ACR Appropriateness Criteria jaundice

Tasneem Lalani, Corey A. Couto, Max P. Rosen, Mark E. Baker, Michael A. Blake, Brooks D. Cash, Jeff L. Fidler, Frederick L. Greene, Nicole M. Hindman, Douglas S. Katz, Harmeet Kaur, Frank H. Miller, Aliya Qayyum, William C. Small, Gary S. Sudakoff, Vahid Yaghmai, Gail M. Yarmish, Judy Yee

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

A fundamental consideration in the workup of a jaundiced patient is the pretest probability of mechanical obstruction. Ultrasound is the first-line modality to exclude biliary tract obstruction. When mechanical obstruction is present, additional imaging with CT or MRI can clarify etiology, define level of obstruction, stage disease, and guide intervention. When mechanical obstruction is absent, additional imaging can evaluate liver parenchyma for fat and iron deposition and help direct biopsy in cases where underlying parenchymal disease or mass is found. Imaging techniques are reviewed for the following clinical scenarios: (1) the patient with painful jaundice, (2) the patient with painless jaundice, and (3) the patient with a nonmechanical cause for jaundice. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)402-409
Number of pages8
JournalJournal of the American College of Radiology
Volume10
Issue number6
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • Appropriateness criteria
  • biliary tract
  • cholangitis
  • cholelithiasis
  • jaundice
  • pancreatic malignancy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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  • Cite this

    Lalani, T., Couto, C. A., Rosen, M. P., Baker, M. E., Blake, M. A., Cash, B. D., Fidler, J. L., Greene, F. L., Hindman, N. M., Katz, D. S., Kaur, H., Miller, F. H., Qayyum, A., Small, W. C., Sudakoff, G. S., Yaghmai, V., Yarmish, G. M., & Yee, J. (2013). ACR Appropriateness Criteria jaundice. Journal of the American College of Radiology, 10(6), 402-409. https://doi.org/10.1016/j.jacr.2013.02.020