ACR Appropriateness Criteria

 The 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. The AC are not intended to be used as coding guidance for radiologic procedures. Learn more »

An interactive way to access the AC topics, variants, clinical scenarios, and recommendations. Use keyword filters and search features to more easily find all content.

AC News and Announcements


New and Revised Topics in 2023




In 2023, we added 13 new and 20 revised topics. The ACR Appropriateness Criteria includes 233 Diagnostic Imaging and Interventional Radiology topics with over 1100 clinical variants and 3000 clinical scenarios.

Diagnostic Imaging Updates

  1. Abnormal Liver Function Tests (New)  
  2. Acute Onset Flank Pain-Suspicion of Stone Disease (Urolithiasis) (Revised) 
  3. Acute Pelvic Pain in the Reproductive Age Group (Revised) 
  4. Breast Implant Evaluation (Revised) 
  5. Cerebrovascular Diseases-Stroke and Stroke-Related Conditions (New) 
  6. Chronic Hand and Wrist Pain (Revised) 
  7. Clinically Suspected Adnexal Mass, No Acute Symptoms (Revised) 
  8. Congenital or Acquired Heart Disease (New) 
  9. Dialysis Fistula Malfunction (New) 
  10. Dizziness and Ataxia (Revised) 
  11. Female Breast Cancer Screening (Revised) 
  12. Hydronephrosis on Prior Imaging-Unknown Cause (New) 
  13. Imaging after Total Hip Arthroplasty (Revised) 
  14. Imaging After Total Knee Arthroplasty (Revised) 
  15. Imaging of Invasive Breast Cancer (New) 
  16. Incidentally Detected Indeterminate Pulmonary Nodule (Revised) 
  17. Left Lower Quadrant Pain (Revised)  
  18. Lower Extremity Chronic Venous Disease (Revised) 
  19. Orbital Imaging and Vision Loss-Child (New) 
  20. Preprocedural Planning for Left Atrial Procedures in Atrial Fibrillation (New) 
  21. Preprocedural Planning for Transcatheter Aortic Valve Replacement (Revised) 
  22. Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix (Revised) 
  23. Pulmonary Arteriovenous Malformation (Revised) 
  24. Pulsatile Abdominal Mass, Suspected Abdominal Aortic Aneurysm (Revised) 
  25. Screening for Abdominal Aortic Aneurysm (New) 
  26. Sepsis (New) 
  27. Soft Tissue Vascular Anomalies-Vascular Malformations and Infantile Vascular Tumors-Child (New) 
  28. Staging and Post-Therapy Assessment of Head and Neck Cancer (New) 
  29. Sudden Onset of Cold, Painful Leg (Revised) 
  30. Tinnitus (Revised) 
  31. Urinary Tract Infection-Child (Revised) 
  32. Workup of Pleural Effusion or Pleural Disease (New) 

Interventional Radiologic Updates

  1. Dialysis Fistula Malfunction (New) 
  2. Lower Extremity Chronic Venous Disease (Revised) 
  3. Management of Uterine Fibroids (Revised) 

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


Provide Feedback


The feedback site allows us to track and manage feedback from a variety of sources. One focus of this site is to capture insights from partners who are not directly involved in the ACR AC development and review processes. Feedback and comments on any topic 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.

Patient Summaries


JACR in collaboration with the ACR AC Patient Engagement Subcommittee, have published Patient Summaries to help patients understand what tests are appropriate for their situation. The summaries, prepared by patients (laypersons) summarize AC recommendations for patients in easy to understand language. Click here to access the patient friendly summaries.

Additional Information


Clinical Decision Support



ACR Select®, a digital representation of the ACR Appropriateness Criteria® for diagnostic imaging, is a module contained within CareSelect Imaging.

ACR Select is ready to incorporate into computerized ordering and EHR systems to guide providers when ordering medical imaging scans.


Get ACR Select

Radiology Support, Communication and Alignment Network



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