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
Staging and Post-Therapy Assessment of Head and Neck Cancer
Suspected or diagnosed cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Initial staging.
MRA neck with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 32113152, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
16
1
1
1
0
0
0
0
0
11,960
Imaging after Mastectomy and Breast Reconstruction
Female. Breast cancer screening. High-risk, bilateral prophylactic mastectomy with nonautologous (implant) reconstructions.
FDG-PET breast dedicated
Usually not appropriate
Expert Consensus
{"References": []}
3
1-10 mSv
0
null
1
1
13
1
0
0
0
0
0
0
0
10,206
Imaging of the Axilla
Female. Newly diagnosed locally recurrent breast cancer. Initial imaging of the axilla following diagnostic mammography or DBT.
Sestamibi MBI
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 26314782, "Study Quality": "4"}, {"PMID": -3182246, "Study Quality": "4"}, {"PMID": 31558898, "Study Quality": "4"}]}
3
1-10 mSv
0
null
1
1
16
0
0
0
0
0
0
0
0
10,409
Urinary Tract Infection–Child
Child. Older than 6 years 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"}]}
0
0 mSv
0
0 mSv
1
1
12
3
0
0
1
1
1
0
0
3,461
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.
FDG-PET/CT skull base to mid-thigh
Usually appropriate
Strong
{"References": [{"PMID": 25348201, "Study Quality": "Good"}, {"PMID": 24283555, "Study Quality": "Not Assessed"}, {"PMID": 25405771, "Study Quality": "2"}, {"PMID": 33416977, "Study Quality": "2"}, {"PMID": 17873135, "Study Quality": "2"}, {"PMID": 31635767, "Study Quality": "4"}, {"PMID": 11130825, "Study Quality": "2"}, {"PMID": 18704401, "Study Quality": "2"}]}
4
10-30 mSv
4
3-10 mSv
8
8
0
0
0
0
1
0
6
4
7
11,900
Acute Onset Flank Pain-Suspicion of Stone Disease (Urolithiasis)
Acute onset flank pain. Suspicion of stone disease. CT without contrast is inconclusive for the presence of stones. Next imaging study.
Radiography abdomen and pelvis
Usually not appropriate
null
{"References": []}
3
1-10 mSv
3
3-3 mSv
1
null
0
0
0
0
0
0
0
0
0
794
Acutely Limping Child Up To Age 5
Child up to age 5. Acute limp. Nonlocalized symptoms. Concern for infection. Initial imaging.
Radiography lumbar spine
Usually not appropriate
Limited
{"References": [{"PMID": 17314640, "Study Quality": "3"}, {"PMID": 18560822, "Study Quality": "2"}]}
3
1-10 mSv
2
3 mSv
3
3
3
3
5
2
2
1
0
0
0
730
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
Adult. Focal neurologic deficit. Clinically suspected acute ischemic stroke. Initial imaging.
CT head with IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
3
1-10 mSv
3
3-3 mSv
1
1
14
4
1
0
0
0
1
1
0
9,812
Headache
Headache with features of intracranial hypertension (eg, papilledema, pulsatile tinnitus, visual symptoms worse on Valsalva). Initial imaging.
Arteriography cervicocerebral
Usually not appropriate
Expert Consensus
{"References": []}
3
1-10 mSv
4
3-10 mSv
1
1
14
2
1
1
1
0
0
0
0
5,140
Anorectal Disease
Suspected complication postproctectomy or coloproctectomy or colectomy with pouch or other anastomosis. Initial imaging.
US pelvis transrectal
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 24156793, "Study Quality": "3"}, {"PMID": 17245179, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
2
2
7
2
5
2
0
0
1
0
0
8,653
Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
Known cerebral aneurysm; untreated. Surveillance monitoring.
MRI head with IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
1
1
14
2
2
0
0
0
0
0
0
10,062
Chronic Hand and Wrist Pain
Adult. Chronic hand or wrist pain. Initial imaging.
CT arthrography area of interest
Usually not appropriate
Expert Consensus
{"References": []}
0
null
0
null
1
1
12
0
1
0
0
0
0
0
0
2,626
Multiple Gestations
Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Growth and antepartum surveillance.
US pregnant uterus transvaginal
May be appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
6
6
0
0
0
1
3
3
2
0
1
4,058
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.
FDG-PET/CT skull base to mid-thigh
Usually not appropriate
Expert Consensus
{"References": []}
4
10-30 mSv
4
3-10 mSv
1
1
10
4
2
0
1
0
0
0
0
4,457
Suspected Pulmonary Embolism
Suspected pulmonary embolism. High pretest probability. Initial Imaging.
CT chest with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 11323478, "Study Quality": "1"}, {"PMID": 18212216, "Study Quality": "3"}, {"PMID": 10966705, "Study Quality": "2"}]}
3
1-10 mSv
4
3-10 mSv
2
2
6
7
5
0
0
0
0
0
0
1,745
Acute Pyelonephritis
Suspected acute pyelonephritis. First-time presentation. Uncomplicated patient (eg, no history of pyelonephritis, diabetes, immune compromise, history of stones or renal obstruction, prior renal surgery, advanced age, vesicoureteral reflux, lack of response to therapy, or pregnancy). Initial imaging.
MRI abdomen and pelvis without IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 18203942, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
14
2
0
0
0
0
0
1
0
5,706
Cerebrovascular Disease
New focal neurologic defect, fixed or worsening. Less than 6 hours. Suspected stroke.
CTA head and neck with IV contrast
Usually appropriate
null
{"References": []}
3
1-10 mSv
4
3-10 mSv
8
null
0
0
0
0
0
0
0
0
0
4,792
Thoracic Outlet Syndrome
Arterial thoracic outlet syndrome. Initial imaging and follow-up imaging after surgery or intervention.
