The American College of Radiology (ACR) has released an update to its ACR Appropriateness Criteria (ACR AC), which includes 198 diagnostic imaging and interventional radiology topics with 965 clinical variants covering more than 1,700 clinical scenarios. This update includes six new and 10 revised topics.

All topics include a narrative, evidence table and a literature search summary. Patient-friendly summaries, which are intended to help patients understand what tests are appropriate for their situation and enhance communication from ordering physicians and radiologists, are available for a number of topics as well.

“The ACR Appropriateness Criteria ensures consistent behaviors for medical imaging and interventional radiology procedures for all patients,” says Mark E. Lockhart, MD, MPH, chair of the ACR Committee on Appropriateness Criteria. “The ACR AC continues to be a critical resource that helps providers enhance quality of care and contribute to the most efficacious use of radiology.”

The new topics are:
1. Imaging of Mediastinal Masses 
2. Postmenopausal Acute Pelvic Pain 
3. Second and Third Trimester Screening for Fetal Anomaly 
4. Staging and Follow-up of Vulvar Cancer 
5. Syncope 
6. Radiologic Management of Portal Hypertension 

Revised topics include:
1. Asymptomatic Patient at Risk for Coronary Artery Disease 
2. Head Trauma 
3. Infective Endocarditis 
4. Intensive Care Unit Patients 
5. Myelopathy 
6. Nonischemic Myocardial Disease with Clinical Manifestations (Ischemic Cardiomyopathy Already Excluded) 
7. Nontraumatic Aortic Disease 
8. Post-Treatment Surveillance of Bladder Cancer 
9. Renal Failure 
10. Radiologic Management of Lower Gastrointestinal Tract Bleeding 

The ACR AC was first introduced in 1993 by expert panels in diagnostic imaging and interventional radiology to help providers make the most appropriate imaging or treatment decisions for specific clinical conditions. These guidelines are developed and reviewed annually.

Referring physicians and other providers may consult the ACR AC to fulfill requirements mandated by the Protecting Access to Medicare Act, which requires that they consult appropriate use criteria prior to ordering advanced diagnostic imaging for Medicare patients. The ACR is designated by the Centers for Medicare and Medicaid Services as a qualified Provider-Led Entity.

For more information about ACR Appropriateness Criteria, visit the ACR website.