| Symptom/Indication | Recommended Exam |
| Body Part: Brain | |
| Headache | CT head without contrast for acute headache. |
| Trauma | CT head without contrast (acute). |
| Suspected intracranial hemorrhage | CT head without contrast. |
| Acute neurological changes | CT head without contrast. Subsequent study: MRI with and without contrast. |
| Acute stroke/TIA | CT head without contrast (if candidate for thrombolysis). Subsequent studies: MRI brain with /without contrast, MRA brain and MRA neck without and with contrast as indicated. |
| Hydrocephalus | CT head without contrast. Alternative: MRI with and without contrast (for acute process). |
| Seizure | First (New Onset) seizure: MRI Brain with and without contrast (CT Head if patient unstable /concern for ICH). |
| Dementia / Memory loss | MRI brain with & without contrast. |
| Mass | Brain MRI with & without contrast. |
| Aneurysm or AVM "Screening" | MRA Head. CTA head with contrast for definition of small aneurysms, patients who can't get MRA. |
| Infection | MRI without and with contrast. If MRI contraindicated: CT without and with contrast. |
| Body Part: Face | |
| Trauma | CT maxillofacial without contrast. |
| Sinus disease | CT sinus without contrast. If suspected orbital/intracranial involvement: MRI Brain and Orbits without and with contrast. |
| Infection | CT maxillofacial with contrast. Suspected orbit or brain extension: MRI Brain and Orbits (IAC protocol). |
| Hearing loss, vertigo | Developmental: CT temporal bones without contrast. Sensorineural: MRI IAC without and with contrast. |
| Body Part: Neck/Soft Tissue | |
| Carotid or vertebral artery stenosis | Carotid Doppler Ultrasound. CTA neck with contrast. MRA neck without and with contrast. |
| Mass | CT neck with contrast. Thyroid nodule: Thyroid ultrasound. Thyroid cancer: MR neck without and with contrast. |
| Infection | CT neck with contrast |
| Carotid or vertebral artery Dissection | MRA neck without and with contrast (Dissection protocol). CTA Neck with contrast. |
| Body Part: Thoracic Spine | |
| Trauma | CT thoracic spine without contrast. Acute neurologic deficit and CT negative: MRI without contrast. |
| Pain, degenerative changes, radiculopathy | MRI thoracic spine without contrast. Prior surgery: MRI T-spine without and with contrast. MRI contraindicated: CT without contrast or CT myelogram. |
| Body Part: Lumbar Spine | |
| Trauma | CT lumbar spine without contrast. Acute neurologic deficit and CT negative: MRI without contrast. |
| Pain, degenerative changes, radiculopathy, sciatica | MRI lumbar spine without contrast. Prior surgery: MRI without and with contrast. MRI contraindicated: CT without contrast or CT myelogram. |
| Mass | MRI without and with contrast. |
| Infection | MRI without and with contrast. |
| Body Part: Chest | |
| Chronic Dyspnea | High-resolution chest CT (HRCT). |
| Hemoptysis | Chest CT with contrast. (If contrast contraindicated then chest CT without contrast may be ordered.) |
| Lung cancer-Noninvasive staging | Chest CT with (or without contrast if renal failure) or PET/CT. |
| Screening for pulmonary metastases | CT chest with or without for initial evaluation or surveillance. Chest X-ray if performed as a baseline. |
| Blunt chest trauma, suspect aortic injury | CTA chest with contrast. |
| Acute chest pain suspect aortic dissection | CTA chest and abdomen is the definitive test to evaluate aortic dissection. |
| Suspected pulmonary embolism | CTA chest with contrast. Alternative: When CT contrast contraindicated, consider ventilation/perfusion (V/Q) scan. |
| Gastrointestinal | |
| Acute abdominal pain, fever, evaluate for abscess | CT abdomen and pelvis with contrast. Note: MRI offers imaging without non-ionizing radiation and can provide information regarding ovarian pathology, PID, ectopic pregnancy, and ovarian torsion. |
| Pregnant patient with acute abdominal pain | Ultrasound. If indeterminate then MRI Abdomen and Pelvis without contrast. |
| Pancreatitis | Abdomen with contrast. Ultrasound to exclude gallstones. |
| Blunt trauma stable patient | CT Chest/Abdomen/Pelvis with contrast. |
| Jaundice-painless | CT pancreas protocol with contrast. |
| Jaundice with pain/fever | Ultrasound abdomen. |
| Left lower quadrant pain | CT abdomen/pelvis with contrast. |
| Right lower quadrant pain suspected appendicitis | CT abdomen/pelvis with contrast. |
| Right lower quadrant pain-pregnant | Ultrasound, obtain MRI if inconclusive. |
| Right lower quadrant pain- children | Ultrasound, obtain MRI if inconclusive. |
| Right upper quadrant pain | Ultrasound limited. If only gallstones present and no other sonogram findings or fever or elevated WBC then hepatobiliary scan. |
| Suspected liver metastases | MRI or CT with contrast. MRI should be first-line study when indeterminate liver lesions found on ultrasound or CT. |
| Suspected small bowel obstruction | CT with IV contrast only if high grade or complete obstruction. Alternative: If partial or low-grade obstruction suspected MRI enterography may be considered. |
| UROLOGIC | |
| Flank pain- suspected stone disease | CT abdomen and pelvis without contrast (CTKUB). If recurrent symptoms of stone disease then CTKUB or ultrasound. |
| Acute pyelonephritis | CT abdomen and pelvis without and with contrast. |
| Hematuria | CT abdomen and pelvis without and with contrast. Order as CT-IVP which includes high-resolution excretory phase imaging of the renal collecting systems and ureters. |
| Incidental renal mass | Either CT or MRI without and with contrast is appropriate. |
| Recurrent urinary tract infections in women | CT without and with contrast for bladder and kidneys evaluation. MRI pelvis to exclude urethral diverticulum or pelvic prolapse |