ACR Appropriateness Criteria® Lower Urinary Tract Symptoms-Suspicion of Benign Prostatic Hyperplasia.

Lower urinary tract symptoms due to benign prostatic enlargement have a high prevalence in men over 50 years of age. Diagnosis is made with a combination of focused history and physician examination and validated symptom questionnaires. Urodynamic studies can help to differentiate storage from voiding abnormalities. Pelvic ultrasound may be indicated to assess bladder volume and wall thickness. Other imaging modalities, including prostate MRI, are usually not indicated in the initial workup and evaluation of uncomplicated lower urinary tract symptoms from an enlarged prostate. 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 include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Journal of the American College of Radiology : JACR. 2019 Nov [Epub]

Expert Panel on Urological Imaging , Lauren F Alexander, Aytekin Oto, Brian C Allen, Oguz Akin, Jaron Chong, Adam T Froemming, Pat F Fulgham, Stanley Goldfarb, Jodi K Maranchie, Rekha N Mody, Bhavik N Patel, Nicola Schieda, David M Schuster, Ismail B Turkbey, Aradhana M Venkatesan, Carolyn L Wang, Mark E Lockhart

Mayo Clinic, Jacksonville, Florida. Electronic address: ., Panel Chair, University of Chicago, Chicago, Illinois., Panel Vice-Chair, Duke University Medical Center, Durham, North Carolina., Memorial Sloan Kettering Cancer Center, New York, New York., McGill University, Montreal, Quebec, Canada., Mayo Clinic, Rochester, Minnesota., Urology Clinics of North Texas, Dallas, Texas, American Urological Association., University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, American Society of Nephrology., UPMC, Pittsburgh, Pennsylvania, American Urological Association., Cleveland Clinic, Cleveland, Ohio., Stanford University Medical Center, Stanford, California., Ottawa Hospital Research Institute and the Department of Radiology, The University of Ottawa, Ottawa, Ontario, Canada., Emory University Hospital, Atlanta, Georgia., National Institutes of Health, Bethesda, Maryland., The University of Texas MD Anderson Cancer Center, Houston, Texas., University of Washington, Seattle Cancer Care Alliance, Seattle, Washington., Specialty Chair, University of Alabama at Birmingham, Birmingham, Alabama.