11
ASCO Resource Levels
Strength of
Recommendation Basic Limited Enhanced Maximal
Digital
rectal exam
(Strong )
Digital
rectal exam
(Strong )
Digital
rectal exam
(Weak)
Digital rectal exam
(Weak)
See individual
ratings
Chest
X-Ray and
abdominal
ultrasound
(US)
– – – Moderate
– Contrast enhanced CT scan chest, abdomen,
pelvis
Strong
N/A N/A N/A PET/CT in
selected cases (such
as for when MDT
is discussing the
possibility of a
patient receiving
resection of
metastases)
Moderate
N/A Liver MRI
or contrast-
enhanced
liver US
a
(if MDT
available)
Liver MRI or contrast-enhanced
liver US
a
Limited setting :
weak; for
both enhanced and
maximal settings:
moderate
– – MRI pelvis rectal cancer protocol Strong
– – Rectal endoscopic ultrasound Weak
