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Home Head Trauma
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, mild, GCS 13-15, imaging not indicated per clinical decision rule, initial imaging 3100796
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, mild, GCS 13-15, imaging indicated per clinical decision rule, initial imaging 3100795
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, severe, GCS 3-8, initial imaging 3194063
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, acute, moderate, GCS 9-12, initial imaging 3194062
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, acute, penetrating, initial imaging 3194064
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, no neuro decline, initial imaging normal, short term follow up imaging 3194024
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, no neuro decline, positive findings on initial imaging, short term follow up imaging 3194025
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, acute, neuro decline since last imaging, short-term follow up imaging 3194020
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, subacute, unexplained cognitive or neuro deficit, initial imaging 3100802
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, chronic, unexplained cognitive or neuro deficit, initial imaging 3100803
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, intracranial arterial injury suspected, positive findings on prior imaging 3194037
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, intracranial arterial injury suspected, risk factors 3194036
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA head and neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head and neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRA head and neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, intracranial venous injury suspected, positive findings on prior imaging 3194039
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Head trauma, intracranial venous injury suspected, risk factors 3194038
CTV head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRV head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRV head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Arteriography cervicocerebral
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Head trauma, CSF leak suspected, initial imaging 3100806
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head cisternography
1-10 mSv
☢☢☢
May be appropriate
DTPA cisternography
1-10 mSv
☢☢☢
May be appropriate
Radiography skull
<0.1 mSv
☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without IV contrast with DTI
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT head without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
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