US duplex Doppler subclavian artery and vein
Usually appropriate
Limited
{"References": [{"PMID": 16439785, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
8
8
0
0
0
0
0
0
5
13
4
7,209
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 chest without IV contrast
May be appropriate
Limited
{"References": [{"PMID": 25239083, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
5
5
0
0
0
4
7
3
3
1
0
11,906
Cranial Neuropathy
Anosmia or other abnormalities of the sense of smell (olfactory nerve, CN I). Initial imaging.
MRI head without IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 20472036, "Study Quality": "3"}, {"PMID": 25712545, "Study Quality": "2"}, {"PMID": 29269404, "Study Quality": "2"}, {"PMID": 29324366, "Study Quality": "2"}, {"PMID": 25977168, "Study Quality": "2"}, {"PMID": 23775878, "Study Quality": "4"}, {"PMID": 29088516, "Study Quality": "4"}, {"PMID": 21330398, "Study Quality": "2"}, {"PMID": 22730050, "Study Quality": "2"}, {"PMID": 23376116, "Study Quality": "2"}, {"PMID": 24051351, "Study Quality": "2"}, {"PMID": 33132007, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
2
2
8
3
4
1
3
1
0
0
0
6,348
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
Clinically suspected prostate cancer. No prior biopsy (biopsy naïve). Initial diagnosis. Initial imaging.
Choline PET/MRI skull base to mid-thigh
Usually not appropriate
Expert Consensus
{"References": []}
3
1-10 mSv
0
null
1
1
11
2
0
0
0
0
1
0
0
1,199
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
Adult. Recent ischemic infarct; greater than 24 hours. Initial imaging.
MRA neck without IV contrast
May be appropriate
Strong
{"References": [{"PMID": 16155164, "Study Quality": "2"}, {"PMID": 15955853, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
6
6
0
1
0
1
7
8
2
0
0
9,841
Palpable Breast Masses
Adult female, younger than 30 years of age. Palpable breast mass. US findings negative (BI-RADS 1). Next imaging study.
Mammography screening
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 28754486, "Study Quality": "3"}, {"PMID": 25341156, "Study Quality": "4"}, {"PMID": 23046046, "Study Quality": "3"}, {"PMID": 21477168, "Study Quality": "3"}]}
2
1-1mSv
0
null
1
1
16
0
0
0
1
0
0
0
0
5,958
Inflammatory Back Pain: Known or Suspected Axial Spondyloarthropathy
Inflammatory back pain. Suspected axial spondyloarthritis. Negative radiographs and negative MRI of the sacroiliac joints. Next imaging study.
CT spine area of interest without and with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 22736088, "Study Quality": "4"}, {"PMID": 18006539, "Study Quality": "3"}, {"PMID": 23842966, "Study Quality": "4"}, {"PMID": 19297344, "Study Quality": "3"}, {"PMID": 29538011, "Study Quality": "4"}, {"PMID": 29127092, "Study Quality": "3"}, {"PMID": 28663306, "Study Quality": "4"}, {"PMID": 28110981, "Study Quality": "4"}, {"PMID": 27889235, "Study Quality": "4"}, {"PMID": 27608795, "Study Quality": "4"}, {"PMID": 27355535, "Study Quality": "4"}, {"PMID": 25837448, "Study Quality": "4"}]}
0
null
0
null
1
1
11
0
1
1
1
0
1
0
0
7,399
Fibroids
Known fibroids. Treatment planning. Initial imaging.
US duplex Doppler pelvis
Usually appropriate
Limited
{"References": [{"PMID": 25251811, "Study Quality": "3"}, {"PMID": 26023602, "Study Quality": "3"}, {"PMID": 28211610, "Study Quality": "3"}, {"PMID": 21147300, "Study Quality": "3"}, {"PMID": 33153547, "Study Quality": "4"}, {"PMID": 11904599, "Study Quality": "3"}, {"PMID": 24077979, "Study Quality": "4"}, {"PMID": 11833866, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
7
7
1
0
0
0
2
3
1
2
3
11,854
Multiple Gestations
Multiple gestations. Dichorionic twins or multichorionic higher order multiples. Second trimester anatomy examination. Follow-up imaging.
MRI fetal without and with IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
1
1
9
1
0
0
0
0
0
0
0
4,040
Nonvariceal Upper Gastrointestinal Bleeding
Adult. Suspected nonvariceal upper gastrointestinal bleeding; no endoscopy performed. Initial imaging.
CTA abdomen and pelvis without and with IV contrast
Usually appropriate
Moderate
{"References": [{"PMID": 31363814, "Study Quality": "3"}, {"PMID": 31987743, "Study Quality": "4"}, {"PMID": 33449577, "Study Quality": "3"}, {"PMID": 25023179, "Study Quality": "3"}, {"PMID": 25650332, "Study Quality": "1"}, {"PMID": 31346741, "Study Quality": "4"}, {"PMID": 23192375, "Study Quality": "M"}, {"PMID": 28754326, "Study Quality": "3"}, {"PMID": 29883267, "Study Quality": "4"}]}
4
10-30 mSv
0
null
9
9
0
0
0
0
0
1
3
2
7
1,889
Suspected Spine Infection
Suspected spine infection (such as epidural abscess or discitis osteomyelitis), with new or worsening back or neck pain, with or without fever, who may have one or more of the following red flags (diabetes mellitus, IV drug use, cancer, HIV, or dialysis) or abnormal lab values. Initial imaging.
Gallium scan whole body
May be appropriate
Limited
{"References": [{"PMID": 22643395, "Study Quality": "4"}, {"PMID": 27523445, "Study Quality": "2"}, {"PMID": 29452617, "Study Quality": "4"}]}
4
10-30 mSv
0
null
4
4
2
1
4
6
6
1
0
0
1
9,730
Plexopathy
Brachial plexopathy, traumatic (not perinatal). Initial imaging.
