Renal and splanchnic artery aneurysms are clinically significant vascular abnormalities with potential for life-threatening complications, including rupture. Accurate imaging is essential for initial detection, risk stratification, treatment planning purposes, and longitudinal surveillance. This document provides evidence-based recommendations for imaging evaluation of suspected and known renal and/or splanchnic artery aneurysms across four clinical scenarios: adults undergoing initial evaluatio…
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ACR Appropriateness Criteria® Abdominal Aortic Aneurysm or Dissection-Interventional Planning and Follow-Up: Update 2025
Guidelines were developed for aortic evaluation based on a patient’s health status, comorbidities, and the aneurysm’s maximum diameter. The arrival of the endovascular aneurysm repair (EVAR) technique and its more advanced permutations introduced new variables to managing abdominal aortic aneurysm (AAA) and aortic dissection. For patients who present de novo for treatment of AAA or aortic dissection without any prior imaging available, the entire aorta (including the thoracic portion) should be …
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ACR Appropriateness Criteria® Staging and Follow-Up of Pancreatic Neuroendocrine Tumors
Accurate staging and appropriate follow-up imaging of pancreatic neuroendocrine tumors (PNET) are essential for guiding management and optimizing outcomes. This document provides evidence-based recommendations for the imaging evaluation of patients with PNET across six clinical variants: local staging, staging for metastatic disease, surveillance postresection, follow-up after treatment of liver-dominant and non-liver dominant disease, and follow-up of untreated disease. Contrast-enhanced CT is …
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Certainty Language Use In Pediatric Radiology: A Single Institution Analysis
Radiologists often employ diagnostic certainty phrases (DCPs) to convey levels of confidence in imaging interpretations. Prior research in adult radiology demonstrated wide variability in DCP usage, potentially complicating communication with clinicians and patients. Little is known about these practices in pediatric radiology. We aimed to characterize DCP use among pediatric radiologists in a large academic institution.
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ACR Appropriateness Criteria® Diagnosis and Monitoring of Sarcopenia
This article reviews evidence for using various imaging studies related to the diagnosis and monitoring of sarcopenia and other clinical conditions associated with muscle depletion. In this setting, DXA is usually appropriate for the assessment of body composition. Thigh ultrasound, performed in conjunction with clinical history and physical examination, may be useful. There is insufficient evidence to support a stand-alone indication for the use of CT of the abdomen (with or without contrast) o…
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ACR Appropriateness Criteria® Chronic Ankle Pain: Update 2025
Chronic ankle pain is common and can be caused by a variety of osseous or soft tissue abnormalities, either alone or in combination. Common etiologies of chronic ankle pain include osteoarthritis, impingement, osteochondral lesion, tarsal coalition, instability, or a chronic sequela of ligament or tendon injury. This document summarizes the current evidence for the appropriate use of specific imaging modalities for each of these clinical scenarios.The American College of Radiology Appropriatenes…
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ACR Appropriateness Criteria® Joint Pain: Idiopathic Arthritis-Child
This document details imaging approaches for children with suspected juvenile idiopathic arthritis in the axial and appendicular skeleton. It provides recommendations for the initial radiologic evaluation as well as for follow-up imaging.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analys…
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ACR Appropriateness Criteria® Autosomal Dominant Polycystic Kidney Disease
Ultrasound is the imaging study of choice for the initial diagnosis of autosomal dominant polycystic kidney disease (ADPKD) due to its high diagnostic accuracy and ability to detect kidney cysts as small as 2 to 3 mm. MRI of the kidneys is also highly sensitive at detecting small cysts and is an alternative to US. MRI is the preferred modality for determining total kidney volume (TKV). TKV can be used as an imaging biomarker to predict kidney function decline, track disease progression, and eval…
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ACR Appropriateness Criteria® Renovascular Hypertension: Update 2026
Renovascular hypertension is the most common cause of secondary hypertension and occurs in 0.5% to 5% of individuals with hypertension. This is more common in individuals who have difficulty controlling their pressure or elderly patients with end-stage kidney disease. An evaluation for renovascular hypertension is indicated if there is a high level of clinical suspicion. The primary imaging modalities for assessing renovascular hypertension are ultrasound, CT, and MRI, and these options can vary…
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ACR Appropriateness Criteria® Staging and Follow-Up of Melanoma
This document provides a comprehensive overview of the evidence supporting different imaging modalities and techniques used for the staging and surveillance of patients with cutaneous, mucocutaneous, and ocular melanoma. Guidelines are provided based on nodal status, presence of metastases at baseline, suspected metastases, and local stage.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a mult…