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Home Acute Pyelonephritis
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Pyelonephritis suspected, acute, uncomplicated, first time presentation, initial imaging 3195297
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 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 abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Pyelonephritis suspected, acute, diabetes, initial imaging 3195304
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, complicated, initial imaging 3195299
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, vesicoureteral reflux, initial imaging 3195301
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, immune compromise, initial imaging 3195303
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, recurrent pyelonephritis, initial imaging 3195305
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, lack of response to initial therapy, initial imaging 3195300
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, advanced age, initial imaging 3195302
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Pyelonephritis suspected, acute, renal stones hx, initial imaging 3195308
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Pyelonephritis suspected, acute, renal obstruction hx, initial imaging 3195307
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Pyelonephritis suspected, acute, pregnant, no other complications, initial imaging 3195310
US abdomen
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without 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
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 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 abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Pyelonephritis suspected, acute, pelvic renal transplant hx, native kidneys in situ, no other complications, initial imaging 3195312
US duplex Doppler kidney transplant
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT abdomen and pelvis with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI abdomen and pelvis without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI abdomen and pelvis without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT abdomen and pelvis without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT abdomen and pelvis without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
US abdomen
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US color Doppler kidneys and bladder retroperitoneal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Fluoroscopy voiding cystourethrography
0.1-1mSv
☢☢ 		0.03-0.3 mSv [ped]
☢☢ 		Usually not appropriate
Fluoroscopy antegrade pyelography
1-10 mSv
☢☢☢
Usually not appropriate
Radiography abdomen and pelvis
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
Radiography intravenous urography
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
MRI abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI abdomen without 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
MRU without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRU without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT abdomen with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT abdomen without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
DMSA renal scan
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT abdomen without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
CTU without and with IV contrast
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
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