Condition stringclasses 232
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Suspected Spine Trauma-Child | Child, 3 to 16 years of age, acute cervical spine trauma, meets low risk criteria (based on PECARN or NEXUS). Initial imaging. | Radiography cervical spine | Usually not appropriate | Limited | {"References": [{"PMID": 20433260, "Study Quality": "4"}]} | 2 | 1-1mSv | 2 | 3 mSv | 2 | 2 | 10 | 6 | 4 | 2 | 1 | 0 | 0 | 0 | 1 | 8,203 |
Malignant or Aggressive Primary Musculoskeletal Tumor-Staging And Surveillance | Malignant or aggressive primary musculoskeletal tumor with no suspected or known recurrence. Surveillance for pulmonary metastasis. | FDG-PET/CT whole body | May be appropriate | Limited | {"References": [{"PMID": 22745027, "Study Quality": "2"}, {"PMID": 22134535, "Study Quality": "3"}]} | 4 | 10-30 mSv | 4 | 3-10 mSv | 5 | 5 | 0 | 0 | 0 | 1 | 13 | 1 | 1 | 0 | 0 | 2,698 |
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions | Adult. Recent ischemic infarct; greater than 24 hours. Initial imaging. | US duplex Doppler carotid artery | May be appropriate | Strong | {"References": [{"PMID": 29522870, "Study Quality": "2"}, {"PMID": 16679163, "Study Quality": "M"}, {"PMID": 10219418, "Study Quality": "2"}, {"PMID": 31662037, "Study Quality": "4"}, {"PMID": 34024117, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 0 | 1 | 5 | 11 | 2 | 0 | 0 | 9,838 |
Cranial Neuropathy | Multiple different lower cranial nerve palsies or combined lower cranial nerve syndromes (CN IX-XII). Initial imaging. | CT head without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 25769354, "Study Quality": "4"}, {"PMID": 6308990, "Study Quality": "4"}, {"PMID": 10871029, "Study Quality": "4"}, {"PMID": 14736665, "Study Quality": "4"}, {"PMID": 19568338, "Study Quality": "4"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 1 | 1 | 14 | 2 | 1 | 0 | 2 | 0 | 1 | 0 | 0 | 6,535 |
Low Back Pain | Acute low back pain with or without radiculopathy. No red flags. No prior management. Initial imaging. | Radiography lumbar spine | 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"}]} | 3 | 1-10 mSv | 2 | 3 mSv | 1 | 1 | 15 | 2 | 4 | 1 | 0 | 0 | 0 | 0 | 0 | 5,211 |
Chronic Ankle Pain | Chronic ankle pain. Ankle radiographs normal or nonspecific, suspected ankle instability. Next study. | MRI ankle without IV contrast | Usually appropriate | Limited | {"References": [{"PMID": 15256624, "Study Quality": "4"}, {"PMID": 12616009, "Study Quality": "3"}, {"PMID": 14743024, "Study Quality": "3"}, {"PMID": 11128010, "Study Quality": "4"}, {"PMID": 25539277, "Study Quality": "3"}, {"PMID": 22078461, "Study Quality": "3"}, {"PMID": 20483139, "Study Quality": "3"}, {"PMID": 1... | 0 | 0 mSv | 0 | 0 mSv | 9 | 9 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2,260 |
Chronic Chest Pain—High Probability of Coronary Artery Disease | Chronic chest pain; high probability of coronary artery disease. No known ischemic heart disease. Initial imaging. | MRA coronary arteries without and with IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 17112982, "Study Quality": "3"}]} | 0 | 0 mSv | 0 | 0 mSv | 3 | 3 | 2 | 5 | 8 | 1 | 0 | 0 | 0 | 0 | 0 | 1,775 |
Staging and Follow-up of Esophageal Cancer | Esophageal cancer. Posttreatment imaging. Suspected or known recurrence. | CT chest abdomen pelvis with IV contrast | May be appropriate (Disagreement) | Expert Opinion | {"References": [{"PMID": 24435775, "Study Quality": "2"}]} | 4 | 10-30 mSv | 4 | 3-10 mSv | 5 | 5 | 1 | 0 | 1 | 2 | 6 | 2 | 3 | 3 | 0 | 11,400 |
Suspected Osteomyelitis of the Foot in Patients with Diabetes Mellitus | Soft-tissue swelling with ulcer. Suspected osteomyelitis of the foot in patients with diabetes mellitus with or without neuropathic arthropathy. Additional imaging following radiographs. | WBC scan and sulfur colloid scan foot | Usually not appropriate | Limited | {"References": [{"PMID": 17127204, "Study Quality": "4"}, {"PMID": 9476948, "Study Quality": "3"}]} | 4 | 10-30 mSv | 0 | null | 2 | 2 | 6 | 2 | 1 | 1 | 2 | 0 | 0 | 0 | 0 | 93 |
Workup of Pleural Effusion or Pleural Disease | Recent minor blunt trauma with suspected pleural effusion. Initial imaging. | Image-guided aspiration chest | Usually not appropriate | Expert Consensus | {"References": []} | 0 | null | 0 | null | 1 | 1 | 10 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 11,207 |
Dementia | Suspected vascular dementia. Initial imaging. | CT head without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 23043907, "Study Quality": "4"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 1 | 1 | 13 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 9,553 |
Low Back Pain | Subacute or chronic low back pain with or without radiculopathy. Surgery or intervention candidate with persistent or progressive symptoms during or following 6 weeks of optimal medical management. Initial imaging. | MRI lumbar spine without and with IV contrast | May be appropriate | Expert Consensus | {"References": [{"PMID": 27387155, "Study Quality": "4"}, {"PMID": 28847557, "Study Quality": "2"}, {"PMID": 28377243, "Study Quality": "2"}, {"PMID": 26550787, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 5 | 5 | 1 | 1 | 0 | 3 | 15 | 2 | 0 | 0 | 0 | 5,235 |
