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ACR AC Portal

Home Congenital or Acquired Heart Disease
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Repaired pulmonary valve stenosis, branch pulmonary artery stenosis suspected, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196439
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Perfusion scan lung
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Repaired tetralogy of Fallot, pulmonary valve dysfunction suspected, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196436
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Perfusion scan lung
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Repaired pulmonary valve stenosis, pulmonary valve dysfunction suspected, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196438
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Perfusion scan lung
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Repaired tetralogy of Fallot, branch pulmonary artery stenosis suspected, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196437
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Perfusion scan lung
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Transposition of the great arteries, post atrial switch, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196441
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Transposition of the great arteries, post arterial switch, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196443
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Congenital coronary artery abnormality, TTE inadequate assessment of coronary morphology, next imaging study 3196447
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
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
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Acquired coronary artery abnormality suspected, TTE inadequate assessment of coronary morphology, next imaging study 3196446
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
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
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Congenital coronary artery abnormality suspected, TTE inadequate assessment of coronary morphology, next imaging study 3196448
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
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
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Acquired coronary artery abnormality, TTE inadequate assessment of coronary morphology, next imaging study 3196445
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
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
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Single ventricle physiology, preop eval, stage 2 single ventricle palliation, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196450
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Single ventricle physiology, preop eval, stage 3 single ventricle palliation, total cavopulmonary connection, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196452
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Single ventricle physiology, postop eval, stage 3 single ventricle palliation, total cavopulmonary connection, TTE inadequate assessment of cardiovascular morphology and function, next imaging study 3196454
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		May be appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Anomalous pulmonary venous return suspected, TTE inadequate, next imaging study 3196456
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Anomalous pulmonary venous return, TTE inadequate, next imaging study 3196457
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Aortic coarctation suspected, TTE inadequate, next imaging study. 3196459
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
US echocardiography transesophageal
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
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Connective tissue disease, aorta surveillance, TTE inadequate, next imaging study 3196462
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
Aortopathy, aorta surveillance, TTE inadequate, next imaging study 3196461
MRA abdomen without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA abdomen without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA chest without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA neck without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually not appropriate
Arteriography coronary with ventriculography
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Arteriography pulmonary
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
MRI heart function with stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function with stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT heart function and morphology with IV contrast
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
FDG-PET/CT heart
10-30 mSv
☢☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		Usually not appropriate
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