ACR Appropriateness Criteria

BlueMan_640The ACR Appropriateness Criteria® (AC) are evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. Employing these guidelines helps providers enhance quality of care and contribute to the most efficacious use of radiology. Learn more »

CMS has designated ACR as a Qualified Provider-Led Entity »

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New and Revised Topics in 2017


New Topics Under Development

Anticipated release is in 2018–2019.

Expert Panel on Breast Imaging

  • Breast Imaging of Pregnant and Lactating Women
  • Breast Implant Evaluation

Expert Panel on Cardiac Imaging

  • Suspected New-Onset and Known Non-Acute Heart Failure
  • Syncope (Joint with Neurological)

Expert Panel on Gastrointestinal Imaging

  • Anorectal Disease
  • Pancreatic Cysts

Expert Panel on Interventional Radiology

  • Dialysis Fistula Malfunction (Joint with Vascular)
  • Radiologic Management of Portal Hypertension (Joint with Vascular)

Expert Panel on Musculoskeletal Imaging

  • Shoulder Pain-Atraumatic

Expert Panel on Neurological Imaging

  • Altered Mental Status
  • Suspected Spine Infection
  • Thyroid Disease

Expert Panel on Pediatric Imaging

  • Acute Respiratory Illness of Immunocompetent – Child
  • Antenatal Hydronephrosis – Child
  • Cerebrovascular Disease – Child
  • Congenital Heart Disease – Child (joint with cardiac panel)
  • Crohn Disease – Child
  • Pneumonia in the Immunocompetent Child – Child
  • Scoliosis – Child
  • Spine Trauma – Child
  • Suspected Appendicitis – Child

Expert Panel on Thoracic Imaging

  • Lung Cancer Screening

Expert Panel on Vascular Imaging

  • Abdominal Aortic Aneurysm Follow-Up (without repair)
  • Chronic Venous Stasis Disease/Symptomatic Varicose Veins (Joint with Interventional)
  • Clinically Suspected Vascular Malformation of the Extremities
  • Diagnostic Evaluation Following Endovascular and Surgical Lower Extremity Arterial Revascularization
  • Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery)
  • Lower Extremity Vascular Disease

Expert Panel on Women’s Imaging

  • Gestational Trophoblastic Disease
  • Imaging of Post-Partum Bleeding Complications (Not Including Placental Attachment Disorder)
  • Nuchal Translucency Evaluation at 11-14 weeks Gestational Age
  • Postmenopausal Acute Pelvic Pain
  • Postmenopausal Sub Acute or Chronic Pelvic Pain
  • Second and Third Trimester Screening for Suspected Fetal Anomaly
  • Staging and Follow-up of Vaginal Cancer
  • Staging and Follow-up of Vulvar Cancer
  • Suspected Placental Attachment Disorder

Expert Panel on Major Trauma

  • Major Blunt Trauma

Topics Under Consideration

Topic Panel Anticipated Start
Suspected Spine Infection
Neuro 2017
Noncerebral Vasculitis
Vascular TBD

Methodology Documents


As a qPLE, the ACR follows guidance development requirements including a balanced, multidisciplinary team involving various stakeholders in the development process. To read more about the development process, please review the information below.

Additional Supporting Information


Additional Information


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Please use our online feedback form* to share suggestions for new topics, questions about guidance provided in a topic, or to let us know what you like. Thanks for helping us make the ACR AC better!

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Learn more about the ACR AC External Review and Commenting process »

Clinical Decision Support



ACR Select® is the digital version of the ACR Appropriateness Criteria®. Incorporate ACR Select into computerized ordering and EHR systems to guide providers when ordering medical imaging scans.

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Radiology Support, Communication and Alignment Network



Collaborate with radiologists and referring clinicians to improve imaging appropriateness based on Choosing Wisely topics.

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