ACR appropriateness criteria® thoracic venous occlusions-suspected superior vena cava syndrome

Expert Panel on Vascular Imaging
Anant D. Bhave, The University of Vermont Medical Center, Burlington, Vermont. Electronic address: anant.bhave@uvmhealth.org.
Nathan Franssen, Research Author, The University of Vermont Medical Center, Burlington, Vermont.
Minhaj S. Khaja, Panel Chair, University of Michigan, Ann Arbor, Michigan.
Nima Kokabi, Panel Vice Chair, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
William F. Browne, Weill Cornell Medicine, New York, New York.
Murthy R. Chamarthy, UT Southwestern Medical Center, Dallas, Texas and Lake Granbury Medical Center, Granbury, Texas; Commission on Nuclear Medicine and Molecular Imaging.
Benjamin N. Contrella, Allegheny Health Network, Pittsburgh, Pennsylvania.
Baljendra S. Kapoor, University of Michigan, Ann Arbor, Michigan.
Nicole A. Keefe, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Mahammed Z. Khan Suheb, Advocate Health - MidwestFollow
Karen M. Kim, UT Health Austin/Dell Medical School, Austin, Texas; The Society of Thoracic Surgeons.
Julie Lahiri, Vascular Surgeon, The University of Vermont Medical Center, Burlington, Vermont.
Andrea Obi, University of Michigan, Ann Arbor, Michigan; Society for Vascular Surgery.
Sherry Scovell, Harvard Medical School, Boston, Massachusetts; Society of Cardiovascular Computed Tomography.
Daniel P. Sheeran, University of Virginia, School of Medicine, Charlottesville, Virginia.
Seda Tierney, Stanford University Medical Center, Stanford, California; American Society of Echocardiography.
Nkiruka Udejiofor, Humana, Louisville, Kentucky; American Academy of Family Physicians.
Madison Wulfeck, Radiology Partners Florida, Tampa, Florida; American Society of Nuclear Cardiology.
Bill S. Majdalany, Specialty Chair, The University of Vermont Medical Center, Burlington, Vermont.

Affiliations

St. Luke's Aurora Medical Center

Abstract

Superior vena cava (SVC) syndrome occurs in approximately 15,000 people in the United States each year. It most commonly occurs secondary to thoracic malignancies, mostly primary lung cancer and lymphoma. The cause is occlusion of the SVC or brachiocephalic veins. The following recommendations for initial imaging evaluation of acute or chronic SVC syndrome are presented. Contrast-enhanced chest CT scans, particularly CT angiography/venography, with or without simultaneous inclusion of the neck are recommended studies. MRI with contrast and MR venography/MRA chest with or without contrast are also recommended studies. The recommended CT and MR studies work well to diagnose and evaluate the cause and extent of superior vena cava or brachiocephalic vein occlusion. 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.

Document Type

Article

PubMed ID

41485866

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