MRI brachial plexus without IV contrast
Usually appropriate
Limited
{"References": [{"PMID": 22071340, "Study Quality": "3"}, {"PMID": 21763092, "Study Quality": "4"}, {"PMID": 24355190, "Study Quality": "4"}, {"PMID": 30688245, "Study Quality": "4"}, {"PMID": 28886666, "Study Quality": "2"}, {"PMID": 29145043, "Study Quality": "4"}, {"PMID": 29778092, "Study Quality": "4"}, {"PMID": 24210315, "Study Quality": "4"}, {"PMID": 27801698, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
9
9
2
0
0
0
0
0
4
1
13
5,544
Sepsis
Suspected or confirmed sepsis. No specific symptoms suggestive of origin, or symptoms cannot be assessed. Initial imaging.
Nuclear medicine scan gallbladder
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 32971451, "Study Quality": "2"}, {"PMID": 25468363, "Study Quality": "4"}]}
2
1-1mSv
0
null
1
1
14
2
3
0
1
1
0
0
0
11,819
Staging of Colorectal Cancer
Rectal cancer. Locoregional staging. Initial imaging.
CT abdomen and pelvis with IV contrast
May be appropriate
Strong
{"References": [{"PMID": 19571705, "Study Quality": "2"}, {"PMID": 20103950, "Study Quality": "3"}, {"PMID": 18697365, "Study Quality": "4"}, {"PMID": 8646512, "Study Quality": "3"}, {"PMID": 9568652, "Study Quality": "1"}, {"PMID": 15376205, "Study Quality": "3"}, {"PMID": 19949791, "Study Quality": "3"}, {"PMID": 21110194, "Study Quality": "2"}, {"PMID": 22100372, "Study Quality": "3"}, {"PMID": 22281979, "Study Quality": "2"}, {"PMID": 22271004, "Study Quality": "3"}, {"PMID": 31305437, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
5
5
0
0
0
0
15
2
0
0
1
32
Chronic Shoulder Pain
Chronic shoulder pain. Initial imaging.
US shoulder
May be appropriate
Strong
{"References": [{"PMID": 31201467, "Study Quality": "3"}, {"PMID": 29504320, "Study Quality": "2"}, {"PMID": 30423642, "Study Quality": "2"}, {"PMID": 32298371, "Study Quality": "3"}, {"PMID": 18599231, "Study Quality": "4"}, {"PMID": 28537759, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
5
5
2
1
0
2
9
1
0
0
0
8,250
Congenital or Acquired Heart Disease
Child. Known single ventricle physiology. Preoperative evaluation for stage 3 single ventricle palliation (total cavopulmonary connection). Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study.
MRI heart function with stress without and with IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
2
2
10
2
5
0
3
0
1
1
0
8,911
Staging and Follow-up of Vulvar Cancer
Post-treatment assessment of clinically suspected recurrence of known vulvar cancer.
CT pelvis without IV contrast
May be appropriate (Disagreement)
Expert Opinion
{"References": [{"PMID": 26059775, "Study Quality": "3"}]}
3
1-10 mSv
4
3-10 mSv
5
5
2
4
2
4
1
0
1
0
1
9,330
Hydronephrosis on Prior Imaging-Unknown Cause
Adult. Symptomatic hydronephrosis with unknown cause. Initial imaging.
CT abdomen and pelvis without IV contrast
May be appropriate
Strong
{"References": [{"PMID": 27533351, "Study Quality": "3"}, {"PMID": 31958894, "Study Quality": "3"}, {"PMID": 28611874, "Study Quality": "1"}, {"PMID": 31535518, "Study Quality": "4"}, {"PMID": 26747219, "Study Quality": "3"}, {"PMID": 29663580, "Study Quality": "2"}, {"PMID": 24440589, "Study Quality": "3"}, {"PMID": 27369294, "Study Quality": "2"}, {"PMID": 34773812, "Study Quality": "2"}, {"PMID": 30853305, "Study Quality": "4"}, {"PMID": 34304393, "Study Quality": "3"}]}
3
1-10 mSv
4
3-10 mSv
6
6
0
0
0
1
3
4
5
1
1
12,137
Supplemental Breast Cancer Screening Based on Breast Density
Supplemental breast cancer screening. High-risk females with nondense breasts.
MRI breast without and with IV contrast abbreviated
May be appropriate
Limited
{"References": [{"PMID": 28506511, "Study Quality": "4"}, {"PMID": 26521970, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
6
6
0
0
0
1
4
7
3
1
1
10,449
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.
MRI spine area of interest without and with IV contrast
Usually appropriate
Strong
{"References": [{"PMID": 22643395, "Study Quality": "4"}, {"PMID": 21669158, "Study Quality": "4"}, {"PMID": 25296275, "Study Quality": "4"}, {"PMID": 26585257, "Study Quality": "2"}, {"PMID": 24999081, "Study Quality": "4"}, {"PMID": 31103765, "Study Quality": "2"}, {"PMID": 27616314, "Study Quality": "4"}, {"PMID": 27452260, "Study Quality": "2"}, {"PMID": 24792614, "Study Quality": "4"}, {"PMID": 22922857, "Study Quality": "2"}, {"PMID": 29582111, "Study Quality": "2"}, {"PMID": 21417700, "Study Quality": "4"}, {"PMID": 27755204, "Study Quality": "4"}, {"PMID": 28379730, "Study Quality": "2"}, {"PMID": 30971277, "Study Quality": "2"}, {"PMID": 1509065, "Study Quality": "2"}, {"PMID": 31399800, "Study Quality": "4"}, {"PMID": 28437330, "Study Quality": "2"}, {"PMID": 32554421, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
9
9
1
0
0
0
0
0
0
6
14
9,737
Thyroid Disease
Suspected recurrence of medullary thyroid cancers.
