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
As part of Choosing Wisely, the ACR has also joined Consumer Reports to distribute patient-friendly resources for consumers and physicians to engage in important conversations regarding these medical imaging exams. The ACR’s list was developed after many months of careful consideration and review of existing professional guidelines and published evidence, by a task force of expert physicians drawn from ACR membership.

Download patient-friendly resources below:

Other Choosing Wisely resources: