The American College of Radiology (ACR) recently released 5 new topic areas and 15 revisions to existing topics in the ACR Appropriateness Criteria. The appropriate use criteria guidance provides support for referring physicians and other providers to enhance radiologic care by outlining the best imaging modality to answer specific clinical questions. This can help reduce the need for additional testing.

This latest update includes five new and 15 revised topics. The new areas include ataxia-child, fibroids, hernia, staging and follow-up of esophageal cancer, and imaging after breast surgery

Each topic has a narrative, an evidence table and a literature search summary. Many of the topics also have patient-friendly summaries. Links to all the new and revised radiology imaging appropriate use sections can be found below

“Referring physicians and other healthcare providers depend on the ACR Appropriateness Criteria for consistency and standards in providing quality patient radiologic care,” said Mark E. Lockhart, MD, MPH, chair of the ACR Committee on Appropriateness Criteria. “This tool is valuable for patients as well, providing them with easy-to-understand summaries that help explain which tests are appropriate for their situation.”

Lockhart is the chief of genitourinary (GU) radiology and a professor in the abdominal imaging section at the University of Alabama at Birmingham.

The ACR Appropriateness Criteria includes 221 diagnostic imaging and interventional radiology topics. It also offers more than 1,050 clinical variants, covering 2,900 clinical scenarios. 

The new ARC appropriate use image topics include:

• Ataxia-Child 
• Fibroids 
• Hernia 
• Imaging After Breast Surgery 
• Staging and Follow-up of Esophageal Cancer 

The revised ARC appropriate use image topics include:

• Acute Pyelonephritis 
• Chronic Elbow Pain 
• Cranial Neuropathy 
• Evaluation of Nipple Discharge 
• Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery) 
• Lower Extremity Arterial Claudication-Imaging Assessment for Revascularization 
• Malignant or Aggressive Primary Musculoskeletal Tumor – Staging and Surveillance 
• Management of Liver Cancer 
• Osteonecrosis 
• Osteoporosis and Bone Mineral Density 
• Radiologic Management of Mesenteric Ischemia 
• Right Lower Quadrant Pain 
• Suspected Osteomyelitis, Septic Arthritis, or Soft Tissue Infection (Excluding Spine and Diabetic Foot) 
• Suspected Pulmonary Embolism 
• Suspected Pulmonary Hypertension