ACR Appropriateness Criteria®

Currently, the ACR AC are the most comprehensive evidence-based guidelines for diagnostic imaging and image guided interventional procedures. They embody the best, current evidence for selecting appropriate diagnostic imaging and interventional procedures for numerous clinical conditions.

We track and manage insights and feedback from a variety of sources who are not directly involved in the ACR AC development and review processes. Comments on existing AC content or suggestions for new AC content may be submitted at any time, including during the focused commenting period scheduled for two months after each release. We do our best to provide timely responses to all input.

These brief summaries, written by patients, for patients, help laypersons understand which imaging is most appropriate for their situation.

Once you have found the Appropriateness Criteria document you want to use, open the corresponding Narrative and Rating Table PDF and use it for the title, authors and URL.

1. If citing a specific ACR Appropriateness Criteria topic: List authors. Title. Available at [URL]. American College of Radiology. Accessed [DATE].
   Example: Bancroft LW, Kransdorf MJ, Adler RA, et al. ACR Appropriateness Criteria^® Acute Trauma to the Foot. Available at https://acsearch.acr.org/docs/70546/Narrative/ . American College of Radiology. Accessed DATE.
2. If citing the entire ACR Appropriateness Criteria
   American College of Radiology. ACR Appropriateness Criteria^®. Available at https://acsearch.acr.org/list . Accessed [DATE].

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The funding for the process is assumed entirely by the American College of Radiology. ACR staff support the expert panels through the conduct of literature searches, acquisition of scientific articles, drafting of evidence tables, dissemination of materials for the Delphi process, collation of results, conference calls, document processing and general assistance to the panelists.

The AC panel members have editorial independence from the ACR when developing the guidance documents. There are inputs within the committee governance structure to encourage diversity and representation for the guidance development panels members and to support adequate review by primary care providers, patient representatives and technical experts. The recommendations on the final documents are the result of the objective evidence-based processes and the process to determine group consensus. The panels review the recommendations and modify the text to ensure the text represents the final recommendations. The final AC documents are not reviewed, modified, or approved by an ACR committee external to the process, such as the ACR Board of Chancellors (BOC).

The ACR BOC has delegated authority for independently creating the committees and documents through ACR’s governing structure and process. The chair of the ACR AC Committee, who is ultimately responsible for the AC documents, is recommended for appointment to the BOC Chair by the Chair of the Commission on Quality and Safety.

An important aspect of committee operations is the disclosure and management of potential conflicts of interest. The ACR AC program’s COI process follows the current ACR COI policy and fulfills any and all additional requirements for qualified provider-led entities as designated by the Centers for Medicare and Medicaid Services’ AUC program.

The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient’s clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient’s condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.