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ACR appropriateness criteria

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https://www.readbyqxmd.com/read/29764746/appropriateness-and-clinical-outcome-of-chest-computed-tomography-without-intravenous-contrast-a-study-conducted-in-pakistan
#1
Amjad Sattar, Sohail Ahmed Khan, Nauman Al-Qamari, Hatem Adel, Syed Omair Adil, Kashif Shafique
BACKGROUND: Chest computed tomography (CT), including high-resolution CT (HRCT), has become an integral part of modern healthcare. It enables the physician to arrive at a diagnosis using a noninvasive approach. Our practice has shown that various chest CT scans without intravenous (IV) contrast, including HRCT, have no proper clinical indication. For the same reason, we have assessed the appropriateness of chest CT without IV contrast based on the evidence-based American College of Radiology (ACR) appropriateness criteria...
March 28, 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29764185/management-of-metastatic-spinal-cord-compression-among-veterans-health-administration-radiation-oncologists
#2
Ruchika Gutt, Sheeta Malhotra, Shruti Jolly, Drew Moghanaki, Alice V Cheuk, Helen Fosmire, Maria Kelly, Lori Hoffman-Hogg, Stephen Lutz, Mitchell Anscher, George Dawson
BACKGROUND: Optimal management of metastatic spinal cord compression (MSCC) improves functional outcomes in patients with metastatic disease. This survey study evaluated management of MSCC by Veterans Health Administration (VHA) radiation oncologists (ROs), to determine whether management of MSCC correlates with American College of Radiology (ACR) guidelines, and to compare times to initiation of treatment between surgery and radiotherapy (RT). METHODS: Surveys emailed to 79 VHA ROs included questions on steroid use, surgical care, palliative care, fractionation of irradiation, re-irradiation, and management of common MSCC case scenarios...
April 2018: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29760842/appropriateness-of-extremity-magnetic-resonance-imaging-examinations-in-an-academic-emergency-department-observation-unit
#3
McKinley Glover, Ravi V Gottumukkala, Yadiel Sanchez, Brian J Yun, Theodore I Benzer, Benjamin A White, Anand M Prabhakar, Ali S Raja
Introduction: Emergency departments (ED) and hospitals face increasing challenges related to capacity, throughput, and stewardship of limited resources while maintaining high quality. Appropriate utilization of extremity magnetic resonance imaging (MRI) examinations within the emergency setting is not well known. Therefore, this study aimed to determine indications for and appropriateness of MRI of the extremities for musculoskeletal conditions in the ED observation unit (EDOU). Methods: We conducted this institutional review board-approved, retrospective study in a large, quaternary care academic center and Level I trauma center...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29754997/patient-friendly-summary-of-the-acr-appropriateness-criteria-monitoring-response-to-neoadjuvant-systemic-therapy-for-breast-cancer
#4
Casey Quinlan, Jennifer W Uyeda
No abstract text is available yet for this article.
May 11, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29728320/the-acr-appropriateness-criteria-%C3%A2-patient-engagement-subcommittee
#5
Jennifer W Uyeda, Andrea Borondy Kitts, Frank J Rybicki
No abstract text is available yet for this article.