CT abdomen with IV contrast
May be appropriate
Limited
{"References": [{"PMID": 25810047, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
6
6
0
1
0
1
6
8
0
0
0
8,736
Central Venous Access Device and Site Selection
Device selection
Tunneled central venous catheter
Usually appropriate
Moderate
{"References": [{"PMID": 16970212, "Study Quality": "M"}, {"PMID": 21652113, "Study Quality": "3"}, {"PMID": 24218174, "Study Quality": "M"}, {"PMID": 31044308, "Study Quality": "Good"}]}
0
null
0
null
7
7
0
0
0
0
1
2
7
4
2
7,759
Imaging After Shoulder Arthroplasty
Symptomatic patient with a primary shoulder arthroplasty, infection not excluded. Additional imaging following radiographs.
3-phase bone scan with SPECT or SPECT/CT shoulder
Usually not 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
3
3
4
1
5
3
1
0
0
0
0
7,816
Cerebrovascular Disease-Child
Child. Clinical presentation suggestive of acute stroke, known or suspected cortical vein or dural venous sinus thrombosis. Initial imaging.
MRI head without and with IV contrast
Usually appropriate
Limited
{"References": [{"PMID": 23212594, "Study Quality": "4"}, {"PMID": 22948810, "Study Quality": "4"}, {"PMID": 25938564, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
8
8
1
1
0
0
1
1
3
5
7
8,506
Headache-Child
Child. Headache attributed to infection. Initial imaging.
CT head without IV contrast
May be appropriate
Limited
{"References": [{"PMID": 25846458, "Study Quality": "2"}]}
3
1-10 mSv
3
3-3 mSv
5
5
0
1
0
4
9
0
1
0
0
3,181
Imaging after Breast Surgery
Female. Age 40 years or older. Postsurgical excision with nonmalignant pathology. Asymptomatic. Initial imaging.
Digital breast tomosynthesis diagnostic
Usually not appropriate
Limited
{"References": [{"PMID": 30172804, "Study Quality": "4"}, {"PMID": 29299726, "Study Quality": "4"}, {"PMID": 25423143, "Study Quality": "3"}, {"PMID": 26492902, "Study Quality": "4"}, {"PMID": 24639339, "Study Quality": "4"}, {"PMID": 27425222, "Study Quality": "4"}, {"PMID": -3194411, "Study Quality": "4"}]}
2
1-1mSv
0
null
1
1
9
6
2
0
0
0
0
0
0
11,416
Acute Nonlocalized Abdominal Pain
Acute nonlocalized abdominal pain and fever. Postoperative patient. Initial imaging.
WBC scan abdomen and pelvis
Usually not appropriate
Strong
{"References": [{"PMID": 4015374, "Study Quality": "4"}, {"PMID": 2112472, "Study Quality": "4"}, {"PMID": 3567506, "Study Quality": "2"}, {"PMID": 1941134, "Study Quality": "1"}]}
4
10-30 mSv
0
null
3
3
2
6
3
4
0
1
0
0
0
4,245
Lung Cancer Screening
Lung cancer screening. Patient of any age with less than 20 packs per year history of smoking, and no additional risk factor (ie, radon exposure or occupational exposure or cancer history or family history of lung cancer or history of COPD or history of pulmonary fibrosis). Initial imaging.
CT chest with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 28724283, "Study Quality": "2"}, {"PMID": 33514608, "Study Quality": "4"}, {"PMID": 31848206, "Study Quality": "2"}, {"PMID": 28783541, "Study Quality": "2"}, {"PMID": 17290054, "Study Quality": "4"}, {"PMID": 28874145, "Study Quality": "2"}, {"PMID": 32482786, "Study Quality": "2"}, {"PMID": 30445189, "Study Quality": "2"}, {"PMID": 33430831, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
1
1
14
0
0
1
0
0
0
1
0
9,009
Pretreatment Evaluation and Follow-Up of Endometrial Cancer
Pretreatment evaluation of endometrial cancer; assessment of lymph node and distant metastasis for low-grade tumor (Type I, grade 1, 2).
US abdomen
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 3049262, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
3
3
4
2
5
2
3
0
0
1
0
3,881
Liver Lesion — Initial Characterization
Incidental liver lesion, less than 1 cm on US, noncontrast or single-phase CT, or noncontrast MRI. Known chronic liver disease.
DOTATATE PET/CT skull base to mid-thigh
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 20098330, "Study Quality": "2"}, {"PMID": 23932636, "Study Quality": "2"}]}
3
1-10 mSv
0
null
1
1
10
5
2
0
0
0
0
0
0
4,519
Penetrating Trauma-Lower Abdomen and Pelvis
Penetrating trauma, lower abdomen and pelvis. Suspected lower urinary tract trauma. Initial imaging.
CT pelvis without IV contrast
May be appropriate
Limited
{"References": [{"PMID": 16488281, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
4
4
0
0
0
0
0
0
0
0
0
1,486
Dementia and Movement Disorders
Suspected dementia with Lewy bodies.
I-123 IMP SPECT head
May be appropriate
null
{"References": []}
3
1-10 mSv
0
null
5
null
0
0
0
0
0
0
0
0
0
605
Recurrent Lower Urinary Tract Infections in Females
Recurrent lower urinary tract infections in a female. Complicated, or patients who are nonresponders to conventional therapy, develop frequent reinfections or relapses, or have known underlying risk factors.
CTU without and with IV contrast
Usually appropriate
Limited
{"References": [{"PMID": 17597338, "Study Quality": "4"}, {"PMID": 19188307, "Study Quality": "4"}, {"PMID": 30466909, "Study Quality": "4"}]}
4
10-30 mSv
5
10-30 mSv
8
8
1
0
0
0
1
0
3
5
4
5,862
Staging and Post-Therapy Assessment of Head and Neck Cancer
Suspected or diagnosed cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. Initial staging.
