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Home Pulmonary Arteriovenous Malformation (PAVM)
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
PAVM suspected, altered sensorium, lung nodule on chest radiography, next imaging study 3197017
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
PAVM suspected, TIA, lung nodule on chest radiography, next imaging study 3197018
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
PAVM suspected, seizures, lung nodule on chest radiography, next imaging study 3197019
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
PAVM suspected, brain abscess, lung nodule on chest radiography, next imaging study 3197020
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
PAVM suspected, shortness of breath, epistaxis hx, family hx HHT, initial imaging 3197022
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
PAVM suspected, hemothorax, epistaxis hx, family hx HHT,initial imaging 3197023
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
PAVM suspected, hemoptysis, epistaxis hx, family hx HHT, initial imaging 3197024
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
PAVM suspected, asymptomatic, family hx HHT, initial imaging 3197026
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
MRA chest without and with 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 and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Pertechnetate albumin pulmonary scan
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
PAVM, post embolization, surveillance 3197028
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
PAVM suspected on chest radiography, asymptomatic, next imaging study 3197030
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA chest 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
(Disagreement)
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
PAVM suspected on chest CT, asymptomatic, next imaging study 3197031
US echocardiography transthoracic with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA pulmonary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA pulmonary arteries with IV contrast
1-10 mSv
☢☢☢
Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢
May be appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA chest 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
(Disagreement)
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transesophageal with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA pulmonary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate