Oncology Imaging Guidelines

This policy covers oncology imaging—advanced radiologic studies (CT, MRI, PET and related modalities) for staging, surveillance, and management of a broad range of malignancies across adult and pediatric populations (application of Oncology vs Pediatric guidelines is determined by age at initial diagnosis). Major limitations/requirements include physician review for atypical presentations, a recent clinical evaluation within 60 days before advanced imaging (unless scheduled off‑therapy surveillance), contrast use restrictions (e.g., eGFR <30, iodinated/GBCA allergy and premedication rules), single approval for initial staging when initiating standard therapy, and that advanced imaging is not indicated for patients who decline standard oncologic treatment.

"This tool addresses common symptoms and symptom complexes."

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