MRI head with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 32113152, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
14
3
1
1
0
0
0
0
0
11,882
Staging and Follow-up of Ovarian Cancer
Extent of disease in suspected or known recurrence of ovarian cancer.
US pelvis transvaginal
Usually not appropriate
Limited
{"References": [{"PMID": 22858859, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
3
3
1
5
10
1
1
1
0
0
0
1,533
Chronic Hand and Wrist Pain
Adult. Chronic wrist pain. Radiographs show old scaphoid fracture. Evaluate for nonunion, malunion, osteonecrosis, or post-traumatic osteoarthritis. Next imaging study.
US wrist
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 23812413, "Study Quality": "3"}, {"PMID": 17449771, "Study Quality": "1"}]}
0
0 mSv
0
0 mSv
1
1
10
1
2
0
0
0
1
0
0
2,651
Pulmonary Arteriovenous Malformation (PAVM)
Adult. Asymptomatic with abnormal imaging on CT or chest radiography suggestive of PAVM. Next imaging study.
MRA chest without and with IV contrast
May be appropriate
Expert Consensus
{"References": [{"PMID": 19553198, "Study Quality": "4"}, {"PMID": 31875234, "Study Quality": "4"}, {"PMID": 25032812, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
5
5
0
1
0
2
6
0
7
1
0
7,498
Crohn Disease
Known Crohn disease, suspected acute exacerbation.
US abdomen and pelvis
Usually not appropriate
Strong
{"References": [{"PMID": 23182513, "Study Quality": "4"}, {"PMID": 27495028, "Study Quality": "Good"}, {"PMID": 24344807, "Study Quality": "3"}, {"PMID": 23921767, "Study Quality": "Good"}, {"PMID": 23643057, "Study Quality": "3"}, {"PMID": 22483566, "Study Quality": "3"}, {"PMID": 27338853, "Study Quality": "4"}, {"PMID": 15987966, "Study Quality": "M"}, {"PMID": 14616167, "Study Quality": "2"}, {"PMID": 19408327, "Study Quality": "1"}, {"PMID": 23796373, "Study Quality": "4"}, {"PMID": 19148846, "Study Quality": "3"}, {"PMID": 21615440, "Study Quality": "4"}, {"PMID": 15942733, "Study Quality": "2"}, {"PMID": 18067121, "Study Quality": "2"}, {"PMID": 17680844, "Study Quality": "1"}]}
0
0 mSv
0
0 mSv
3
3
1
3
4
2
4
1
0
0
0
4,365
Epigastric Pain
Epigastric pain with clinical suspicion for acid reflux or esophagitis or gastritis or peptic ulcer or duodenal ulcer. Initial imaging.
Fluoroscopy single contrast esophagram
May be appropriate
Limited
{"References": [{"PMID": 26562229, "Study Quality": "4"}]}
3
1-10 mSv
0
null
6
6
1
0
0
0
3
7
8
1
0
10,523
Imaging of Invasive Breast Cancer
Surveillance. Regardless of clinical stage of breast cancer at time of original presentation. Evaluation for distant metastatic disease.
CT chest abdomen pelvis with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": -3195169, "Study Quality": "4"}, {"PMID": -3195171, "Study Quality": "4"}, {"PMID": 23601761, "Study Quality": "4"}, {"PMID": 26314782, "Study Quality": "4"}]}
4
10-30 mSv
4
3-10 mSv
1
1
11
0
4
0
0
1
0
0
0
11,769
Acute Respiratory Illness in Immunocompetent Patients
Acute respiratory illnesses in immunocompetent patients with positive physical examination, abnormal vital signs, organic brain disease or other risk factors. Initial imaging.
MRI chest without and with IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
1
1
8
3
1
0
0
0
0
0
0
3,532
Staging of Renal Cell Carcinoma
Renal cell carcinoma. No contraindication to either iodinated CT contrast or gadolinium-based MR intravenous contrast. Staging.
CT chest without IV contrast
Usually not appropriate
Strong
{"References": [{"PMID": 31955483, "Study Quality": "3"}, {"PMID": 27684653, "Study Quality": "3"}, {"PMID": 21557795, "Study Quality": "2"}, {"PMID": 19450840, "Study Quality": "3"}, {"PMID": 25241004, "Study Quality": "3"}, {"PMID": 20846691, "Study Quality": "3"}, {"PMID": 26880407, "Study Quality": "2"}, {"PMID": -3195129, "Study Quality": "4"}, {"PMID": 30803729, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
2
2
6
3
3
1
3
0
0
0
0
1,330
Routine Chest Imaging
Routine chest imaging for hospital admission. No clinical concern for cardiopulmonary disease. Initial Imaging.
MRI chest without and with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 31407223, "Study Quality": "2"}, {"PMID": 26781150, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
14
1
1
0
0
0
0
0
0
3,693
Adrenal Mass Evaluation
Indeterminate adrenal mass, greater than 2 cm and less than 4 cm on initial imaging. No diagnostic benign imaging features. No history of malignancy. Adrenal specific imaging.
Image-guided biopsy adrenal gland
Usually not appropriate
Limited
{"References": [{"PMID": 8497619, "Study Quality": "3"}, {"PMID": 3871150, "Study Quality": "4"}, {"PMID": 1910990, "Study Quality": "4"}, {"PMID": 9167965, "Study Quality": "4"}, {"PMID": 1643776, "Study Quality": "4"}, {"PMID": 10732267, "Study Quality": "4"}, {"PMID": 10690869, "Study Quality": "4"}, {"PMID": 9267279, "Study Quality": "3"}, {"PMID": 19451490, "Study Quality": "4"}, {"PMID": 24836548, "Study Quality": "3"}]}
0
null
0
null
1
1
9
5
2
0
0
0
1
0
0
957
Cerebrovascular Disease
Proven parenchymal hemorrhage (hematoma).
