April 26, 2021 — The American College of Radiology (ACR) released an update to its ACR Appropriateness Criteria (ACR AC), which includes 211 diagnostic imaging and interventional radiology topics with more than 1,000 clinical variants covering approximately 1,900 clinical scenarios. This update includes 13 new and five revised topics. All topics include a narrative, evidence table and a literature search summary.
Patient-friendly summaries, a tool to help patients understand what tests are appropriate for their situation and enhance communication from ordering physicians and radiologists, are available for numerous topics.
“ACR Appropriateness Criteria creates consistent behaviors for medical imaging and interventional radiology procedures for all patients,” said Mark E. Lockhart, M.D., MPH, Chair of the ACR Committee on Appropriateness Criteria. “By employing these guidelines, providers enhance quality of care and contribute to the most efficacious use of radiology.”
The new topics in today’s release are:
- Anorectal Disease
- Cerebrovascular Diseases — Aneurysm, Vascular Malformation, and Subarachnoid Hemorrhage
- Chronic Cough
- Diffuse Lung Disease
- Epigastric Pain
- Noncerebral Vasculitis
- Nontraumatic Chest Wall Pain
- Parathyroid Adenoma
- Staging and Follow-up of Primary Vaginal Cancer
- Supplemental Breast Cancer Screening Based on Breast Density
- Suspected Retroperitoneal Bleed
- Suspected Spine Infection
- Transgender Breast Cancer Screening
Revised topics include:
- Adrenal Mass Evaluation
- Inflammatory Back Pain: Known or Suspected Axial Spondyloarthropathy
- Low Back Pain
- Plexopathy
- Suspected Acute Aortic Syndrome
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: ACR website
November 10, 2025 
