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Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, mild, dementia criteria not met, initial imaging 3198685
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
(Disagreement)
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without 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
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, memory deficits, Alzheimer disease suspected, typical clinical presentation, initial imaging 3198687
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MR spectroscopy head 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
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, memory deficits, Alzheimer disease suspected, atypical clinical presentation, initial imaging 3198689
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
(Disagreement)
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Alzheimer disease, antiamyloid monoclonal antibodies therapy, pretreatment imaging. 3198691
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
Usually appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Alzheimer disease, antiamyloid monoclonal antibodies therapy, posttreatment imaging. 3198693
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
(Disagreement)
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, behavioral abnormalities, frontotemporal dementia suspected, initial imaging. 3198694
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Cognitive impairment, progressive aphasia, frontotemporal dementia suspected, initial imaging 3198695
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
May be appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
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
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, parkinsonian symptoms, dementia with Lewy bodies suspected, initial imaging. 3198697
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Cognitive impairment, visual hallucinations, dementia with Lewy bodies suspected, initial imaging 3198696
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, recent stroke, vascular dementia suspected, initial imaging 3198698
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA 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
(Disagreement)
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without 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
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Cognitive impairment, stepwise decline, vascular dementia suspected, initial imaging 3198699
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
MRA head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA neck without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
MRA 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
(Disagreement)
CTA head and neck with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
MR spectroscopy head without 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
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Cognitive impairment, urinary incontinence, normal pressure hydrocephalus suspected, initial imaging 3073679
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
DTPA cisternography
1-10 mSv
☢☢☢
May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Cognitive impairment, gait disturbance, normal pressure hydrocephalus suspected, initial imaging 3198700
MRI head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
DTPA cisternography
1-10 mSv
☢☢☢
May be appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI head without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Dementia, rapidly progressive, initial imaging 3198702
MRI head 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 		Usually appropriate
CT head without IV contrast
1-10 mSv
☢☢☢ 		0.3-3 mSv [ped]
☢☢☢ 		Usually appropriate
MR spectroscopy head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI functional (fMRI) head without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
Amyloid PET/CT brain
1-10 mSv
☢☢☢
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
FDG-PET/CT brain
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain perfusion
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
SPECT or SPECT/CT brain striatal
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Tau PET/CT brain
1-10 mSv
☢☢☢
Usually not appropriate
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