RadiologyInfo.org - For Patients

Ten Things Physicians and Patients Should Question.

As part of its ongoing efforts to ensure safe, effective and appropriate use of medical imaging, the American College of Radiology (ACR) identified a list of five imaging exams whose necessity should be discussed before being ordered. The list, created as part of the Choosing Wisely® campaign, initiated by the American Board of Internal Medicine (ABIM) Foundation, provides evidence-based recommendations to support physicians working with patients to make wise choices about medical imaging care.

ACR recommendations address the following:

  1. Imaging for uncomplicated headache absent specific risk factors for structural disease or injury
  2. Imaging for suspected pulmonary embolism (PE) without moderate or high pre-test probability of PE
  3. Pre-operative chest X-rays without specific reasons due to patient history or physical exam
  4. Computed tomography (CT) to evaluate suspected appendicitis in children until ultrasound is considered an option
  5. Follow-up imaging for adnexal (reproductive tract) cysts 5cm or less in diameter in reproductive-age women
  6. Ultrasound imaging for incidental thyroid nodules found on CT, MRI or non-thyroid-focused neck ultrasound in low-risk patients unless the nodule meets age-based size criteria or has suspicious features.
  7. Abdominal CT imaging that includes unenhanced CT followed by IV contrast-enhanced CT except for certain indications.
  8. Abdominal CT imaging that includes a delayed post-contrast phase after the venous phase except for certain indications.
  9. CT or MRI imaging for Pelvic Congestion Syndrome in patients that meet clinical and imaging criteria.
  10. Follow-up imaging for nonobstructed, asymptomatic, isolated, short-segment jejunojejunal intusseption in adults.

Download patient-friendly resource here (PDF).

This page was reviewed on October 18, 2017

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RadiologyInfo.org is not a medical facility. Please contact your physician with specific medical questions or for a referral to a radiologist or other physician. To locate a medical imaging or radiation oncology provider in your community, you can search the ACR-accredited facilities database.

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Web page review process: This Web page is reviewed regularly by a physician with expertise in the medical area presented and is further reviewed by committees from the American College of Radiology (ACR) and the Radiological Society of North America (RSNA), comprising physicians with expertise in several radiologic areas.

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