April 30, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724430/acr-appropriateness-criteria-%C3%A2-hematuria-child
#6
Jonathan R Dillman, Cynthia K Rigsby, Ramesh S Iyer, Adina L Alazraki, Sudha A Anupindi, Brandon P Brown, Sherwin S Chan, Scott R Dorfman, Richard A Falcone, Matthew D Garber, Jie C Nguyen, Craig A Peters, Nabile M Safdar, Andrew T Trout, Boaz K Karmazyn
Hematuria is the presence of red blood cells in the urine, either visible to the eye (macroscopic hematuria) or as viewed under the microscope (microscopic hematuria). The clinical evaluation of children and adolescents with any form of hematuria begins with a meticulous history and thorough evaluation of the urine. The need for imaging evaluation depends on the clinical scenario in which hematuria presents, including the suspected etiology. Ultrasound and CT are the most common imaging methods used to assess hematuria in children, although other imaging modalities may be appropriate in certain instances...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724429/acr-appropriateness-criteria-%C3%A2-headache-child
#7
Laura L Hayes, Susan Palasis, Twyla B Bartel, Timothy N Booth, Ramesh S Iyer, Jeremy Y Jones, Nadja Kadom, Sarah S Milla, John S Myseros, Ann Pakalnis, Sonia Partap, Richard L Robertson, Maura E Ryan, Gaurav Saigal, Bruno P Soares, Aylin Tekes, Boaz K Karmazyn
Headaches in children are not uncommon and have various causes. Proper neuroimaging of these children is very specific to the headache type. Care must be taken to choose and perform the most appropriate initial imaging examination in order to maximize the ability to properly determine the cause with minimum risk to the child. This evidence-based report discusses the different headache types in children and provides appropriate guidelines for imaging these children. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724428/acr-appropriateness-criteria-%C3%A2-first-trimester-vaginal-bleeding
#8
Douglas L Brown, Ann Packard, Katherine E Maturen, Sandeep Prakash Deshmukh, Kika M Dudiak, Tara L Henrichsen, Benjamin J Meyer, Liina Poder, Elizabeth A Sadowski, Thomas D Shipp, Lynn Simpson, Therese M Weber, Carolyn M Zelop, Phyllis Glanc
Vaginal bleeding is not uncommon in the first trimester of pregnancy. The majority of such patients will have a normal intrauterine pregnancy (IUP), a nonviable IUP, or an ectopic pregnancy. Ultrasound (US) is the primary imaging modality in evaluation of these patients. US, along with clinical observations and serum human chorionic gonadotropin levels, can usually distinguish these causes. Although it is important to diagnose ectopic pregnancies and nonviable IUPs, one should also guard against injury to normal pregnancies due to inappropriate treatment with methotrexate or surgical intervention...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724427/acr-appropriateness-criteria-%C3%A2-colorectal-cancer-screening
#9
Courtney Moreno, David H Kim, Twyla B Bartel, Brooks D Cash, Kevin J Chang, Barry W Feig, Kathryn J Fowler, Evelyn M Garcia, Avinash R Kambadakone, Drew L Lambert, Angela D Levy, Daniele Marin, Christine M Peterson, Christopher D Scheirey, Martin P Smith, Stefanie Weinstein, Laura R Carucci
This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724426/acr-appropriateness-criteria-%C3%A2-chronic-wrist-pain
#10
David A Rubin, Catherine C Roberts, Jenny T Bencardino, Angela M Bell, R Carter Cassidy, Eric Y Chang, Soterios Gyftopoulos, Darlene F Metter, William B Morrison, Naveen Subhas, Siddharth Tambar, Jeffrey D Towers, Joseph S Yu, Mark J Kransdorf
Radiographs are indicated as the first imaging test in all patients with chronic wrist pain, regardless of the suspected diagnosis. When radiographs are normal or equivocal, advanced imaging with MRI (without or without intravenous contrast or following arthrography), CT (usually without contrast), and ultrasound each has a role in establishing a diagnosis. Furthermore, these examinations may contribute to staging disease, treatment planning, and prognostication, even when radiographs are diagnostic of a specific condition...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724425/acr-appropriateness-criteria-%C3%A2-chronic-ankle-pain
#11
Eric Y Chang, Anthony S Tadros, Behrang Amini, Angela M Bell, Stephanie A Bernard, Michael G Fox, Tetyana Gorbachova, Alice S Ha, Kenneth S Lee, Darlene F Metter, Pekka A Mooar, Nehal A Shah, Adam D Singer, Stacy E Smith, Mihra S Taljanovic, Ralf Thiele, Mark J Kransdorf