MRA head and neck without IV contrast
May be appropriate
null
{"References": []}
0
0 mSv
0
0 mSv
5
null
0
0
0
0
0
0
0
0
0
4,822
Acute Nonlocalized Abdominal Pain
Acute nonlocalized abdominal pain. Neutropenic patient. Initial imaging.
CT abdomen and pelvis with IV contrast
Usually appropriate
Limited
{"References": [{"PMID": 18580213, "Study Quality": "3"}, {"PMID": 23245270, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
9
9
0
0
0
0
0
0
0
2
14
4,246
Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded)
Suspected restrictive cardiomyopathy or infiltrative disease. Ischemic cardiomyopathy already excluded. Initial imaging.
US echocardiography transesophageal
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
2
2
6
7
3
0
0
0
0
0
0
6,888
Assessment of Gravid Cervix
Assessment of gravid cervix. History of prior preterm birth. Initial imaging.
US cervix transperineal
May be appropriate
Limited
{"References": [{"PMID": 15904442, "Study Quality": "3"}, {"PMID": 11339192, "Study Quality": "3"}, {"PMID": 11587014, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
6
6
0
0
4
1
0
6
0
0
0
4,122
Staging and Post-Therapy Assessment of Head and Neck Cancer
Treated cancer of the oral cavity or oropharynx or hypopharynx or larynx or cancer of unknown primary of the head and neck. Surveillance imaging or follow-up imaging for suspected or known recurrence.
CT maxillofacial with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 32113152, "Study Quality": "4"}]}
2
1-1mSv
0
null
1
1
11
3
2
0
2
0
0
0
0
11,995
Suspected Acute Aortic Syndrome
Acute chest pain; suspected acute aortic syndrome.
MRI chest abdomen pelvis without IV contrast
May be appropriate
Expert Consensus
{"References": [{"PMID": 23521452, "Study Quality": "2"}, {"PMID": 24939821, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
4
4
0
5
3
7
2
0
0
0
0
1,660
Lower Urinary Tract Symptoms: Suspicion of Benign Prostatic Hyperplasia
Lower urinary tract symptoms. Suspicion of benign prostatic hyperplasia. Initial imaging.
CT abdomen and pelvis with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 25433478, "Study Quality": "2"}, {"PMID": 10664665, "Study Quality": "4"}, {"PMID": 27476123, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
1
1
0
0
0
0
0
0
0
0
0
1,026
Chronic Liver Disease
Chronic liver disease. Diagnosis and staging of liver fibrosis. Initial imaging.
CT abdomen with IV contrast multiphase
May be appropriate
Limited
{"References": [{"PMID": 23192205, "Study Quality": "3"}, {"PMID": 24261358, "Study Quality": "4"}, {"PMID": 23169796, "Study Quality": "3"}]}
4
10-30 mSv
0
null
5
5
0
0
1
4
9
0
0
0
0
7,895
Shoulder Pain-Traumatic
Traumatic shoulder pain. Radiographs show humeral head or neck fracture. Next imaging study.
MR arthrography shoulder
Usually not appropriate
Limited
{"References": [{"PMID": 24060014, "Study Quality": "3"}, {"PMID": 19098184, "Study Quality": "3"}, {"PMID": 23716283, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
1
1
13
0
0
0
1
1
0
0
0
2,879
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer
Clinically established low-risk prostate cancer. Active surveillance.
Choline PET/MRI skull base to mid-thigh
Usually not appropriate
Expert Consensus
{"References": []}
3
1-10 mSv
0
null
1
1
9
3
0
0
0
1
1
0
0
1,247
Nuchal Translucency Evaluation at 11 to 14 Weeks Gestational Age
Routine nuchal translucency measurement at 11 to 14 weeks of gestation for single or twin gestations. Initial imaging.
US pregnant uterus transvaginal
May be appropriate
Limited
{"References": [{"PMID": 7640926, "Study Quality": "3"}, {"PMID": 12389656, "Study Quality": "4"}, {"PMID": 15572480, "Study Quality": "4"}, {"PMID": 1392745, "Study Quality": "4"}, {"PMID": 18558475, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
6
6
0
0
0
1
2
5
1
2
0
9,159
Dementia and Movement Disorders
Clinical features suggestive of neurodegeneration with brain iron accumulation.
CT head with IV contrast
May be appropriate
null
{"References": []}
3
1-10 mSv
3
3-3 mSv
4
null
0
0
0
0
0
0
0
0
0
655
Dementia and Movement Disorders
Suspected vascular dementia.
MR spectroscopy head without IV contrast
Usually not appropriate
null
{"References": []}
0
0 mSv
0
0 mSv
2
null
0
0
0
0
0
0
0
0
0
623
Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot)
Suspected osteomyelitis. Initial radiographs normal or with findings suggestive of osteomyelitis. Next imaging study.
3-phase bone scan and WBC scan and sulfur colloid scan area of interest
May be appropriate
Limited
{"References": [{"PMID": 27742026, "Study Quality": "4"}, {"PMID": 30675635, "Study Quality": "4"}]}
4
10-30 mSv
5
10-30 mSv
5
5
0
0
1
2
10
1
0
0
0
7,690
Palpable Breast Masses
Adult female, younger than 30 years of age. Palpable breast mass. US findings are suspicious or highly suggestive of malignancy (BI-RADS 4 or 5). Next imaging study.
MRI breast without and with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 25341156, "Study Quality": "4"}, {"PMID": 21477168, "Study Quality": "3"}, {"PMID": 23046046, "Study Quality": "3"}, {"PMID": 28754486, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
1
1
13
0
1
2
0
0
1
0
0
5,931
Liver Lesion — Initial Characterization
Incidental liver lesion, less than 1 cm on US, noncontrast or single-phase CT, or noncontrast MRI. Known chronic liver disease.
