title: ACR Appropriateness Criteria(®) non-spine bone metastases.
abstract: Bone metastases are a common clinical problem, affecting many types of cancer patients. The presence of tumor in bone can cause significant morbidity including pain, neurological dysfunction, hypercalcemia, and pathological fracture leading to functional loss. The optimal treatment of a patient with bone metastases depends on many factors, including evaluation of the patient's goals of care, performance status, mechanical stability of the affected bone, life expectancy, and overall extent of disease. Treatment options may include radiotherapy, systemic therapies, surgical stabilization, medical pain management, and radiopharmaceuticals. Ideal management of bone metastases requires a coordinated multidisciplinary approach among diagnostic radiologists, radiation oncologists, medical oncologists, orthopedic surgeons, pain specialists, physiatrists, and palliative care specialists. The American College of Radiology Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guidelines 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.
authors.affiliation: 1 University of Washington , Seattle, Washington.
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Kim
authors.forename: Tobias R
authors.initials: TR
authors.lastname: Chapman
authors.forename: Samuel
authors.initials: S
authors.lastname: Ryu
authors.forename: Eric L
authors.initials: EL
authors.lastname: Chang
authors.forename: Nicholas
authors.initials: N
authors.lastname: Galanopoulos
authors.forename: Joshua
authors.initials: J
authors.lastname: Jones
authors.forename: Charlotte D
authors.initials: CD
authors.lastname: Kubicky
authors.forename: Charles P
authors.initials: CP
authors.lastname: Lee
authors.forename: Bin S
authors.initials: BS
authors.lastname: Teh
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Traughber
authors.forename: Catherine
authors.initials: C
authors.lastname: Van Poznak
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Vassil
authors.forename: Kristy
authors.initials: K
authors.lastname: Weber
authors.forename: Simon Shek-Man
authors.initials: SS
authors.lastname: Lo
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D006801:Humans; D017410:Practice Guidelines as Topic; D011829:Radiation Dosage; D011878:Radiotherapy / Q000592:standards; D012955:Societies, Medical; D014481:United States