The Appropriateness Criteria (AC) Committee of the ACR remains dedicated to offering guidance to ordering providers on the appropriate use of imaging in patient care. Our physician leadership, staff, and methodology subcommittee collaborate regularly to enhance the structure of the AC process, ensuring that we continue to deliver high-quality guidance to all ordering providers.
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From AI breakthroughs to imaging trends, we serve up real-time radiology insights.
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ACR Appropriateness Criteria® Staging and Follow-Up of Leukemia
Imaging associated with staging and follow-up of leukemia can play an important role in accurately assessing disease; however, the type of imaging and usefulness varies significantly by the subtype of leukemia. This document reviews the current literature regarding the impact of imaging for both staging and surveillance of several of the most common leukemic variants. These include acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, Richter transformation, and chr…
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ACR Appropriateness Criteria® Screening, Locoregional Assessment, and Surveillance of Pancreatic Ductal Adenocarcinoma: 2025 Update
Pancreatic ductal adenocarcinoma is a highly lethal cancer that often presents with vague and indolent symptoms leading to advanced stage diagnosis. Imaging plays a crucial role in the diagnosis, assessment of locoregional and metastatic disease, surgical planning, and surveillance after neoadjuvant therapy and surgery. This document reviews available imaging modalities that are best used for these clinical scenarios, and a summary of current evidence is provided to support the use of the variou…
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ACR Appropriateness Criteria® Vision Loss
Vision loss is a common medical problem that can arise secondary to a variety of pathologies including trauma, ischemia, infection or inflammation, demyelination, and mass lesions anywhere along the visual pathway. Most nontraumatic pathology to the globe is diagnosed by ophthalmologic examination and does not require imaging. When needed, the choice of imaging study is directed at the known or suspected cause and the expected anatomic location of the insult along the visual pathway. This docume…
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Assessing deep learning artificial intelligence support for detecting elbow fractures in the pediatric emergency department
Elbow fractures are among the most common pediatric injuries, accounting for 15–20 % of all fractures in children [1,2]. Diagnosing these fractures can be particularly challenging due to the complex radiographic appearance of the developing elbow, which features multiple ossification centers that emerge at different stages [3,4]. As a result, identifying fractures often requires recognizing indirect signs, such as the fat pad sign, which suggests joint effusion [5–7]. Accurate diagnosis is criti…
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ACR Appropriateness Criteria® First Trimester Vaginal Bleeding: 2025 Update
Vaginal bleeding is a relatively common occurrence in the first trimester of pregnancy, but can be distressing for both patients and clinicians. Differential considerations include normal intrauterine pregnancy (IUP), a nonviable IUP, an ectopic pregnancy (EP), or much less commonly gestational trophoblastic disease (GTD). Although the diagnosis of EP, nonviable IUP, and GTD is important, it is also crucial to avoid harming potentially normal pregnancies through early medical or surgical treatme…
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ACR Appropriateness Criteria® Horner Syndrome
Horner syndrome is a combination of signs and symptoms caused by abnormalities in the oculosympathetic pathway. Typically, patients present with ipsilateral miosis, ptosis, and anhidrosis. Imaging the oculosympathetic pathway is complex because of its extensive course, need for targeted protocols, and the wide range of pathology that can cause it. For this document, we focus our attention on workup guidelines based on clinical features: 1) acuity (acute, nonacute including chronic, insidious, an…
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Oct 31 2025 This Week in Cardiology
Four pillars of cardiology today, stable coronary artery disease, severe aortic stenosis, the evaluation of chest pain, and best therapies for atrial fibrillation are the topics John Mandrola, MD, discusses in this week’s podcast. theheart.org on Medscape
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AI Generates Future Knee X-Rays to Predict Osteoarthritis Progression Risk
An AI system predicts future knee X-rays to help millions manage osteoarthritis progression.