Chronic ankle pain is a common clinical problem whose cause is often elucidated by imaging. The ACR Appropriateness Criteria for chronic ankle pain define best practices of image ordering. Clinical scenarios are followed by the imaging choices and their appropriateness. The information is in ordered tables with an accompanying narrative explanation to guide physicians to order the right test. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724424/acr-appropriateness-criteria-%C3%A2-suspected-thoracic-aortic-aneurysm
#12
Shelby J Bennett, Karin E Dill, Michael Hanley, Osmanuddin Ahmed, Benoit Desjardins, Kenneth L Gage, Michael Ginsburg, Ali Khoynezhad, Isabel B Oliva, Michael L Steigner, Richard Strax, Nupur Verma, Frank J Rybicki
Although the incidence of thoracic aortic aneurysm is on the rise, initial imaging diagnosis can present a challenge for many clinicians. Providers are faced with many imaging choices as part of the initial workup. Considering level of invasiveness, relative radiation level, and quality of associated diagnostic data, CT angiography and MR angiography are believed to be the most appropriate options for radiological diagnosis of suspected thoracic aortic aneurysm. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724423/acr-appropriateness-criteria-%C3%A2-abdominal-aortic-aneurysm-interventional-planning-and-follow-up
#13
Christopher J Francois, Erik P Skulborstad, Bill S Majdalany, Ankur Chandra, Jeremy D Collins, Khashayar Farsad, Marie D Gerhard-Herman, Heather L Gornik, A Tuba Kendi, Minhajuddin S Khaja, Margaret H Lee, Patrick D Sutphin, Baljendra S Kapoor, Sanjeeva P Kalva
Abdominal aortic aneurysms (AAAs) are a relatively common vascular problem that can be treated with either open, surgical repair or endovascular aortic aneurysm repair (EVAR). Both approaches to AAA repair require dedicated preoperative imaging to minimize adverse outcomes. After EVAR, cross-sectional imaging has an integral role in confirming the successful treatment of the AAA and early detection of complications related to EVAR. CT angiography is the primary imaging modality for both preoperative planning and follow-up after repair...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724422/acr-appropriateness-criteria-%C3%A2-staging-and-follow-up-of-ovarian-cancer
#14
Stella K Kang, Caroline Reinhold, Mostafa Atri, Carol B Benson, Priyadarshani R Bhosale, Anuja Jhingran, Yulia Lakhman, Katherine E Maturen, Refky Nicola, Pari V Pandharipande, Gloria M Salazar, Thomas D Shipp, Lynn Simpson, William Small, Betsy L Sussman, Jennifer W Uyeda, Darci J Wall, Bradford P Whitcomb, Carolyn M Zelop, Phyllis Glanc
In the management of epithelial ovarian cancers, imaging is used for cancer detection and staging, both before and after initial treatment. The decision of whether to pursue initial cytoreductive surgery for ovarian cancer depends in part on accurate staging. Contrast-enhanced CT of the abdomen and pelvis (and chest where indicated) is the current imaging modality of choice for the initial staging evaluation of ovarian cancer. Fluorine-18-2-fluoro-2-deoxy-d-glucose PET/CT and MRI may be appropriate for problem-solving purposes, particularly when lesions are present on CT but considered indeterminate...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724421/acr-appropriateness-criteria-%C3%A2-soft-tissue-masses
#15
Mark J Kransdorf, Mark D Murphey, Daniel E Wessell, R Carter Cassidy, Gregory J Czuczman, Jennifer L Demertzis, Leon Lenchik, Kambiz Motamedi, Jennifer L Pierce, Akash Sharma, Eric A Walker, Elizabeth Ying-Kou Yung, Francesca D Beaman
Imaging is an integral component of the evaluation of patients with a suspected soft-tissue mass. Imaging can not only confirm the presence of a mass but can provide essential information necessary for diagnosis, local staging, and biopsy planning. Although the objectives of the evaluation have not changed, the choices available for imaging of musculoskeletal masses have evolved dramatically in recent years. The purpose of this document is to identify the most common clinical scenarios and the most appropriate imaging for their assessment on the basis of the current literature and to provide general guidance for those scenarios that are not specifically addressed...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724420/acr-appropriateness-criteria-%C3%A2-shoulder-pain-traumatic
#16
