April 15, 2022 — The American College of Radiology (ACR) has released the latest edition of the ACR Appropriateness Criteria, which includes 221 diagnostic imaging and interventional radiology topics with more than 1,050 clinical variants covering 2,900 clinical scenarios.
“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.”
The ACR Appropriateness Criteria has been providing the most comprehensive evidence-based guidelines for diagnostic imaging selection and image guided interventional procedures since 1993.
This latest update includes five new and 15 revised topics. Each topic has a narrative, an evidence table and a literature search summary. Many of the topics also have patient-friendly summaries.
The new topics in today’s release are:
- Ataxia-Child
- Fibroids
- Hernia
- Imaging After Breast Surgery
- Staging and Follow-up of Esophageal Cancer
Revised Topics:
- 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
Medical providers may consult the ACR Appropriateness Criteria to fulfill Protecting Access to Medicare Act (PAMA) requirements 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: www.acr.org
October 15, 2026 
