| null | 0
| null | 5
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 6,772
|
Sinonasal Disease
|
Acute (less than 4 weeks) uncomplicated rhinosinusitis. Initial Imaging.
|
SPECT or SPECT/CT paranasal sinuses
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 16
| 0
| 2
| 0
| 0
| 0
| 0
| 0
| 0
| 6,069
|
Pretreatment Staging of Urothelial Cancer
|
Adult. Nonmuscle invasive bladder cancer. Pretreatment staging.
|
MRI abdomen without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 21178055, "Study Quality": "4"}, {"PMID": 12712482, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 2
| 2
| 3
| 4
| 2
| 0
| 2
| 1
| 0
| 0
| 0
| 1,112
|
Cervical Neck Pain or Cervical Radiculopathy
|
Chronic cervical or neck pain without or with radiculopathy. Radiographs show ossification in the posterior longitudinal ligament (OPLL). Next imaging study.
|
MRA neck with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 1636514, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 12
| 2
| 3
| 0
| 1
| 0
| 0
| 0
| 0
| 2,608
|
Abnormal Liver Function Tests
|
Abnormal liver function tests. Cholestatic predominance. Elevated alkaline phosphatase with or without elevated gamma-glutamyl transpeptidase. Initial imaging.
|
CT abdomen and pelvis with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 28154908, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 7
| 7
| 0
| 0
| 1
| 1
| 2
| 2
| 6
| 4
| 0
| 10,503
|
Imaging after Mastectomy and Breast Reconstruction
|
Female. Palpable lump or clinically significant pain on the side of the mastectomy without reconstruction. Initial imaging.
|
Sestamibi MBI
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 20965904, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 0
| null | 2
| 2
| 7
| 4
| 3
| 0
| 0
| 0
| 0
| 0
| 0
| 10,214
|
Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
|
Known acute subarachnoid hemorrhage (SAH) on CT. Next imaging study.
|
CT head without and with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 31685104, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 14
| 3
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 10,024
|
Chronic Dyspnea-Noncardiovascular Origin
|
Chronic dyspnea. Suspected disease of the pleura or chest wall. Initial imaging.
|
FDG-PET/CT skull base to mid-thigh
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 2
| 2
| 5
| 3
| 3
| 1
| 1
| 0
| 0
| 0
| 0
| 3,643
|
Ataxia-Child
|
Child. Chronic progressive ataxia. Initial imaging.
|
CT complete spine without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 1
| 1
| 15
| 0
| 2
| 0
| 1
| 0
| 0
| 0
| 0
| 10,838
|
Central Venous Access Device and Site Selection
|
Device selection
|
Tunneled dialysis catheter
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 29202728, "Study Quality": "2"}]}
| 0
| null | 0
| null | 7
| 7
| 0
| 0
| 0
| 2
| 0
| 2
| 8
| 3
| 0
| 7,744
|
Radiologic Management of Biliary Obstruction
|
Initial therapeutic procedure for a patient with dilated bile ducts and suspected biliary sepsis or acute cholangitis.
|
Permanent biliary metallic stent
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 28834389, "Study Quality": "1"}]}
| 0
| null | 0
| null | 1
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 267
|
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
|
Adult. Prior ischemic infarct. Surveillance imaging.
|
MRV head without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 27939758, "Study Quality": "2"}, {"PMID": 22068990, "Study Quality": "2"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 11
| 2
| 3
| 0
| 2
| 0
| 0
| 0
| 1
| 9,867
|
Management of Liver Cancer
|
Metastatic liver disease
|
Surgical liver resection
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 12831921, "Study Quality": "2"}, {"PMID": 7817996, "Study Quality": "3"}, {"PMID": 22658833, "Study Quality": "4"}, {"PMID": 24655881, "Study Quality": "3"}, {"PMID": 1701060, "Study Quality": "4"}]}
| 0
| null | 0
| null | 4
| 4
| 0
| 3
| 2
| 4
| 4
| 1
| 1
| 0
| 0
| 1,598
|
Preprocedural Planning for Transcatheter Aortic Valve Replacement
|
Preintervention planning for transcatheter aortic valve replacement
|
CT heart function and morphology with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 2
| 2
| 8
| 2
| 6
| 0
| 0
| 1
| 0
| 0
| 0
| 7,050
|
Sinonasal Disease
|
Suspected CSF leak. Initial Imaging.
