ACR Appropriateness Criteria® Suspected Abdominal Neoplasm-Child

Suspected abdominal neoplasms in children encompass a wide range of malignant and benign tumors originating from various abdominal organs and structures. Neoplasms often present with a palpable abdominal mass, which may be accompanied by other symptoms such as abdominal pain, distension, or systemic signs. However, not all palpable masses in children represent neoplasms, as they may also result from benign conditions such as constipation or hernias. Imaging plays a vital role in differentiating these conditions. The role of imaging is to characterize the mass, identify the organ of origin, assess the extent of disease, and guide treatment decisions. This document provides imaging guidelines for children presenting with three clinical scenarios: palpable abdominal mass with suspected neoplasm at initial imaging, palpable abdominal mass with suspected neoplasm following negative radiography, and palpable abdominal wall mass with suspected abdominal wall neoplasm at initial imaging. 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.