Hydronephrosis on Prior Imaging-Unknown Cause | Adult. Asymptomatic unilateral hydronephrosis with unknown cause. Initial imaging. | CT abdomen and pelvis without IV contrast | May be appropriate | Expert Consensus | {"References": [{"PMID": 31237781, "Study Quality": "2"}, {"PMID": 8917195, "Study Quality": "4"}, {"PMID": 24591488, "Study Quality": "4"}, {"PMID": 25444983, "Study Quality": "2"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 4 | 4 | 0 | 1 | 1 | 8 | 5 | 0 | 0 | 0 | 0 | 12,092 |
Cerebrovascular Diseases-Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage | Known cerebral aneurysm; previously treated. Surveillance monitoring. | US duplex Doppler transcranial | Usually not appropriate | Expert Consensus | {"References": []} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 17 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 10,080 |
Acutely Limping Child Up To Age 5 | Child up to age 5. Acute limp. Pain. Localized symptoms. No concern for infection. Initial imaging. | MRI lower extremity area of interest without and with IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 17566800, "Study Quality": "4"}, {"PMID": 16741713, "Study Quality": "4"}, {"PMID": 24609825, "Study Quality": "4"}, {"PMID": 19995859, "Study Quality": "2"}, {"PMID": 22764042, "Study Quality": "4"}, {"PMID": 26122807, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 9 | 3 | 0 | 1 | 1 | 2 | 0 | 0 | 0 | 714 |
Post-Treatment Follow-up of Prostate Cancer | Metastatic prostate cancer treated by systemic therapy (androgen deprivation therapy [ADT], chemotherapy, immunotherapy). Follow-up. | Choline PET/CT skull base to mid-thigh | Usually appropriate | Strong | {"References": [{"PMID": 26768648, "Study Quality": "2"}, {"PMID": 25808631, "Study Quality": "3"}, {"PMID": 25504434, "Study Quality": "1"}, {"PMID": 26323576, "Study Quality": "3"}, {"PMID": 23486334, "Study Quality": "M"}, {"PMID": 23628493, "Study Quality": "M"}]} | 3 | 1-10 mSv | 0 | null | 7 | 7 | 0 | 0 | 0 | 1 | 2 | 5 | 3 | 5 | 0 | 1,076 |
Management of Vertebral Compression Fractures | New symptomatic vertebral compression fracture (VCF) identified on radiographs. No known malignancy. Next imaging study. | Bone scan whole body | May be appropriate | Strong | {"References": [{"PMID": 21165311, "Study Quality": "3"}, {"PMID": 26364958, "Study Quality": "3"}, {"PMID": 18349795, "Study Quality": "2"}, {"PMID": 20706042, "Study Quality": "3"}, {"PMID": 22927151, "Study Quality": "3"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 5 | 5 | 1 | 0 | 2 | 6 | 8 | 3 | 0 | 0 | 0 | 6,569 |
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions | Adult. Known intraparenchymal hemorrhage. No history of trauma. Follow-up imaging study. | MRA head without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 34794589, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 2 | 2 | 7 | 4 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 9,883 |
Clinically Suspected Adnexal Mass, No Acute Symptoms | Adult female. Adnexal mass, likely benign, no acute symptoms. Premenopausal. Follow-up imaging. | MRI pelvis without and with IV contrast | May be appropriate | Limited | {"References": [{"PMID": 31482379, "Study Quality": "3"}, {"PMID": 35040672, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 4 | 4 | 1 | 0 | 0 | 8 | 5 | 1 | 1 | 0 | 0 | 4,156 |
Acute Hand and Wrist Trauma | Suspect acute hand or wrist trauma. Initial radiographs negative or equivocal. Next imaging study. | CT area of interest with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 0 | null | 0 | null | 1 | 1 | 11 | 2 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 2,015 |
Lower Extremity Arterial Claudication-Imaging Assessment for Revascularization | Lower extremity arterial claudication-imaging assessment for revascularization. Initial imaging. | MRA lower extremity without and with IV contrast | May be appropriate | Strong | {"References": [{"PMID": 23801421, "Study Quality": "M"}, {"PMID": 22109304, "Study Quality": "2"}, {"PMID": 25241315, "Study Quality": "4"}, {"PMID": 10887229, "Study Quality": "M"}, {"PMID": 12239057, "Study Quality": "3"}, {"PMID": 21098208, "Study Quality": "4"}, {"PMID": 16864668, "Study Quality": "1"}, {"PMID": 9... | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 0 | 0 | 4 | 8 | 4 | 1 | 0 | 1,885 |
Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women | Surveillance. Stage I breast cancer. Asymptomatic. Rule out bone, thoracic, abdominal, and brain metastases. Initial imaging. | Bone scan whole body | Usually not appropriate | Limited | {"References": [{"PMID": 23601761, "Study Quality": "4"}, {"PMID": 26314782, "Study Quality": "4"}, {"PMID": -3146467, "Study Quality": "4"}, {"PMID": -3146470, "Study Quality": "4"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 1 | null | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6,004 |
Inflammatory Back Pain: Known or Suspected Axial Spondyloarthropathy | Known axial spondyloarthritis. Follow-up for treatment response or disease progression. | MRI sacroiliac joints without IV contrast | May be appropriate | Strong | {"References": [{"PMID": 19446974, "Study Quality": "2"}, {"PMID": 20032094, "Study Quality": "3"}, {"PMID": 23418080, "Study Quality": "4"}, {"PMID": 31436026, "Study Quality": "4"}, {"PMID": 28749173, "Study Quality": "2"}, {"PMID": 28593478, "Study Quality": "3"}, {"PMID": 25837448, "Study Quality": "4"}, {"PMID": 2... | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 1 | 0 | 1 | 4 | 2 | 3 | 2 | 2 | 7,407 |
Hearing Loss and/or Vertigo | Episodic vertigo with or without associated hearing loss or aural fullness (peripheral vertigo). Initial imaging. | MRA head and neck without and with IV contrast | May be appropriate | Limited | {"References": [{"PMID": 10459295, "Study Quality": "3"}]} | 0 | 0 mSv | 0 | 0 mSv | 4 | 4 | 1 | 2 | 3 | 5 | 2 | 2 | 0 | 0 | 0 | 5,676 |