|
MRI orbits face neck without and with IV contrast
|
May be appropriate (Disagreement)
|
Expert Opinion
|
{"References": [{"PMID": 18710972, "Study Quality": "4"}, {"PMID": 12087336, "Study Quality": "3"}, {"PMID": 27890184, "Study Quality": "4"}, {"PMID": 27738899, "Study Quality": "2"}, {"PMID": 26370330, "Study Quality": "4"}, {"PMID": 16145599, "Study Quality": "2"}, {"PMID": 9576647, "Study Quality": "2"}, {"PMID": 17970620, "Study Quality": "2"}, {"PMID": 19723768, "Study Quality": "3"}, {"PMID": 19762462, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 2
| 0
| 1
| 2
| 5
| 3
| 2
| 2
| 0
| 6,158
|
Hydronephrosis on Prior Imaging-Unknown Cause
|
Adult. Asymptomatic bilateral hydronephrosis or asymptomatic hydronephrosis in a solitary kidney with unknown cause. Initial imaging.
|
CT abdomen without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 2
| 2
| 5
| 4
| 2
| 2
| 1
| 1
| 0
| 0
| 0
| 12,125
|
Ataxia-Child
|
Child. Acute ataxia, no history of recent trauma. Initial imaging.
|
CT chest abdomen pelvis without IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 23683541, "Study Quality": "4"}, {"PMID": 24716559, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 1
| 1
| 15
| 2
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 10,766
|
Chronic Hand and Wrist Pain
|
Adult. Chronic hand or wrist pain. Radiographs normal or show nonspecific arthritis. Suspect tendon injury, tenosynovitis, or tendon pathology. Next imaging study.
|
CT arthrography area of interest
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 0
| null | 0
| null | 1
| 1
| 11
| 1
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 2,678
|
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
|
Adult. Known venous sinus thrombosis. Surveillance imaging.
|
MRI head perfusion with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 24172883, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 2
| 2
| 8
| 3
| 4
| 3
| 1
| 0
| 0
| 0
| 0
| 9,923
|
Dialysis Fistula Malfunction
|
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.
|
CTV extremity area of interest with IV contrast
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 32778223, "Study Quality": "4"}]}
| 0
| null | 0
| null | 2
| 2
| 5
| 6
| 2
| 0
| 0
| 0
| 1
| 1
| 0
| 10,649
|
Ovarian Cancer Screening
|
Ovarian cancer screening. Postmenopausal. High risk (personal history or family history or known or suspected genetic predisposition or elevated CA-125).
|
US pelvis transvaginal
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 23822892, "Study Quality": "M"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 6
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 4,111
|
Radiologic Management of Gastric Varices
|
Cirrhotic patient bleeding from large high flow gastric varices with a MELD score of 12 and a hepatic wedge pressure of 10 mmHg. MRI demonstrates a large gastrorenal shunt.
|
TIPS
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 3391371, "Study Quality": "2"}]}
| 0
| null | 0
| null | 7
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 6,786
|
Staging of Renal Cell Carcinoma
|
Renal cell carcinoma. Contraindication only to iodinated CT intravenous contrast. Staging.
|
Bone scan whole body
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": -3195129, "Study Quality": "4"}, {"PMID": 11696720, "Study Quality": "3"}, {"PMID": 4060382, "Study Quality": "3"}, {"PMID": 30803729, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 3
| 3
| 4
| 2
| 3
| 2
| 4
| 0
| 0
| 1
| 0
| 1,379
|
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
|
Adult. Focal neurologic deficit. Clinically suspected acute ischemic stroke. Initial imaging.
|
MRV head without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 11
| 3
| 4
| 1
| 2
| 0
| 0
| 0
| 0
| 9,811
|
Movement Disorders and Neurodegenerative Diseases
|
Suspected motor neuron disease. Initial imaging.
|
CT head with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 3
|
3-3 mSv
| 1
| 1
| 10
| 0
| 2
| 0
| 0
| 2
| 0
| 0
| 0
| 9,616
|
Right Lower Quadrant Pain
|
Right lower quadrant pain. Initial imaging.
