iven the growing interest in appropriateness criteria from awmakers, the media, payers, and others, future criteria will e called “Appropriate Use Criteria” to better reflect the mportant role the criteria play in identifying appropriate se of medical technology and procedures. The coronary evascularization document has maintained the former title, ecause it was developed mainly during the peri...

Ductal carcinoma in situ (DCIS) describes a wide spectrum of non-invasive tumors which carry a significant risk of invasive relapse, thus prevention of local recurrence is vital. For appropriate patients with limited disease, management with breast conserving surgery (BCS) followed by whole-breast radiation (RT) is supported by multiple Phase III studies, but mastectomy may be appropriate in se...

The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+) benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential ...

Neurodegenerative disease, including dementia, extrapyramidal degeneration, and motor system degeneration, is a growing public health concern and is quickly becoming one of the top health care priorities of developed nations. The primary function of anatomic neuroimaging studies in evaluating patients with dementia or movement disorders is to rule out structural causes that may be reversible. L...

Renal cell carcinoma accounts for 2%-3% of all visceral malignancies. Preoperative imaging can provide important staging and anatomic information to guide treatment decisions. Size of the primary tumor and degree of local invasion, such as involvement of perinephric fat or renal sinus fat, and tumor thrombus in renal veins and inferior vena cava are important detriments to local staging of prim...

Stroke is the sudden onset of focal neurologic symptoms due to ischemia or hemorrhage in the brain. Current FDA-approved clinical treatment of acute ischemic stroke involves the use of the intravenous thrombolytic agent recombinant tissue plasminogen activator given Ͻ3 hours after symptom onset, following the exclusion of intrace-rebral hemorrhage by a noncontrast CT scan. Advanced MRI, CT, and...

Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positi...

Acute right upper quadrant pain is a common presenting symptom in patients with acute cholecystitis. When acute cholecystitis is suspected in patients with right upper quadrant pain, in most clinical scenarios, the initial imaging modality of choice is ultrasound. Although cholescintigraphy has been shown to have slightly higher sensitivity and specificity for diagnosis, ultrasound is preferred...

Radiologic Procedure Rating Comments RRL* Rule Out Bone Metastases Tc-99m bone scan whole body 2 ☢ ☢ ☢ X-ray radiographic survey whole body 2 ☢ ☢ ☢ FDG-PET/CT whole body 2 ☢ ☢ ☢ ☢ Rule Out Thoracic Metastases X-ray chest 2 ☢ CT chest without contrast 2 ☢ ☢ ☢ CT chest with contrast 2 ☢ ☢ ☢ CT chest without and with contrast 2 ☢ ☢ ☢ X-ray tomography chest 2 ☢ ☢ FDG-PET/CT whole body 2 ☢ ☢ ☢ ☢ Rul...

The present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic factors, and treatment options for patients with localized nodal indolent lymphoma, with an emphasis on radiation guidelines, including radiation dose, field design, and radiation techniques. Following a discussion of the current literature and available data for treatment and outcomes of patients w...