ACR Appropriateness Criteria® Staging and Disease Monitoring of Colon Cancer and Appendiceal Cancer

The role of imaging in initial staging of colon cancer, and in posttreatment restaging or surveillance, is most beneficial in identifying distant metastases in the chest, abdomen, and pelvis, regardless of primary T or N stage. Appendiceal cancers are classified separately and managed differently than colon cancer; however, initial staging and postoperative surveillance is also primarily focused on detection of distant metastatic disease, usually in the abdomen and pelvis. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.