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Do not order a frozen section on a pathology specimen if the result will not affect immediate (i.e., intraoperative or perioperative) patient management.
Choosing Wisely Canada
American Society for Clinical Pathology
Although the result of an intraoperative frozen section evaluation is often helpful to determine the treatment path of a patient during a surgical procedure, the frozen section analysis may be limited in regards to sampling and technical issues that can hinder interpretation and/or compromise the integrity of the specimen for the final diagnosis. If there is no therapeutic decision to be made for the patient on the day of the surgical procedure based on the results of the frozen section, it is ...
ver más ... 2017Don’t routinely recommend follow-up for nonobstructed, asymptomatic, isolated, short-segment jejunojejunal intussusception in adults.
Choosing Wisely®
American College of Radiology
Transient, idiopathic jejunojejunal intussusception in adult patients can be identified on MDCT in the absence of gastrointestinal pathology. In patients without an identifiable lead point mass lesion, imaging characteristics that favor the transient variety include short length (≤ 3.5cm) and absence of bowel dilation. Self-limited jejunojejunal intussusception can occur in the absence of any bowel disease, or the finding may indicate an infectious or inflammatory process, such as enteritis ...
ver más ... 2017Don’t make the diagnosis of Pelvic Congestion Syndrome on CT or MRI unless the patients meet clinical and imaging criteria.
Choosing Wisely®
American College of Radiology
Dilated pelvic veins can be an incidental, clinically insignificant finding on CT and MRI, or may reflect pelvic congestion syndrome. In the latter condition, dilated pelvic veins and venous reflux account for a range of symptoms, including chronic pain of more than 6-month duration. Radiologists must be cognizant of established criteria to suggest this diagnosis on CT and MRI. The diagnostic criteria include the following: 4 or more ipsilateral pelvic varicosities, 1 or more pelvic ...
ver más ... 2017Don’t routinely use a protocol for abdominal CT that includes a delayed post-contrast phase after the venous phase, except for the following indications: renal lesion characterization, hematuria ...
Choosing Wisely®
American College of Radiology
With the goal of modulating patient radiation exposure, IV contrast enhanced multidetector CT (MDCT) protocols should include a delayed post contrast acquisition (defined as an acquisition after the portal venous, hepatic or nephrographic phases) only if it will provide additional diagnostic information. The literature supports an additional delayed acquisition for the following indications: (1) Renal lesion characterization, hematuria work up or CT urogram a. contrast enhancement pattern of ...
ver más ... 2017Don’t use a protocol for abdominal CT that includes unenhanced CT followed by IV contrast-enhanced CT, except for the following indications: renal lesion characterization, hematuria work up, ...
Choosing Wisely®
American College of Radiology
With the goal of modulating patient radiation exposure and costs, IV contrast enhanced multidetector CT (MDCT) protocols should include an unenhanced acquisition only if it will provide additional diagnostic information. In conjunction with IV contrast enhanced abdominal MDCT, the literature supports an unenhanced acquisition for the following indications: (1) Renal lesion characterization or hematuria work up a. Compare unenhanced with post-contrast to identify enhancement in a mass (2) ...
ver más ... 2017