|
CT abdomen and pelvis with IV contrast
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 26341808, "Study Quality": "2"}, {"PMID": 25419588, "Study Quality": "3"}, {"PMID": 23023965, "Study Quality": "2"}, {"PMID": 19843741, "Study Quality": "2"}, {"PMID": 19733421, "Study Quality": "4"}, {"PMID": 2239906, "Study Quality": "4"}, {"PMID": 31743429, "Study Quality": "Good"}, {"PMID": 31219315, "Study Quality": "4"}, {"PMID": 32684379, "Study Quality": "3"}, {"PMID": 33211574, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 9
| 9
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 5
| 12
| 416
|
Tinnitus
|
Pulsatile tinnitus, unilateral or bilateral; No retrotympanic lesion on otoscopy. Initial imaging.
|
MRV head without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 0
|
0 mSv
| 0
|
0 mSv
| 2
| 2
| 7
| 4
| 4
| 3
| 1
| 0
| 0
| 0
| 0
| 7,524
|
Low Back Pain
|
Subacute or chronic low back pain with or without radiculopathy. No red flags. No prior management. Initial imaging.
|
MRI lumbar spine without IV contrast
|
Usually not appropriate
|
Strong
|
{"References": [{"PMID": 21282698, "Study Quality": "4"}, {"PMID": 12783911, "Study Quality": "1"}, {"PMID": 16244269, "Study Quality": "1"}, {"PMID": 25781443, "Study Quality": "3"}, {"PMID": 23910019, "Study Quality": "2"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 13
| 5
| 1
| 3
| 0
| 0
| 0
| 0
| 0
| 5,225
|
Nonvariceal Upper Gastrointestinal Bleeding
|
Adult. Postsurgical or traumatic causes of nonvariceal upper gastrointestinal bleeding. Endoscopy is contraindicated. Initial imaging.
|
CT enterography
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 34597220, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 4
| 4
| 1
| 2
| 2
| 3
| 3
| 2
| 0
| 0
| 0
| 1,962
|
Dementia and Movement Disorders
|
Suspected vascular dementia.
|
CT head without IV contrast
|
May be appropriate
| null |
{"References": []}
| 3
|
1-10 mSv
| 3
|
3-3 mSv
| 6
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 620
|
Chest Pain-Possible Acute Coronary Syndrome
|
Chest pain, high probability for acute coronary syndrome. Initial imaging.
|
MRI heart with function and inotropic stress without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 26883335, "Study Quality": "4"}, {"PMID": 27593539, "Study Quality": "3"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 9
| 2
| 3
| 0
| 0
| 1
| 1
| 0
| 0
| 1,703
|
Cranial Neuropathy
|
Unilateral isolated weakness or paralysis of the tongue (hypoglossal nerve, CN XII). Initial imaging.
|
CT temporal bone with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 0
| null | 1
| 1
| 16
| 2
| 1
| 0
| 1
| 0
| 0
| 0
| 0
| 6,515
|
Cranial Neuropathy
|
Unilateral isolated weakness or paralysis of the tongue (hypoglossal nerve, CN XII). Initial imaging.
|
CT temporal bone without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 0
| null | 1
| 1
| 15
| 3
| 1
| 1
| 0
| 0
| 0
| 0
| 0
| 6,517
|
Sinusitis–Child
|
Child. Sinusitis with clinical concern of orbital or intracranial complications. Initial imaging.
|
CTV head with IV contrast
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 11889374, "Study Quality": "3"}, {"PMID": 21416657, "Study Quality": "4"}, {"PMID": 16025049, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 5
| 5
| 0
| 0
| 0
| 2
| 8
| 3
| 5
| 0
| 0
| 3,353
|
Imaging After Shoulder Arthroplasty
|
Symptomatic patient with a primary shoulder arthroplasty, infection excluded. Suspected loosening. Additional imaging following radiographs.
|
3-phase bone scan with SPECT or SPECT/CT shoulder
|
May be appropriate
|
Limited
|
{"References": [{"PMID": 19038601, "Study Quality": "4"}, {"PMID": 536788, "Study Quality": "4"}, {"PMID": 30193652, "Study Quality": "4"}, {"PMID": -3194396, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 5
| 5
| 0
| 0
| 5
| 1
| 7
| 1
| 0
| 0
| 0
| 7,825
|
Cranial Neuropathy
|
Unilateral isolated weakness or paralysis of the tongue (hypoglossal nerve, CN XII). Initial imaging.
