American College of Radiology updates imaging appropriateness criteria with 11 new topics
The American College of Radiology announced updates to its influential imaging appropriateness criteria on Tuesday, including 11 new topics.
ACR first launched this clinical tool in 1993, utilizing guidance from experts in diagnostic and interventional radiology to better inform physicians who order imaging. Its latest update covers scenarios such as breast imaging during pregnancy, vision loss, and Horner’s syndrome (a neurological disorder that affects one side of the face).
“…For the first time, the ACR Appropriateness Criteria is providing guidance covering staging and follow-up of leukemia,” Ihab Kamel, MD, PhD, chair of the college committee charged with maintaining the AAC, said in a statement April 29. “This is our first completed topic for the Systemic Oncology panel, and we believe this will help referring physicians and other providers enhance the quality of care they provide to these patients.”
A group of experts led by University of Nebraska radiologist Rustain L. Morgan, MD, devised the new recommendations related to leukemia. They note that each year, there are 60,650 new cases of the disease and 24,000 deaths. It’s the ninth most common cancer in men, 10th in women and No. 1 among children, accounting for 28% of new pediatric cases. ACR emphasized that exams such as CT of the chest, abdomen and pelvis with IV contrast are “usually appropriate” for assessing patients with the disease. Conversely, MRI is typically not advised in these scenarios.
Experts also issued revisions to six topics covering female breast cancer screening, first trimester vaginal bleeding, hematospermia (the presence of blood in ejaculate), pancreatic ductal adenocarcinoma (a highly lethal form of cancer affecting the pancreas), ovarian cancer, and suspected bone infection of the foot in diabetes patients. Altogether, the ACR Appropriateness Criteria cover 257 diagnostic and interventional radiology topics with 1,200 clinical variants and almost 3,700 scenarios. Experts review the guidelines annually, with Spanish translations also available across 60-plus topics.
ACR issued its last update to the appropriateness criteria in October, covering eight new topics. The college has billed such efforts as an alternative way to relieve radiologist shortages, forcing referrers to focus only on necessary imaging exams so rads’ time is not wasted. Here is the full list of new items:
- Acute Left Upper Quadrant Pain
- Breast Imaging During Pregnancy
- Horner Syndrome
- Male Breast Cancer Screening
- Management of Acute Pulmonary Embolism
- Preoperative and Postoperative Imaging for Bariatric Procedures
- Staging and Disease Monitoring of Colon Cancer and Appendiceal Cancer
- Staging and Follow-Up of Leukemia
- Staging and Disease Monitoring of Rectal Cancer
- Staging and Follow-up of Primary Liver Cancer
- Vision Loss
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.