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Home Liver Lesion-Initial Characterization
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, >1cm, indeterminate on US, normal liver, no extrahepatic malignancy 3100711
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, >1cm, indeterminate on noncontrast MRI, normal liver, no extrahepatic malignancy 3191932
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, >1cm, indeterminate on noncontrast or single phase CT, normal liver, no extrahepatic malignancy 3191931
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, >1cm, indeterminate on US, hx of extrahepatic malignancy 3100714
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
May be appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
May be appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, >1cm, indeterminate on noncontrast or single phase CT, hx of extrahepatic malignancy 3191933
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
May be appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
May be appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
Liver lesion, >1cm, indeterminate on noncontrast MRI, hx of extrahepatic malignancy 3191934
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
May be appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
May be appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, >1cm, incidental finding on noncontrast or single phase CT, chronic liver disease 3191936
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, >1cm, incidental finding on noncontrast MRI, chronic liver disease 3191937
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, >1cm, incidental finding on US, chronic liver disease 3191935
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, <1cm, indeterminate on US, hx of extrahepatic malignancy 3100710
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, <1cm, indeterminate on noncontrast MRI, hx of extrahepatic malignancy 3191939
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, <1cm, indeterminate on noncontrast or single phase CT, hx of extrahepatic malignancy 3191938
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Liver lesion, <1cm, incidental finding on US, chronic liver disease 3191940
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, <1cm, incidental finding on noncontrast MRI, chronic liver disease 3191942
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
Liver lesion, <1cm, incidental finding on noncontrast or single phase CT, chronic liver disease 3191941
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen with IV contrast multiphase
10-30 mSv
☢☢☢☢
Usually appropriate
US abdomen with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Image-guided biopsy liver

Varies
Varies 		Usually not appropriate
DOTATATE PET/CT skull base to mid-thigh
1-10 mSv
☢☢☢
Usually not appropriate
Liver spleen scan
1-10 mSv
☢☢☢
Usually not appropriate
RBC scan abdomen and pelvis
1-10 mSv
☢☢☢
Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Octreotide scan with SPECT or SPECT/CT chest and abdomen
10-30 mSv
☢☢☢☢
Usually not appropriate
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