|
MRI head without and with IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 18832666, "Study Quality": "3"}, {"PMID": 12066914, "Study Quality": "3"}, {"PMID": 30648931, "Study Quality": "4"}, {"PMID": 25043533, "Study Quality": "2"}, {"PMID": 24210309, "Study Quality": "4"}, {"PMID": 28109859, "Study Quality": "4"}, {"PMID": 23192210, "Study Quality": "4"}, {"PMID": 9282872, "Study Quality": "4"}, {"PMID": 18065504, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 7
| 7
| 0
| 0
| 0
| 0
| 4
| 1
| 6
| 3
| 6
| 6,495
|
Newly Diagnosed Palpable Scrotal Abnormality
|
Newly diagnosed palpable scrotal abnormality. History of trauma or infection. Initial imaging.
|
CT abdomen and pelvis with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 9
| 3
| 1
| 0
| 1
| 0
| 0
| 0
| 0
| 11,342
|
Acute Pelvic Pain in the Reproductive Age Group
|
Acute pelvic pain in the reproductive age group. Nongynecological etiology suspected, ß-hCG positive (either urine or serum). Initial imaging.
|
CT pelvis without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 1
| 1
| 11
| 0
| 2
| 0
| 1
| 0
| 0
| 0
| 0
| 6,214
|
Cervical Neck Pain or Cervical Radiculopathy
|
Prior cervical spine surgery. New or increasing nontraumatic cervical or neck pain or radiculopathy. Initial imaging.
|
Bone scan whole body with SPECT or SPECT/CT neck
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 11037993, "Study Quality": "1"}, {"PMID": 9171175, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| null | 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 0
| 2,516
|
Major Blunt Trauma
|
Major blunt trauma. Hemodynamically stable. Suspected facial injury. Initial imaging.
|
CT head with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 22964404, "Study Quality": "4"}, {"PMID": 16702454, "Study Quality": "4"}, {"PMID": 15730983, "Study Quality": "3"}]}
| 3
|
1-10 mSv
| 3
|
3-3 mSv
| 2
| 2
| 3
| 6
| 2
| 1
| 0
| 1
| 0
| 0
| 1
| 9,371
|
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
|
Clinically suspected prostate cancer. No prior biopsy (biopsy naïve). Initial diagnosis. Initial imaging.
|
MRI pelvis without and with IV contrast
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 26215604, "Study Quality": "M"}, {"PMID": 30667329, "Study Quality": "3"}, {"PMID": 27439401, "Study Quality": "3"}, {"PMID": 26395278, "Study Quality": "2"}, {"PMID": 27488931, "Study Quality": "3"}, {"PMID": 28336078, "Study Quality": "Good"}, {"PMID": 30268722, "Study Quality": "2"}, {"PMID": 29341356, "Study Quality": "2"}, {"PMID": 28570099, "Study Quality": "2"}, {"PMID": 27101772, "Study Quality": "3"}, {"PMID": 28196723, "Study Quality": "Good"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 9
| 9
| 0
| 1
| 0
| 0
| 0
| 0
| 1
| 5
| 7
| 1,190
|
Staging and Follow-up of Vulvar Cancer
|
Initial staging of pretreatment vulvar cancer
|
MRI pelvis without IV contrast
|
May be appropriate (Disagreement)
|
Expert Opinion
|
{"References": [{"PMID": 20092880, "Study Quality": "2"}, {"PMID": 11804896, "Study Quality": "3"}, {"PMID": 16859737, "Study Quality": "3"}, {"PMID": 16803503, "Study Quality": "2"}, {"PMID": 12409110, "Study Quality": "3"}, {"PMID": -3165329, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 5
| 5
| 0
| 1
| 1
| 0
| 5
| 1
| 6
| 1
| 0
| 9,289
|
Lower Extremity Chronic Venous Disease
|
Varicose veins. Initial diagnosis.
|
Catheter venography iliac veins
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 23482555, "Study Quality": "4"}]}
| 4
|
10-30 mSv
| 0
| null | 3
| 3
| 1
| 7
| 3
| 2
| 1
| 2
| 0
| 0
| 0
| 6,227
|
Staging and Post-Therapy Assessment of Head and Neck Cancer
|
Suspected or diagnosed nasopharynx cancer or EBV-associated unknown primary of the head and neck. Initial staging.