Behrang Amini, Nicholas M Beckmann, Francesca D Beaman, Daniel E Wessell, Stephanie A Bernard, R Carter Cassidy, Gregory J Czuczman, Jennifer L Demertzis, Bennett S Greenspan, Bharti Khurana, Kenneth S Lee, Leon Lenchik, Kambiz Motamedi, Akash Sharma, Eric A Walker, Mark J Kransdorf
Traumatic shoulder pain is pain directly attributed to a traumatic event, either acute or chronic. This pain may be the result of either fracture (the clavicle, scapula, or proximal humerus) or soft-tissue injury (most commonly of the rotator cuff, acromioclavicular ligaments, or labroligamentous complex). Imaging assessment of traumatic shoulder pain begins with conventional radiography and, depending on physical examination findings, will require MRI or MR arthrography for assessment of soft-tissue injuries and CT for delineation of fracture planes...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724419/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-uterine-leiomyomas
#17
M-Grace Knuttinen, Gregory Stark, Eric J Hohenwalter, Linda D Bradley, Aaron R Braun, Matthew G Gipson, Charles Y Kim, Jason W Pinchot, Matthew J Scheidt, David M Sella, Clifford R Weiss, Jonathan M Lorenz
Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy. It is important to understand the role of these treatment options in various clinical scenarios so that appropriate consultation is performed...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724418/acr-appropriateness-criteria-%C3%A2-pretreatment-staging-of-muscle-invasive-bladder-cancer
#18
Christian B van der Pol, V Anik Sahni, Steven C Eberhardt, Aytekin Oto, Oguz Akin, Lauren F Alexander, Brian C Allen, Fergus V Coakley, Adam T Froemming, Pat F Fulgham, Keyanoosh Hosseinzadeh, Jodi K Maranchie, Rekha N Mody, Nicola Schieda, David M Schuster, Aradhana M Venkatesan, Carolyn L Wang, Mark E Lockhart
Muscle-invasive bladder cancer (MIBC) has a tendency toward urothelial multifocality and is at risk for local and distant spread, most commonly to the lymph nodes, bone, lung, liver, and peritoneum. Pretreatment staging of MIBC should include imaging of the urothelial upper tract for synchronous lesions; imaging of the chest, abdomen, and pelvis for metastases; and MRI pelvis for local staging. CT abdomen and pelvis without and with contrast (CT urogram) is recommended to assess the urothelium and abdominopelvic organs...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724417/acr-appropriateness-criteria-%C3%A2-post-treatment-follow-up-prostate-cancer
#19
Adam T Froemming, Sadhna Verma, Steven C Eberhardt, Aytekin Oto, Lauren F Alexander, Brian C Allen, Fergus V Coakley, Brian J Davis, Pat F Fulgham, Keyanoosh Hosseinzadeh, Christopher Porter, V Anik Sahni, David M Schuster, Timothy N Showalter, Aradhana M Venkatesan, Carolyn L Wang, Erick M Remer
Diagnosis and management of prostate cancer post treatment is a large and complex problem, and care of these patients requires multidisciplinary involvement of imaging, medical, and surgical specialties. Imaging capabilities for evaluation of men with recurrent prostate cancer are rapidly evolving, particularly with PET and MRI. At the same time, treatment options and capabilities are expanding and improving. These recommendations separate patients into three broad categories: (1) patients status post-radical prostatectomy, (2) clinical concern for residual or recurrent disease after nonsurgical local and pelvic treatments, and (3) metastatic prostate...
May 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29724416/acr-appropriateness-criteria-%C3%A2-breast-implant-evaluation
#20
Ana P Lourenco, Linda Moy, Paul Baron, Aarati D Didwania, Roberta M diFlorio, Samantha L Heller, Anna I Holbrook, Alana A Lewin, Tejas S Mehta, Bethany L Niell, Priscilla J Slanetz, Ashley R Stuckey, Daymen S Tuscano, Nina S Vincoff, Susan P Weinstein, Mary S Newell
Breast implant imaging varies depending on patient age, implant type, and symptoms. For asymptomatic patients (any age, any implant), imaging is not recommended. Rupture of saline implants is often clinically evident, as the saline is resorbed and there is a change in breast contour. With saline implants and equivocal clinical findings, ultrasound (US) is the examination of choice for patients less than 30 years of age, either mammography/digital breast tomosynthesis or US may be used for those 30 to 39 years of age, and mammography/digital breast tomosynthesis is used for those 40 years and older...
May 2018: Journal of the American College of Radiology: JACR
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