The Pulmonary Embolism Reporting and Data Systems framework aims to improve communication and patient care through a structured grading scale for computed tomography and magnetic resonance angiography.
The Pulmonary Embolism Reporting and Data Systems framework for diagnosing and classifying acute pulmonary embolism using computed tomography (CT) and magnetic resonance (MR) angiography was published in Radiology, a journal of the Radiological Society of North America. Developed by the American College of Radiology in collaboration with representatives from six other medical groups, the framework aims to streamline communication and patient care for the condition.
Timely and accurate assessment of acute pulmonary embolism is essential, as the sudden blockage in the blood vessels of the lungs reduces blood flow, may strain the heart, and can be fatal if untreated. Common symptoms include shortness of breath, chest pain, and low blood pressure.
“The goal of PE-RADS is to improve communication between healthcare providers who care for patients with acute pulmonary embolism,” says Lynne M Koweek, MD, professor of radiology and associate professor of medicine at Duke University School of Medicine and chair of the American College of Radiology committee for the framework, in a release. “As the first standardized lexicon and structured reporting system for pulmonary embolism imaging, PE-RADS v2026 is designed to provide a framework for reporting CT and MR angiographic findings in a clear, consistent manner to guide next steps patient care.”
Standardizing Communication and Care
CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism, and MR angiography is another noninvasive, accurate test used for diagnosis.
“These are commonly performed exams that can be challenging to interpret, and imaging findings are critical to patient management,” says Koweek in a release. “Standard terminology reduces variability in reporting and understanding the radiology report. We hope that all radiologists will use PE-RADS to enable clear communication and coordination with care teams.”
The framework provides a 0-4 grading scale and hierarchical structure to classify clot location combined with right heart imaging features, supporting risk stratification and guiding patient management across multidisciplinary teams. The system also includes modifiers to indicate limitations in diagnosis due to image quality and non-pulmonary embolism causes of disease in the pulmonary arteries.
Collaborative Development
Imaging specialists and clinicians who care for patients with suspected or diagnosed pulmonary embolism developed the system. Half of the specialists were selected by the American College of Radiology, and the other half were nominated by the American College of Emergency Physicians, American College of Chest Physicians, Pulmonary Embolism Response Team Consortium, Society of Thoracic Radiology, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology.
The new framework is aligned with existing pulmonary embolism guidelines and designed for adoption and future expansion as data assessing its impact on outcomes and resource utilization emerge.
“Consistent terminology and reporting not only fosters effective communication between healthcare providers, it also creates a stronger foundation for studying outcomes, resource utilization and future improvements in pulmonary embolism care,” says Koweek in a release. “PE-RADS provides a structured framework to standardize reports today and evolve as treatments and evidence advance.”
The American College of Radiology reporting and data systems program originated in 1992 to provide standardized frameworks for the interpretation and reporting of medical imaging results and facilitate communication between radiologists and referring physicians.
Photo caption: Image quality modifications. (A) Non-diagnostic axial CT angriography image quality with inability to exclude presence of acute pulmonary embolus in the central vessels, Pulmonary Embolism Reporting and Data System (PE-RADS) N. (B) Limited axial CT angiography image quality, no acute pulmonary embolism identified in the central vessels with incomplete assessment of segmental and/or subsegmental vessels due to motion artifact (arrows), PE-RADS 0L.
Photo credit: RSNA