RBC scan abdomen and pelvis
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 20098330, "Study Quality": "2"}, {"PMID": 23932636, "Study Quality": "2"}]}
3
1-10 mSv
0
null
1
1
10
4
3
0
0
0
0
0
0
4,521
Primary Bone Tumors
Suspect primary bone tumor. Lesion on radiographs. Indeterminate or aggressive appearance for malignancy. Next imaging study.
FDG-PET/CT whole body
May be appropriate
Strong
{"References": [{"PMID": 15286325, "Study Quality": "2"}, {"PMID": 11376267, "Study Quality": "3"}, {"PMID": 8657920, "Study Quality": "2"}, {"PMID": 15937711, "Study Quality": "3"}, {"PMID": 18278491, "Study Quality": "3"}, {"PMID": 18756363, "Study Quality": "3"}, {"PMID": 18309481, "Study Quality": "3"}, {"PMID": 26356700, "Study Quality": "Good"}, {"PMID": 22072239, "Study Quality": "Good"}]}
4
10-30 mSv
4
3-10 mSv
5
5
1
0
0
1
10
1
1
0
0
2,199
Suspected Physical Abuse — Child
Child ≤24 months of age. High suspicion for abuse. Negative initial skeletal survey. Follow-up imaging evaluation.
CT head without and with IV contrast
Usually not appropriate
null
{"References": []}
3
1-10 mSv
4
3-10 mSv
1
null
0
0
0
0
0
0
0
0
0
3,418
Crohn Disease
Known Crohn disease, disease surveillance; monitoring therapy.
CT abdomen and pelvis without and with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 17604930, "Study Quality": "2"}]}
4
10-30 mSv
5
10-30 mSv
3
3
2
4
7
0
1
0
0
1
0
4,385
Workup of Noncerebral Systemic Arterial Embolic Source
Known multiorgan system arterial occlusions. Suspected embolic etiology. Next imaging study to determine source.
MRA chest without IV contrast
May be appropriate
Limited
{"References": [{"PMID": 17285264, "Study Quality": "2"}, {"PMID": 20013276, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
6
6
0
0
0
0
3
9
4
1
0
11,335
Hernia
Suspected diaphragmatic hernia including traumatic, Bochdalek, or Morgagni. Initial imaging.
Fluoroscopy upper GI series with small bowel follow-through
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 30157820, "Study Quality": "4"}, {"PMID": 28135794, "Study Quality": "4"}, {"PMID": 26705205, "Study Quality": "4"}, {"PMID": 26303737, "Study Quality": "4"}, {"PMID": 21951119, "Study Quality": "4"}, {"PMID": 20039230, "Study Quality": "4"}, {"PMID": 19242298, "Study Quality": "4"}, {"PMID": 15899350, "Study Quality": "4"}, {"PMID": 26105131, "Study Quality": "3"}, {"PMID": 26100355, "Study Quality": "3"}, {"PMID": 30539157, "Study Quality": "4"}]}
3
1-10 mSv
4
3-10 mSv
3
3
3
2
4
4
1
1
1
0
0
10,607
Parathyroid Adenoma
Adult or child. Primary hyperparathyroidism. Initial imaging.
Sestamibi dual-phase scan with SPECT or SPECT/CT neck
Usually appropriate
Strong
{"References": [{"PMID": 21710322, "Study Quality": "Good"}, {"PMID": 26932954, "Study Quality": "2"}, {"PMID": 22454482, "Study Quality": "4"}, {"PMID": 26825209, "Study Quality": "2"}, {"PMID": 20466104, "Study Quality": "4"}, {"PMID": 19893394, "Study Quality": "2"}, {"PMID": 25642803, "Study Quality": "Good"}, {"PMID": 18794320, "Study Quality": "4"}, {"PMID": 30835187, "Study Quality": "2"}]}
3
1-10 mSv
0
null
9
9
0
0
0
0
0
2
2
5
12
10,689
Asymptomatic Patient at Risk for Coronary Artery Disease
Asymptomatic patient. Intermediate risk for coronary artery disease. Initial imaging.
SPECT or SPECT/CT MPI rest and stress
Usually not appropriate
Limited
{"References": [{"PMID": 21181519, "Study Quality": "4"}, {"PMID": 24556531, "Study Quality": "4"}]}
4
10-30 mSv
5
10-30 mSv
2
2
5
6
4
1
0
0
0
0
0
6,851
Nontraumatic Aortic Disease
Congenital aortic disease. Initial imaging.
MRA chest and abdomen without and with IV contrast
Usually appropriate
Strong
{"References": [{"PMID": 16891235, "Study Quality": "3"}, {"PMID": 18356435, "Study Quality": "2"}, {"PMID": 25644073, "Study Quality": "3"}, {"PMID": 25476670, "Study Quality": "4"}, {"PMID": 28617686, "Study Quality": "4"}, {"PMID": 27384018, "Study Quality": "4"}, {"PMID": 15699283, "Study Quality": "3"}, {"PMID": 16249863, "Study Quality": "4"}, {"PMID": 11305558, "Study Quality": "4"}, {"PMID": 25061611, "Study Quality": "3"}, {"PMID": 27390537, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
9
9
0
0
0
0
0
1
0
5
8
7,053
Acute Respiratory Illness in Immunocompetent Patients
Acute respiratory illness in immunocompetent patients with negative physical examination, normal vital signs and no other risk factors. Initial imaging.
MRI chest without IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
1
1
9
3
0
0
0
0
0
0
0
3,526
Chronic Hand and Wrist Pain
Adult. Chronic hand or wrist pain. Initial imaging.
CT area of interest without IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
null
0
null
1
1
11
1
1
0
0
0
0
0
0
2,625
Female Breast Cancer Screening
Adult female. Breast cancer screening. Average risk.
