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Home Sinonasal Disease
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Rhinosinusitis, acute, <4 wks, uncomplicated, initial imaging 3194899
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
Usually not appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT maxillofacial without 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 head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Rhinosinusitis, acute, intracranial complication suspected, initial imaging 3194901
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Rhinosinusitis, acute, orbital complication suspected, initial imaging 3194900
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
(Disagreement)
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Silent sinus syndrome suspected, surgical candidate, initial imaging 3194907
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinusitis, noninvasive fungal, surgical candidate, initial imaging 3194905
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Deviated nasal septum, surgical candidate, initial imaging 3194909
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Rhinosinusitis, chronic, surgical candidate, initial imaging 3194904
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinonasal polyposis, surgical candidate, initial imaging 3194906
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinusitis, acute, recurring, surgical candidate, initial imaging 3194903
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Mucocele suspected, surgical candidate, initial imaging 3194908
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinusitis, acute, rapid progression, initial imaging 3194911
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinusitis, invasive fungal suspected, initial imaging 3194912
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
Sinonasal mass suspected, initial imaging 3194914
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT head with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT paranasal sinuses
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
CSF leak suspected, initial imaging 3194916
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI orbits face neck 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
SPECT or SPECT/CT paranasal sinuses
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Radiography paranasal sinuses
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography craniofacial
1-10 mSv
☢☢☢
Usually not appropriate
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA 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 orbits face neck with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT cone beam paranasal sinuses without IV contrast
0.1-1mSv
☢☢
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 head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CT maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually not appropriate
CTA head with 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
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