|
CT neck with IV contrast
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 31635767, "Study Quality": "4"}, {"PMID": 11130825, "Study Quality": "2"}, {"PMID": 25348201, "Study Quality": "Good"}, {"PMID": 18704401, "Study Quality": "2"}, {"PMID": 30912815, "Study Quality": "2"}]}
| 3
|
1-10 mSv
| 3
|
3-3 mSv
| 8
| 8
| 0
| 0
| 0
| 0
| 0
| 3
| 4
| 3
| 8
| 11,898
|
Urinary Tract Infection–Child
|
Child assigned male at birth (AMB). Younger than 2 months of age. First febrile urinary tract infection with appropriate response to medical management. Initial imaging.
|
MRU without and with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": -3192173, "Study Quality": "4"}, {"PMID": 10321827, "Study Quality": "4"}, {"PMID": 22698573, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 1
| 1
| 13
| 2
| 1
| 0
| 1
| 1
| 0
| 0
| 0
| 3,425
|
Plexopathy
|
Lumbosacral plexopathy, known malignancy or post-treatment syndrome. Initial imaging.
|
CT lumbar spine without IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 1
| 1
| 13
| 1
| 3
| 2
| 0
| 0
| 0
| 1
| 0
| 5,605
|
Clinically Suspected Adnexal Mass, No Acute Symptoms
|
Female . Adnexal mass, indeterminate on initial pelvic US, no acute symptoms. Pregnant. Next imaging study for characterization.
|
FDG-PET/CT skull base to mid-thigh
|
Usually not appropriate
|
Expert Consensus
|
{"References": []}
| 4
|
10-30 mSv
| 4
|
3-10 mSv
| 1
| 1
| 13
| 0
| 1
| 0
| 0
| 0
| 0
| 0
| 0
| 4,219
|
Cranial Neuropathy
|
Unilateral isolated weakness or paralysis of the tongue (hypoglossal nerve, CN XII). Initial imaging.
|
CT maxillofacial with IV contrast
|
Usually not appropriate
|
Expert Consensus
|
{"References": [{"PMID": 12066914, "Study Quality": "3"}, {"PMID": 25043533, "Study Quality": "2"}, {"PMID": 24210309, "Study Quality": "4"}, {"PMID": 28109859, "Study Quality": "4"}, {"PMID": 18065504, "Study Quality": "4"}]}
| 2
|
1-1mSv
| 0
| null | 1
| 1
| 13
| 3
| 1
| 1
| 0
| 1
| 1
| 0
| 0
| 6,508
|
Growth Disturbances–Risk of Fetal Growth Restriction
|
Established fetal growth restriction. Follow-up evaluation.
|
US duplex Doppler ductus venosus
|
Usually appropriate
|
Strong
|
{"References": [{"PMID": 25747582, "Study Quality": "2"}, {"PMID": 28032647, "Study Quality": "2"}, {"PMID": 16319247, "Study Quality": "3"}, {"PMID": 27854382, "Study Quality": "4"}, {"PMID": 28938063, "Study Quality": "4"}]}
| 0
|
0 mSv
| 0
|
0 mSv
| 7
| 7
| 0
| 0
| 0
| 0
| 1
| 3
| 4
| 3
| 2
| 1,506
|
Head Trauma
|
Head trauma with suspected cerebrospinal fluid (CSF) leak. Initial imaging.
|
CT maxillofacial without IV contrast
|
Usually appropriate
|
Limited
|
{"References": [{"PMID": 25086806, "Study Quality": "4"}, {"PMID": 10319986, "Study Quality": "3"}, {"PMID": 12087336, "Study Quality": "3"}, {"PMID": 29910174, "Study Quality": "4"}]}
| 2
|
1-1mSv
| 0
| null | 9
| 9
| 0
| 0
| 0
| 0
| 0
| 1
| 1
| 1
| 16
| 5,064
|
Hernia
|
Suspected abdominal wall hernia such as umbilical, ventral, incisional, lumbar, or spigelian. Initial imaging.
|
Fluoroscopy upper GI series with small bowel follow-through
|
Usually not appropriate
|
Limited
|
{"References": [{"PMID": 16702448, "Study Quality": "4"}]}
| 3
|
1-10 mSv
| 4
|
3-10 mSv
| 3
| 3
| 4
| 3
| 4
| 6
| 0
| 0
| 0
| 0
| 0
| 10,573
|
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