Stage I Breast Cancer: Initial Workup and Surveillance for Local Recurrence and Distant Metastases in Asymptomatic Women | Surveillance. Stage I breast cancer. Asymptomatic. Rule out local recurrence. | Mammography screening | Usually appropriate | Limited | {"References": [{"PMID": 17548838, "Study Quality": "4"}, {"PMID": 16409580, "Study Quality": "4"}, {"PMID": 18368477, "Study Quality": "4"}, {"PMID": 17033037, "Study Quality": "4"}, {"PMID": -3146467, "Study Quality": "4"}, {"PMID": 22692036, "Study Quality": "3"}, {"PMID": 18206623, "Study Quality": "0"}]} | 2 | 1-1mSv | 0 | null | 8 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6,018 |
Hematuria-Child | Child. Traumatic hematuria (macroscopic). Initial imaging. | Fluoroscopy retrograde urethrography | May be appropriate | Limited | {"References": [{"PMID": 8632293, "Study Quality": "4"}]} | 3 | 1-10 mSv | 3 | 3-3 mSv | 6 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3,244 |
Penetrating Trauma-Lower Abdomen and Pelvis | Penetrating trauma, lower abdomen and pelvis. Suspected lower urinary tract trauma. Initial imaging. | Radiography intravenous urography | Usually not appropriate | Limited | {"References": [{"PMID": -3091864, "Study Quality": "4"}]} | 3 | 1-10 mSv | 3 | 3-3 mSv | 2 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1,488 |
Low Back Pain | Low back pain with or without radiculopathy. One or more of the following | CT myelography lumbar spine | May be appropriate | Limited | {"References": [{"PMID": 12637281, "Study Quality": "3"}]} | 4 | 10-30 mSv | 0 | null | 5 | 5 | 0 | 0 | 1 | 4 | 15 | 1 | 1 | 0 | 0 | 5,270 |
Acute Pancreatitis | Acute pancreatitis. Known pancreatic or peripancreatic fluid collections with continued abdominal pain, early satiety, nausea, vomiting, or signs of infection. Greater than 4 weeks after symptom onset. | CT abdomen and pelvis with IV contrast | Usually appropriate | Limited | {"References": [{"PMID": 25425489, "Study Quality": "2"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 9 | 9 | 0 | 0 | 0 | 0 | 0 | 1 | 2 | 5 | 10 | 4,313 |
Staging and Post-Therapy Assessment of Head and Neck Cancer | Treated cancer of a major salivary gland (parotid, submandibular, and sublingual glands). Surveillance imaging or follow-up imaging for suspected or known recurrence. | MRA neck without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 32113152, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 14 | 2 | 0 | 0 | 2 | 0 | 0 | 0 | 0 | 12,069 |
Acute Respiratory Illness in Immunocompetent Patients | Acute COPD exacerbation in immunocompetent patients with accompanying chest pain, fever, or leukocytosis, or a history of coronary artery disease, or heart failure. Initial imaging. | CT chest without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 4 | 3-10 mSv | 3 | 3 | 4 | 0 | 3 | 0 | 3 | 1 | 0 | 0 | 0 | 3,576 |
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. | US chest | Usually not appropriate | Strong | {"References": [{"PMID": 24184011, "Study Quality": "3"}, {"PMID": 21030550, "Study Quality": "2"}, {"PMID": 25758182, "Study Quality": "2"}, {"PMID": 22700780, "Study Quality": "3"}]} | 0 | 0 mSv | 0 | 0 mSv | 2 | 2 | 3 | 4 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 3,524 |
Imaging After Total Knee Arthroplasty | Pain after total knee arthroplasty. Infection excluded. Suspect aseptic loosening or osteolysis or instability. Additional imaging following radiographs. | CT knee without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 27468360, "Study Quality": "4"}, {"PMID": 11553828, "Study Quality": "4"}, {"PMID": 17448973, "Study Quality": "3"}, {"PMID": 16512924, "Study Quality": "3"}, {"PMID": -3195824, "Study Quality": "4"}, {"PMID": 15100514, "Study Quality": "2"}]} | 1 | 1 mSv | 2 | 3 mSv | 1 | 1 | 10 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2,759 |
Orbital Imaging and Vision Loss-Child | Child. Nontraumatic acute vision loss without papilledema. Initial imaging. | CT head and orbits without IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 3 | 3-3 mSv | 2 | 2 | 7 | 4 | 2 | 2 | 0 | 0 | 1 | 0 | 0 | 10,889 |
Congenital or Acquired Heart Disease | Child. Suspected or confirmed congenital or acquired coronary artery abnormality. Incomplete or inadequate assessment of coronary morphology after transthoracic echocardiography. Next imaging study. | MRI heart function and morphology without IV contrast | Usually appropriate | Expert Consensus | {"References": [{"PMID": 33755749, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 7 | 7 | 0 | 0 | 0 | 1 | 5 | 4 | 7 | 3 | 0 | 8,862 |
Staging and Surveillance of Testicular Cancer | Surveillance of stage IA and IB pure seminoma testicular cancer. Diagnosed by orchiectomy. No clinical suspicion of recurrence. | MRI abdomen and pelvis without and with IV contrast | Usually appropriate | Strong | {"References": [{"PMID": 6539790, "Study Quality": "3"}, {"PMID": 16286125, "Study Quality": "2"}, {"PMID": 4023233, "Study Quality": "4"}, {"PMID": 1716204, "Study Quality": "4"}, {"PMID": 19264179, "Study Quality": "2"}, {"PMID": 23122041, "Study Quality": "4"}, {"PMID": 31177136, "Study Quality": "4"}, {"PMID": 3204... | 0 | 0 mSv | 0 | 0 mSv | 7 | 7 | 0 | 0 | 0 | 0 | 1 | 2 | 3 | 4 | 1 | 1,437 |
