Introduction to Oncology Guidelines – Care to Care's Clinical Criteria

These are permissive guidelines, meant to allow rapid approval of routine studies, i.e. those ordered as part of a standard work up or surveillance, not to evaluate a change in clinical status. These are routine studies, appropriate to the diagnosis alone. Requests that do not meet these criteria should be reviewed based on the clinical history presented and the criteria established for the study requested. No requests should be denied based on failure to meet the criteria in this section alone.

In all of the entires, both here and in the criteria in general, PET refers to PET/CT. As such, whenever PET exams are requested at the same time as CT exams of the region covered by the PET study the request should be sent for Physician review.

Initial Work up and Staging refers to imaging studies that are part of the routine evaluation of a patient prior to therapy

Restaging After Treatment refers to recommendations for studies to be performed regardless of the clinical status of the patient after completion of an episode of treatment.

Surveillance Imaging refers to recommendations for imaging to be performed at intervals following therapy regardless of the clinical status of the patient.

Evaluation for Change in Clinical Status refers to examinations ordered to evaluate new or worsening signs and symptoms.