MRI breast without IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 32524221, "Study Quality": "2"}, {"PMID": 31880677, "Study Quality": "4"}, {"PMID": 27186635, "Study Quality": "3"}, {"PMID": 33223001, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
19
0
1
2
0
0
0
0
0
6,739
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions
Adult. Known cervical vascular dissection or injury. Surveillance imaging.
US duplex Doppler transcranial
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
1
1
12
2
2
0
1
2
0
0
0
9,993
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.
MRI abdomen and pelvis without 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
1
1
1
2
0
0
0
0
3,424
Suspected Pulmonary Embolism
Suspected pulmonary embolism. High pretest probability. Initial Imaging.
CT chest without and with IV contrast
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 11323478, "Study Quality": "1"}, {"PMID": 18212216, "Study Quality": "3"}, {"PMID": 10966705, "Study Quality": "2"}]}
3
1-10 mSv
4
3-10 mSv
2
2
7
6
4
0
0
0
0
0
1
1,746
Low Back Pain
Acute low back pain with or without radiculopathy. No red flags. No prior management. Initial imaging.
CT lumbar spine with IV contrast
Usually not appropriate
Expert Consensus
{"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"}]}
3
1-10 mSv
4
3-10 mSv
1
1
14
2
3
1
0
0
0
0
0
5,216
Osteomyelitis or Septic Arthritis-Child (Excluding Axial Skeleton)
Child. 5 years of age or older. Concern for osteomyelitis or septic arthritis involving an extremity. Initial radiographs normal, or with findings suggestive of osteomyelitis. Next imaging study.
Image-guided aspiration area of interest
Usually appropriate
Limited
{"References": [{"PMID": 8475290, "Study Quality": "4"}, {"PMID": 27603195, "Study Quality": "3"}, {"PMID": 26830217, "Study Quality": "3"}, {"PMID": 23389564, "Study Quality": "2"}]}
0
null
0
null
7
7
0
0
0
1
1
6
5
1
2
11,099
Orbits, Vision, and Visual Loss
Traumatic visual defect. Suspect orbital injury. Initial imaging.
CT orbits without and with IV contrast
Usually not appropriate
Strong
{"References": [{"PMID": 22964404, "Study Quality": "4"}, {"PMID": 27262056, "Study Quality": "4"}, {"PMID": 21326128, "Study Quality": "4"}, {"PMID": 10726796, "Study Quality": "2"}, {"PMID": 24694248, "Study Quality": "3"}, {"PMID": 24614544, "Study Quality": "4"}, {"PMID": 21772209, "Study Quality": "4"}, {"PMID": 22698295, "Study Quality": "3"}, {"PMID": 23287107, "Study Quality": "3"}]}
3
1-10 mSv
0
null
1
1
10
1
6
2
0
0
0
0
0
5,403
Chronic Hip Pain
Chronic hip pain. Radiographs suspicious for intra-articular synovial hyperplasia or neoplasia, including nodular synovitis, diffuse tenosynovial giant cell tumor, osteochondromatosis, other synovial neoplasm. Next imaging study.
Image-guided aspiration hip
Usually not appropriate
Limited
{"References": [{"PMID": 2383449, "Study Quality": "4"}, {"PMID": 2845469, "Study Quality": "4"}]}
0
null
0
null
3
3
6
0
2
3
4
0
0
0
0
2,457
Orbital Imaging and Vision Loss-Child
Child. Six months of age or older. Papilledema detected on the ophthalmologic examination or signs of raised intracranial pressure. Initial imaging.
MRI orbits without IV contrast
Usually not appropriate
Expert Consensus
{"References": []}
0
0 mSv
0
0 mSv
3
3
5
1
6
3
0
0
1
0
0
10,964
Noninvasive Clinical Staging of Primary Lung Cancer
Noninvasive initial clinical staging of small-cell lung carcinoma.
MRI head without IV contrast
May be appropriate
Expert Consensus
{"References": [{"PMID": 10473359, "Study Quality": "4"}, {"PMID": 23649448, "Study Quality": "4"}, {"PMID": 27877227, "Study Quality": "3"}]}
0
0 mSv
0
0 mSv
5
5
0
0
3
3
6
1
0
0
0
3,798
Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus
Soft-tissue swelling without ulcer. Suspected osteomyelitis or early neuropathic arthropathy changes of the foot in patients with diabetes mellitus. Additional imaging following radiographs.
US foot
Usually not appropriate
Expert Consensus
{"References": [{"PMID": 27587513, "Study Quality": "4"}, {"PMID": 24764120, "Study Quality": "4"}, {"PMID": 18025514, "Study Quality": "4"}, {"PMID": 20567730, "Study Quality": "4"}, {"PMID": 29058098, "Study Quality": "4"}]}
0
0 mSv
0
0 mSv
1
1
7
1
0
2
1
0
0
0
0
76
Seizures and Epilepsy
Known seizure disorder. Change in seizure semiology or new neurologic deficit or no return to previous neurologic baseline.
CT head with IV contrast
Usually not appropriate
Limited
{"References": [{"PMID": 27430454, "Study Quality": "4"}, {"PMID": 23676306, "Study Quality": "4"}, {"PMID": 19513318, "Study Quality": "4"}]}
3
1-10 mSv
3
3-3 mSv
1
null
0
0
0
0
0
0
0
0
0
4,881
Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
High-risk cerebral aneurysm screening.
MRA head without IV contrast
Usually appropriate
Strong
{"References": [{"PMID": 24326447, "Study Quality": "Good"}, {"PMID": 24495263, "Study Quality": "2"}, {"PMID": 21529794, "Study Quality": "2"}]}
0
0 mSv
0
0 mSv
9
9
1
0
0
0
0
0
1
5
11
10,097