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer | Clinically suspected prostate cancer. Negative TRUS-guided biopsy. Initial diagnosis. Next imaging study. | Fluciclovine PET/CT skull base to mid-thigh | Usually not appropriate | Expert Consensus | {"References": []} | 4 | 10-30 mSv | 0 | null | 1 | 1 | 9 | 3 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 1,233 |
Radiologic Management of Thoracic Nodules and Masses | Young adult patient (20–35 years old) with 1.0-cm smooth-walled noncalcified lung nodule seen on CT after minor motor vehicle trauma. No known risk factors for lung cancer. | Follow-up imaging only | Usually appropriate | null | {"References": []} | 0 | null | 0 | null | 8 | null | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 185 |
Liver Lesion — Initial Characterization | Incidental liver lesion, greater than 1 cm on US, noncontrast or single-phase CT, or noncontrast MRI. Known chronic liver disease. | CT abdomen with IV contrast multiphase | Usually appropriate | Moderate | {"References": [{"PMID": 20098330, "Study Quality": "2"}, {"PMID": 23883211, "Study Quality": "3"}, {"PMID": 20806437, "Study Quality": "3"}]} | 4 | 10-30 mSv | 0 | null | 8 | 8 | 0 | 0 | 0 | 0 | 0 | 1 | 5 | 10 | 1 | 4,484 |
Chronic Hip Pain | Chronic hip pain with low back or knee pathology or pain. Radiographs demonstrate hip osteoarthritis. Want to quantify amount of pain related to the hip. Next imaging study. | US hip | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 22915391, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 13 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 2,465 |
Acute Pelvic Pain in the Reproductive Age Group | Acute pelvic pain in the reproductive age group. Gynecological etiology suspected, ß-hCG positive (either serum or urine). Initial imaging. | US pelvis transabdominal | Usually appropriate | Limited | {"References": [{"PMID": -3195244, "Study Quality": "4"}, {"PMID": 24901772, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 9 | 9 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 2 | 10 | 6,179 |
Dizziness and Ataxia | Adult. Chronic recurrent vertigo. Associated with other brainstem neurologic deficits. Initial imaging. | MRI head with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 16 | 1 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 4,696 |
Tinnitus | Nonpulsatile tinnitus, unilateral; no hearing loss, and no neurologic deficit, and no trauma. 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 | 13 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 7,571 |
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer | Clinically established high-risk prostate cancer. Staging. | MRI whole body without and with IV contrast | May be appropriate | Strong | {"References": [{"PMID": 26215604, "Study Quality": "M"}, {"PMID": 30519933, "Study Quality": "2"}, {"PMID": 28957842, "Study Quality": "2"}, {"PMID": 22109291, "Study Quality": "3"}, {"PMID": 15197809, "Study Quality": "3"}, {"PMID": 30382380, "Study Quality": "3"}]} | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 1 | 0 | 1 | 6 | 2 | 2 | 1 | 1,297 |
Orbital Imaging and Vision Loss-Child | Child. Traumatic visual loss. Suspected orbital injury. Initial imaging. | MRA head without IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 18936032, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 9 | 4 | 1 | 1 | 0 | 0 | 1 | 0 | 0 | 10,868 |
Imaging after Breast Surgery | Female. Age 40 years or older. Postsurgical excision with nonmalignant pathology. Asymptomatic. Initial imaging. | Sestamibi MBI | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 0 | null | 1 | 1 | 17 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11,420 |
Palpable Abdominal Mass-Suspected Neoplasm | Palpable abdominal mass. Suspected intra-abdominal neoplasm. Initial imaging. | Fluoroscopy upper GI series | Usually not appropriate | Limited | {"References": [{"PMID": 23219189, "Study Quality": "3"}]} | 3 | 1-10 mSv | 3 | 3-3 mSv | 2 | 2 | 3 | 6 | 3 | 1 | 0 | 0 | 0 | 0 | 0 | 4,532 |
Osteoporosis and Bone Mineral Density | Osteoporosis screening or initial imaging of clinically suspected low bone mineral density. | QUS calcaneus | Usually not appropriate | Limited | {"References": [{"PMID": 18442758, "Study Quality": "4"}, {"PMID": 11256897, "Study Quality": "3"}, {"PMID": 29541626, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 10 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 449 |
Ovarian Cancer Screening | Ovarian cancer screening. Postmenopausal. Average risk. | FDG-PET/CT whole body | Usually not appropriate | Limited | {"References": [{"PMID": 16515568, "Study Quality": "3"}]} | 4 | 10-30 mSv | 4 | 3-10 mSv | 1 | null | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4,099 |
Vomiting in Infants | Vomiting within the first 2 days after birth. Poor feeding or no passage of meconium. Initial imaging. | Nuclear medicine gastroesophageal reflux scan | Usually not appropriate | Expert Consensus | {"References": []} | 0 | null | 3 | 3-3 mSv | 1 | 1 | 14 | 3 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 3,495 |
Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded) | Suspected inflammatory cardiomyopathy. Ischemic cardiomyopathy already excluded. Initial imaging. | US echocardiography transthoracic resting | Usually appropriate | Limited | {"References": [{"PMID": 27086044, "Study Quality": "2"}, {"PMID": 29306364, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 8 | 8 | 0 | 0 | 0 | 1 | 0 | 1 | 5 | 2 | 6 | 6,940 |
