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Home Plexopathy
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy brachial, chronic, nontraumatic, no malignancy, initial imaging 3194223
MRI brachial plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI brachial plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI brachial plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Plexopathy brachial, acute, nontraumatic, no malignancy, initial imaging 3194222
MRI brachial plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI brachial plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI brachial plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy lumbosacral, acute, nontraumatic, no malignancy, initial imaging 3194224
MRI lumbosacral plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbosacral plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbosacral plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Plexopathy lumbosacral, chronic, nontraumatic, no malignancy, initial imaging 3194225
MRI lumbosacral plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbosacral plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI lumbar spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbosacral plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy brachial, traumatic, not perinatal, initial imaging 3194226
MRI brachial plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI brachial plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI brachial plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy lumbosacral, traumatic, initial imaging 3194227
MRI lumbosacral plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbosacral plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI lumbar spine 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 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
May be appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbosacral plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy brachial, malignancy, initial imaging 3194228
MRI brachial plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI brachial plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI brachial plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Plexopathy brachial, post treatment syndrome, initial imaging 3194229
MRI brachial plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI brachial plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI cervical spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI cervical spine without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI brachial plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI cervical spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cervical spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT cervical spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography cervical spine
10-30 mSv
☢☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Plexopathy lumbosacral, post treatment syndrome, initial imaging 3194231
MRI lumbosacral plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbosacral plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI lumbar spine 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 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbosacral plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
Plexopathy lumbosacral, malignancy, initial imaging 3194230
MRI lumbosacral plexus without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbosacral plexus without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI lumbar spine without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI lumbar spine 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 		May be appropriate
MRI pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
FDG-PET/CT whole body
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRI lumbar spine with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI lumbosacral plexus with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI pelvis with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT lumbar spine without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CT lumbar spine without and with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT myelography lumbar spine
10-30 mSv
☢☢☢☢
Usually not appropriate
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