Oncology Imaging Guidelines

EviCore’s Oncology Imaging Guidelines (v3.0.2025) cover advanced imaging (CT, MRI, nuclear medicine, PET/CT and specified PET radiotracers, with PET/MRI only in limited situations) for defined oncologic indications (e.g., MRI brain for suspected/known brain mets, bone scan for suspected bony mets, PET/CT for problem‑solving, staging, biopsy planning) and explicitly exclude routine surveillance/asymptomatic screening, PET for infection/inflammation, CNS metastases, lesions <8 mm, concomitant diagnostic CT, post‑local therapy surveillance, and any studies not listed in disease‑specific sections. Key requirements for approval include a prior clinical evaluation or meaningful contact, usually histologic confirmation and documented disease stage (or a documented reason biopsy wasn’t pursued), relevant symptoms or prior imaging findings, specification of the PET radiotracer and a statement of how results will affect management, and adherence to timing and disease‑specific documentation constraints (e.g., post‑radiation/RAI timing, tumor‑marker thresholds).