Multiple Gestations | Multiple gestations. Dichorionic or multichorionic higher order multiples or monochorionic gestations. Known abnormality or discordance between fetuses (fluid, size, weight). Growth and antepartum surveillance. | 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 | 4,081 |
Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis, Crystalline Arthritis, or Erosive Osteoarthritis | Chronic extremity joint pain. Suspect inflammatory arthritis (seropositive or seronegative arthritis). Radiographs normal or inconclusive. Next imaging study. | MRI area of interest without IV contrast | Usually appropriate | Limited | {"References": [{"PMID": 25537977, "Study Quality": "3"}, {"PMID": 20966327, "Study Quality": "4"}, {"PMID": 23192434, "Study Quality": "4"}, {"PMID": 25636414, "Study Quality": "3"}, {"PMID": 26681086, "Study Quality": "3"}, {"PMID": 27134251, "Study Quality": "3"}, {"PMID": 24528508, "Study Quality": "4"}, {"PMID": 2... | 0 | 0 mSv | 0 | 0 mSv | 7 | 7 | 0 | 0 | 1 | 1 | 1 | 5 | 4 | 2 | 2 | 7,852 |
Known or Suspected Congenital Heart Disease in the Adult | Known or suspected congenital heart disease in the adult. | CTA coronary arteries with IV contrast | Usually appropriate | Strong | {"References": [{"PMID": 19766923, "Study Quality": "4"}, {"PMID": 18195386, "Study Quality": "2"}, {"PMID": 18089704, "Study Quality": "3"}, {"PMID": 18796669, "Study Quality": "2"}, {"PMID": 20729443, "Study Quality": "2"}, {"PMID": 25773919, "Study Quality": "1"}, {"PMID": 19897497, "Study Quality": "3"}, {"PMID": 1... | 3 | 1-10 mSv | 4 | 3-10 mSv | 7 | null | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 381 |
Workup of Pleural Effusion or Pleural Disease | Recent minor blunt trauma with suspected pleural effusion. Initial imaging. | CTA chest with IV contrast | May be appropriate (Disagreement) | Expert Opinion | {"References": [{"PMID": 27299139, "Study Quality": "Good"}, {"PMID": 26440607, "Study Quality": "1"}, {"PMID": 21045745, "Study Quality": "2"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 5 | 5 | 1 | 2 | 0 | 1 | 1 | 0 | 1 | 7 | 0 | 11,206 |
Pretreatment Staging of Urothelial Cancer | Adult. Muscle invasive bladder cancer. Pretreatment staging. | CT pelvis without IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 4 | 3-10 mSv | 2 | 2 | 3 | 6 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 1,155 |
Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix | Surveillance of treated cervical cancer in asymptomatic patients. | CT chest without and with IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": -3195133, "Study Quality": "4"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 2 | 2 | 3 | 4 | 4 | 0 | 0 | 0 | 0 | 0 | 0 | 3,994 |
Myelopathy | Acute onset myelopathy. Initial imaging. | Radiography spine area of interest | Usually not appropriate | Limited | {"References": [{"PMID": 19525791, "Study Quality": "3"}, {"PMID": 3257332, "Study Quality": "4"}, {"PMID": 28457932, "Study Quality": "3"}, {"PMID": 9231966, "Study Quality": "2"}]} | 0 | null | 0 | null | 3 | 3 | 2 | 0 | 7 | 5 | 0 | 2 | 0 | 0 | 0 | 5,294 |
Cerebrovascular Diseases-Stroke and Stroke-Related Conditions | Adult. Focal neurologic deficit. Clinically suspected acute ischemic stroke. Initial imaging. | CTA head with IV contrast | Usually appropriate | Strong | {"References": [{"PMID": 35342807, "Study Quality": "2"}, {"PMID": 29364767, "Study Quality": "1"}, {"PMID": 36239645, "Study Quality": "2"}, {"PMID": 36239644, "Study Quality": "1"}, {"PMID": 29129157, "Study Quality": "4"}, {"PMID": 26898852, "Study Quality": "Not Assessed"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 9 | 9 | 0 | 0 | 1 | 0 | 0 | 1 | 1 | 6 | 12 | 9,798 |
Suspected Pulmonary Embolism | Suspected pulmonary embolism. Low or intermediate pretest probability with a positive D-dimer. Initial imaging. | US duplex Doppler lower extremity | Usually not appropriate | Moderate | {"References": [{"PMID": 15845793, "Study Quality": "3"}, {"PMID": 18043357, "Study Quality": "3"}, {"PMID": 19427980, "Study Quality": "1"}, {"PMID": 17555069, "Study Quality": "4"}, {"PMID": 17179348, "Study Quality": "1"}]} | 0 | 0 mSv | 0 | 0 mSv | 3 | 3 | 2 | 7 | 4 | 0 | 3 | 2 | 0 | 0 | 0 | 1,728 |
Shoulder Pain-Traumatic | Traumatic shoulder pain. Radiographs normal. Physical examination findings consistent with rotator cuff tear. Next imaging study. | US shoulder | Usually appropriate | Strong | {"References": [{"PMID": 24060014, "Study Quality": "3"}, {"PMID": 18591598, "Study Quality": "2"}, {"PMID": 18160242, "Study Quality": "3"}, {"PMID": 18449121, "Study Quality": "3"}, {"PMID": 20514507, "Study Quality": "2"}, {"PMID": 17149764, "Study Quality": "2"}, {"PMID": 15674840, "Study Quality": "2"}, {"PMID": 2... | 0 | 0 mSv | 0 | 0 mSv | 8 | 8 | 0 | 0 | 0 | 0 | 1 | 0 | 4 | 5 | 5 | 2,927 |
Suspected New-Onset and Known Nonacute Heart Failure | Suspected new-onset nonacute heart failure, not previously diagnosed. Initial imaging. | MRI heart with function and inotropic stress without IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 23500216, "Study Quality": "4"}, {"PMID": 19755468, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 2 | 2 | 3 | 5 | 6 | 1 | 0 | 0 | 0 | 0 | 0 | 8,581 |
