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Home Clinically Suspected Adnexal Mass, No Acute Symptoms
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass suspected, no acute symptoms, postmenopausal, initial imaging 3197148
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Adnexal mass suspected, no acute symptoms, premenopausal, initial imaging 3074166
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, likely benign, no acute symptoms, premenopausal, follow-up imaging 3074171
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, likely benign, no acute symptoms, postmenopausal, follow-up imaging 3082200
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, no acute symptoms, postmenopausal, initial pelvic US indeterminate, next imaging study for characterization 3197151
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Adnexal mass, no acute symptoms, premenopausal, initial pelvic US indeterminate, next imaging study for characterization 3197150
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, no acute symptoms, premenopausal, initial pelvic US indeterminate, follow-up imaging 3082202
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, no acute symptoms, postmenopausal, initial pelvic US indeterminate, follow-up imaging 3149341
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, no acute symptoms, premenopausal, pelvic US suspicious for malignancy, next imaging study for characterization 3149342
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Adnexal mass, no acute symptoms, postmenopausal, pelvic US suspicious for malignancy, next imaging study for characterization 3197155
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass suspected, no acute symptoms, pregnant, initial imaging 3149744
US duplex Doppler pelvis
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transabdominal and US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US pelvis transvaginal
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Adnexal mass, no acute symptoms, pregnant, initial pelvic US indeterminate, next imaging study for characterization 3197158
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
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