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Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Anosmia, initial imaging 3195207
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head 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 maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		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 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
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Olfaction abnormal, initial imaging 3195208
MRI orbits face neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI head 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 maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
0 mSv
O 		0 mSv [ped]
O 		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 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
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
Mastication muscles weakness, unilateral, isolated, initial imaging 3195210
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
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 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
Head and face sensory abnormalities, unilateral, isolated, initial imaging 3195212
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
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 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
Trigeminal neuralgia, unilateral, isolated, initial imaging 3195214
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
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 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
Mastication muscles paralysis, unilateral, isolated, initial imaging 3195211
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
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 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
Facial numbness, unilateral, isolated, initial imaging 3195213
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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
(Disagreement)
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
US neck
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 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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Bell palsy, unilateral, isolated, initial imaging 3195219
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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 IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
May be appropriate
US neck
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 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
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
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
Facial weakness, unilateral, isolated, initial imaging 3195216
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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 IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
May be appropriate
US neck
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 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
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
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
Hemifacial spasm, unilateral, isolated, initial imaging 3195218
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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 IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
May be appropriate
US neck
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 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
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
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
Facial expression paralysis, unilateral, isolated, initial imaging 3195217
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
MRA head with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA head without 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 IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT maxillofacial without IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CT temporal bone with IV contrast
1-10 mSv
☢☢☢
May be appropriate
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
May be appropriate
US neck
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 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
CT temporal bone without and with IV contrast
1-10 mSv
☢☢☢
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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Multiple middle cranial nerve palsies, cranial nerve V–VII, initial imaging 3195221
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
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 without 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
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 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 maxillofacial without and with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 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
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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Oropharnygeal neurogenic dysphagia, unilateral, isolated, initial imaging 3195225
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
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 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
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 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 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
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 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Oropharyngeal pain, unilateral, isolated, initial imaging 3195224
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
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 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
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 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 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
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 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Palate weakness, unilateral, isolated, initial imaging 3195223
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
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 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
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 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 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
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 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Palatal paralysis, unilateral, isolated, initial imaging 3195228
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 neck with 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
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT neck without 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
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		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 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 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 chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Vocal cord paralysis, unilateral, isolated, initial imaging 3195227
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 neck with 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
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT neck without 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
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		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 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 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 chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Trapezius and sternocleidomastoid muscle paralysis, unilateral, isolated, initial imaging 3195231
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 neck with 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
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck without 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
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 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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Trapezius and sternocleidomastoid muscle weakness, unilateral, isolated, initial imaging 3195230
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 neck with 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
MRI orbits face neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT neck without 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
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 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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Tongue paralysis, unilateral, isolated, initial imaging 3195234
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually 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
MRA head and neck without 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 neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tongue weakness, unilateral, isolated, initial imaging 3195233
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually 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
MRA head and neck without 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 neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
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
Lower cranial nerve syndromes cranial nerve IX–XII, initial imaging 3195237
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually 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
MRA head and neck without 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 neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
FDG-PET/CT skull base to mid-thigh
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Multiple lower cranial nerve palsies, initial imaging 3195236
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 neck with IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually 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
MRA head and neck without 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 neck without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		May be appropriate
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US neck
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 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
CT neck without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
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
Head and neck cancer, perineural tumor spread, initial imaging 3195240
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
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 maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		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
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 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 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
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 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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
Head and neck cancer, perineural tumor spread suspected, initial imaging 3195239
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
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 maxillofacial with IV contrast
0.1-1mSv
☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		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
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 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 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
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 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
CT temporal bone without IV contrast
1-10 mSv
☢☢☢
Usually not appropriate
CTA head and neck 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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