Chronic Hip Pain | Chronic hip pain. Suspect impingement or dysplasia. Radiographs negative or nondiagnostic. Next imaging study. | MRI hip without and with IV contrast | Usually not appropriate | Strong | {"References": [{"PMID": 16275571, "Study Quality": "4"}, {"PMID": 8657921, "Study Quality": "3"}, {"PMID": 8451409, "Study Quality": "4"}, {"PMID": 12606867, "Study Quality": "4"}, {"PMID": 22907475, "Study Quality": "2"}, {"PMID": 22933489, "Study Quality": "3"}, {"PMID": 20872764, "Study Quality": "2"}, {"PMID": 210... | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 8 | 2 | 5 | 0 | 0 | 0 | 0 | 0 | 0 | 2,425 |
Imaging After Total Knee Arthroplasty | Follow-up of symptomatic or asymptomatic patients with a total knee arthroplasty. Initial imaging. | Image-guided aspiration knee | Usually not appropriate | Expert Consensus | {"References": []} | 0 | null | 0 | null | 1 | 1 | 11 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2,727 |
Pretreatment Detection, Surveillance, and Staging of Prostate Cancer | Clinically established low-risk prostate cancer. Active surveillance. | CT chest abdomen pelvis with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 4 | 10-30 mSv | 4 | 3-10 mSv | 1 | 1 | 10 | 3 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1,253 |
Liver Lesion — Initial Characterization | Indeterminate, less than 1 cm liver lesion on initial imaging with CT (noncontrast or single-phase) or noncontrast MRI. Known history of an extrahepatic malignancy. | US abdomen | Usually not appropriate | Limited | {"References": [{"PMID": 20517816, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 1 | 0 | 0 | 0 | 4,508 |
Pulmonary Arteriovenous Malformation (PAVM) | Adult. Asymptomatic with abnormal imaging on CT or chest radiography suggestive of PAVM. Next imaging study. | CT chest without IV contrast | May be appropriate | Limited | {"References": [{"PMID": 8184042, "Study Quality": "4"}, {"PMID": 25032812, "Study Quality": "4"}, {"PMID": 19553198, "Study Quality": "4"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 4 | 4 | 2 | 4 | 2 | 5 | 2 | 2 | 0 | 0 | 0 | 7,502 |
Cervical Neck Pain or Cervical Radiculopathy | New or increasing nontraumatic cervical radiculopathy. No “red flags.” Initial imaging. | CTA neck with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 3823440, "Study Quality": "2"}, {"PMID": 9534693, "Study Quality": "2"}]} | 3 | 1-10 mSv | 3 | 3-3 mSv | 1 | 1 | 10 | 4 | 2 | 1 | 1 | 0 | 0 | 0 | 0 | 2,503 |
Staging and Post-Therapy Assessment of Head and Neck Cancer | Treated cancer of the paranasal sinuses or nasal cavity. Surveillance imaging or follow-up imaging for suspected or known recurrence. | MRI head without IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 32113152, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 15 | 1 | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 12,048 |
Hearing Loss and/or Vertigo | Persistent vertigo with or without neurological symptoms (central vertigo). Initial imaging. | MRI head and internal auditory canal without IV contrast | Usually appropriate | Strong | {"References": [{"PMID": 27495834, "Study Quality": "3"}, {"PMID": 25956665, "Study Quality": "3"}, {"PMID": 24920847, "Study Quality": "2"}, {"PMID": 23336972, "Study Quality": "3"}, {"PMID": 22940762, "Study Quality": "4"}, {"PMID": 11698800, "Study Quality": "4"}, {"PMID": 24314796, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 8 | 8 | 0 | 0 | 0 | 0 | 1 | 1 | 5 | 5 | 3 | 5,687 |
Imaging of Invasive Breast Cancer | Surveillance. Regardless of clinical stage of breast cancer at time of original presentation. Evaluation for local recurrence in patient with history of mastectomy. | Mammography with IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": -3195173, "Study Quality": "4"}, {"PMID": -3195175, "Study Quality": "4"}, {"PMID": -3195384, "Study Quality": "4"}]} | 2 | 1-1mSv | 0 | null | 1 | 1 | 15 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11,746 |
Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded) | Suspected arrhythmogenic cardiomyopathy (arrhythmia of ventricular origin). Ischemic cardiomyopathy already excluded. Initial imaging. | US echocardiography transthoracic stress | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 20172912, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 3 | 3 | 3 | 5 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 6,926 |
Recurrent Lower Urinary Tract Infections in Females | Recurrent lower urinary tract infections in a female. Uncomplicated with no underlying risk factors. | CTU without and with IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 21792579, "Study Quality": "4"}, {"PMID": 20842992, "Study Quality": "4"}]} | 4 | 10-30 mSv | 5 | 10-30 mSv | 2 | 2 | 5 | 3 | 3 | 1 | 1 | 0 | 0 | 1 | 0 | 5,860 |
Dizziness and Ataxia | Adult. Acute persistent vertigo. Normal neurologic examination and HINTS examination examination consistent with peripheral vertigo. Initial imaging. | CT temporal bone without IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 0 | null | 1 | 1 | 16 | 1 | 1 | 3 | 0 | 0 | 0 | 0 | 0 | 4,643 |
Management of Liver Cancer | Metastatic liver disease | Hepatic arterial chemotherapy infusion | May be appropriate | Strong | {"References": [{"PMID": 26133575, "Study Quality": "4"}, {"PMID": 28433600, "Study Quality": "2"}, {"PMID": 28293087, "Study Quality": "2"}, {"PMID": 24646562, "Study Quality": "2"}, {"PMID": 22922040, "Study Quality": "2"}]} | 0 | null | 0 | null | 6 | 6 | 0 | 0 | 0 | 3 | 3 | 4 | 4 | 1 | 0 | 1,612 |
Pelvic Floor Dysfunction in Females | Female. Urinary dysfunction (involuntary leakage of urine, or frequent urination, or urgency, straining to void, incomplete voiding, splinting, or digital maneuvers to void). Initial imaging. | CT pelvis with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 3 | 1-10 mSv | 4 | 3-10 mSv | 3 | 3 | 3 | 4 | 3 | 1 | 1 | 2 | 0 | 0 | 0 | 7,247 |
Primary Bone Tumors | Suspect primary bone tumor. Radiographs or clinical presentation suggest osteoid osteoma. Next imaging study. | CT area of interest without and with IV contrast | May be appropriate (Disagreement) | Expert Opinion | {"References": [{"PMID": 2119115, "Study Quality": "4"}, {"PMID": 8134575, "Study Quality": "3"}, {"PMID": 24631034, "Study Quality": "4"}]} | 0 | null | 0 | null | 5 | 5 | 0 | 4 | 1 | 2 | 5 | 0 | 2 | 0 | 0 | 2,191 |
Fibroids | Clinically suspected fibroids. Initial imaging. | MRI pelvis without and with IV contrast | May be appropriate | Strong | {"References": [{"PMID": 27921159, "Study Quality": "2"}, {"PMID": 23563602, "Study Quality": "3"}, {"PMID": -3188535, "Study Quality": "4"}, {"PMID": 23206612, "Study Quality": "3"}, {"PMID": 30207503, "Study Quality": "4"}, {"PMID": 31427216, "Study Quality": "4"}, {"PMID": 26397344, "Study Quality": "4"}, {"PMID": 2... | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 0 | 0 | 1 | 7 | 2 | 2 | 0 | 11,849 |
Thoracoabdominal Aneurysm or Dissection: Treatment Planning and Follow-Up | Follow-up after open repair of thoracoabdominal aortic aneurysm or dissection. | CT chest abdomen pelvis without IV contrast | May be appropriate | Strong | {"References": [{"PMID": 24503676, "Study Quality": "4"}, {"PMID": 30835189, "Study Quality": "1"}, {"PMID": 22451563, "Study Quality": "2"}]} | 4 | 10-30 mSv | 4 | 3-10 mSv | 5 | 5 | 0 | 0 | 2 | 7 | 12 | 1 | 0 | 0 | 0 | 11,600 |
Tinnitus | Pulsatile tinnitus, unilateral or bilateral; No retrotympanic lesion on otoscopy. Initial imaging. | US head | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 23632978, "Study Quality": "3"}, {"PMID": 15068515, "Study Quality": "4"}, {"PMID": 2296650, "Study Quality": "4"}, {"PMID": 29561378, "Study Quality": "2"}, {"PMID": 21402614, "Study Quality": "2"}, {"PMID": 17320776, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 15 | 0 | 2 | 0 | 0 | 1 | 0 | 0 | 0 | 7,520 |
Pretreatment Evaluation and Follow-Up of Endometrial Cancer | Surveillance of asymptomatic patients with treated low- or intermediate-risk endometrial cancer. | MRI abdomen without IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 28372871, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 2 | 2 | 5 | 7 | 1 | 2 | 0 | 0 | 0 | 0 | 0 | 3,902 |
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. | CT abdomen and pelvis without and with IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 4 | 10-30 mSv | 5 | 10-30 mSv | 1 | 1 | 16 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 3,429 |
Management of Vertebral Compression Fractures | New back pain. Previously treated VCF or multiple VCFs. Initial Imaging. | CT myelography spine area of interest | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 20528649, "Study Quality": "2"}, {"PMID": 15690210, "Study Quality": "4"}, {"PMID": 22637642, "Study Quality": "2"}, {"PMID": 22091375, "Study Quality": "4"}, {"PMID": 14519867, "Study Quality": "4"}]} | 0 | null | 0 | null | 3 | 3 | 7 | 2 | 4 | 5 | 2 | 0 | 0 | 0 | 0 | 6,594 |
Thoracic Outlet Syndrome | Arterial thoracic outlet syndrome. Initial imaging and follow-up imaging after surgery or intervention. | Arteriography upper extremity | Usually appropriate | Expert Consensus | {"References": [{"PMID": 21129894, "Study Quality": "4"}, {"PMID": 22140211, "Study Quality": "4"}, {"PMID": 22544354, "Study Quality": "4"}, {"PMID": 23446121, "Study Quality": "4"}, {"PMID": 22542345, "Study Quality": "4"}]} | 1 | 1 mSv | 0 | null | 7 | 7 | 1 | 0 | 0 | 0 | 2 | 5 | 7 | 7 | 0 | 7,210 |
Preprocedural Planning for Transcatheter Aortic Valve Replacement | Preintervention planning for transcatheter aortic valve replacement | CTA abdomen and pelvis with IV contrast | Usually appropriate | Limited | {"References": [{"PMID": 31732445, "Study Quality": "3"}]} | 4 | 10-30 mSv | 0 | null | 8 | 8 | 0 | 0 | 0 | 0 | 0 | 1 | 5 | 8 | 3 | 7,030 |
Suspected Spine Trauma | Age greater than or equal to 16 years. Suspected acute cervical spine blunt trauma. Clinical or imaging findings suggest arterial injury with or without positive cervical spine CT. Next imaging study. | MRA neck without IV contrast | May be appropriate | Strong | {"References": [{"PMID": 22695428, "Study Quality": "3"}, {"PMID": 12435934, "Study Quality": "1"}, {"PMID": 24458034, "Study Quality": "3"}, {"PMID": 18635617, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 5 | 5 | 0 | 0 | 0 | 0 | 13 | 3 | 0 | 0 | 0 | 530 |
Head Trauma-Child | Child. Minor acute blunt head trauma. High risk for clinically important brain injury per PECARN criteria. Excluding suspected abusive head trauma. Initial imaging. | CT head without and with IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 19758692, "Study Quality": "2"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 1 | 1 | 20 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7,143 |
Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix | Evaluation of known or suspected cervical cancer local recurrence or distant metastatic disease. Follow-up imaging. | MRI pelvis without IV contrast | May be appropriate | Limited | {"References": [{"PMID": -3195133, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 1 | 0 | 4 | 2 | 4 | 0 | 0 | 4,003 |
Orbits, Vision, and Visual Loss | Nontraumatic orbital asymmetry, exophthalmos, or enophthalmos. Initial imaging. | MRA head and neck without and with IV contrast | May be appropriate | Limited | {"References": [{"PMID": 18356442, "Study Quality": "4"}, {"PMID": 18071114, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 0 | 0 | 1 | 1 | 5 | 5 | 3 | 2 | 0 | 5,407 |
Staging and Post-Therapy Assessment of Head and Neck Cancer | Suspected or diagnosed cancer of the paranasal sinuses or nasal cavity. Initial staging. | MRA neck without IV contrast | Usually not appropriate | Expert Consensus | {"References": [{"PMID": 32113152, "Study Quality": "4"}]} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 17 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 11,938 |
Seizures-Child | Children 1 month to 17 years of age. Intractable seizures or refractory epilepsy. | SPECT or SPECT/CT brain perfusion | May be appropriate | Strong | {"References": [{"PMID": 27818371, "Study Quality": "2"}, {"PMID": 26021550, "Study Quality": "2"}, {"PMID": 25308754, "Study Quality": "2"}, {"PMID": 24799620, "Study Quality": "3"}, {"PMID": 23293926, "Study Quality": "2"}, {"PMID": 23030361, "Study Quality": "3"}, {"PMID": 21275980, "Study Quality": "2"}, {"PMID": 1... | 3 | 1-10 mSv | 4 | 3-10 mSv | 6 | null | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3,328 |
Headache | Headache with features of intracranial hypotension (eg, positional, worse when upright, better when lying down). Initial imaging. | MRA head without IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 11 | 1 | 4 | 0 | 1 | 1 | 1 | 0 | 0 | 5,155 |
Neuroendocrine Imaging | Adult. Pituitary apoplexy. Initial imaging. | MRI sella without IV contrast | Usually appropriate | Limited | {"References": [{"PMID": 26414232, "Study Quality": "4"}, {"PMID": 23585661, "Study Quality": "3"}, {"PMID": 17898201, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 7 | 7 | 0 | 0 | 0 | 1 | 2 | 2 | 5 | 4 | 1 | 5,354 |
Imaging of the Axilla | Female. Breast cancer, greater than 2 cm in size, at mid-treatment of neoadjuvant chemotherapy, with initial clinical node-negative disease but now presenting with new palpable axillary lump. Imaging of the axilla at mid-treatment. | US axilla | Usually appropriate | Moderate | {"References": [{"PMID": 29972239, "Study Quality": "Good"}, {"PMID": 28314842, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 9 | 9 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 2 | 12 | 10,375 |
Sinonasal Disease | Suspected sinonasal mass. Initial Imaging. | MRI head without and with IV contrast | May be appropriate | Expert Consensus | {"References": [{"PMID": 29685531, "Study Quality": "4"}, {"PMID": 31939885, "Study Quality": "1"}, {"PMID": 29696477, "Study Quality": "4"}, {"PMID": 29217745, "Study Quality": "1"}, {"PMID": 26830408, "Study Quality": "4"}, {"PMID": 26359585, "Study Quality": "2"}]} | 0 | 0 mSv | 0 | 0 mSv | 6 | 6 | 1 | 0 | 0 | 1 | 1 | 8 | 4 | 2 | 0 | 6,137 |
Congenital or Acquired Heart Disease | Child or adult. Repaired tetralogy of Fallot or pulmonary valve stenosis with concern for pulmonary valve dysfunction or branch pulmonary artery stenosis. Incomplete or inadequate assessment of cardiovascular morphology and function after transthoracic echocardiography. Next imaging study. | MRA abdomen without IV contrast | Usually not appropriate | Expert Consensus | {"References": []} | 0 | 0 mSv | 0 | 0 mSv | 1 | 1 | 21 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 8,814 |
Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix | Initial local staging of pretreatment cervical cancer; assessment of local tumor extension (T staging) for any clinically visible lesion. | FDG-PET/CT skull base to mid-thigh | May be appropriate | Limited | {"References": [{"PMID": 32551909, "Study Quality": "4"}, {"PMID": 32415584, "Study Quality": "3"}]} | 4 | 10-30 mSv | 4 | 3-10 mSv | 6 | 6 | 1 | 0 | 0 | 0 | 5 | 0 | 4 | 1 | 1 | 3,944 |
Osteomyelitis or Septic Arthritis-Child (Excluding Axial Skeleton) | Child. Younger than 5 years of age. Concern for osteomyelitis or septic arthritis involving an extremity. Initial radiographs normal, or with findings suggestive of osteomyelitis. Next imaging study. | Bone scan whole body and 3-phase bone scan area of interest | May be appropriate | Limited | {"References": [{"PMID": 12368368, "Study Quality": "4"}, {"PMID": 23478935, "Study Quality": "4"}, {"PMID": 21383641, "Study Quality": "4"}, {"PMID": 20308478, "Study Quality": "3"}, {"PMID": 22582364, "Study Quality": "4"}, {"PMID": 1178860, "Study Quality": "4"}, {"PMID": 179356, "Study Quality": "4"}, {"PMID": 1250... | 0 | null | 4 | 3-10 mSv | 4 | 4 | 0 | 2 | 2 | 5 | 4 | 3 | 0 | 0 | 0 | 11,078 |
Cranial Neuropathy | Head and neck cancer. Suspected or known perineural spread of tumor. Initial imaging. | CT neck without IV contrast | Usually not appropriate | Limited | {"References": [{"PMID": 27890182, "Study Quality": "4"}, {"PMID": 14736668, "Study Quality": "4"}, {"PMID": 17576903, "Study Quality": "2"}]} | 3 | 1-10 mSv | 3 | 3-3 mSv | 2 | 2 | 10 | 4 | 5 | 1 | 0 | 0 | 0 | 0 | 0 | 6,561 |
Rib Fractures | Suspected rib fractures after cardiopulmonary resuscitation (CPR). Initial imaging. | CT chest without IV contrast | May be appropriate | Limited | {"References": [{"PMID": 21705131, "Study Quality": "2"}]} | 3 | 1-10 mSv | 4 | 3-10 mSv | 4 | 4 | 1 | 2 | 2 | 5 | 3 | 0 | 0 | 0 | 0 | 3,679 |
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