ACR’s PE-RADS™️standardizes how radiologists report pulmonary embolism and bolsters communication with other ordering clinicians.
The College provides a host of Reporting and Data Systems (RADS) — standardized reporting frameworks designed to help radiologists use consistent terminology, assessment categories and management recommendations. By using RADS, practices can put standard terminology in place for simpler, better reporting, clearer communication between radiologists and referrers and improved tracking of outcomes.
The newly published PE-RADS standardizes how radiologists report acute pulmonary embolism (PE) on CT and MR angiography — with the goal of getting radiologists, referring clinicians, PE response teams and other specialists on the same page. The guidelines also address the need for precise location information for new catheter-directed therapies.
By using PE-RADS, practices enhance the clarity of reports, support evidence based decision making and promote better patient care. PE-RADS was developed by ACR in collaboration with representatives from six other leading medical groups. The Bulletin spoke with Shari B. Brosnahan, MD, MS, a pulmonologist at NYU Langone Health, a member of the PE-RADS steering committee and one of the authors of a new paper explaining the most recent data and reporting system.
Standardization of reporting is helpful because it allows the most important information to be delivered succinctly and clearly to the clinical provider interpreting the report. That clear communication allows patients to get the best care based on their specific pulmonary embolism.
PE-RADS has two major parts. The first is the location of the clot, but the second is how the heart is doing when the clot is identified. In other words, is the heart able to handle the blood clot? This is incredibly important to patient outcomes because the heart failing is the cause of decompensation from a pulmonary embolism. PE-RADS provides a standard report of how the right heart is doing in relation to acute PE.
The field of pulmonary embolism has changed a lot in the last decade. New catheter-directed therapies can only be completed if pulmonary embolism is in certain locations. Despite this, not all CT reads or other chest imaging include the exact location of the pulmonary embolism and, if they do, it is not in a way that is understandable to a non-radiologist. The goal of PE-RADS is to ensure that we can communicate the location of the PE so that radiologists and non-radiologists can understand.
A lot of pulmonary embolism response teams are often called with many questions. “What does this report mean?” “Where is this embolism?” “This person has a PE, should I be nervous?” I think the standardization of reporting will allow improvement in that throughput. Clinicians will be able to understand the urgency of a PE more easily and more important calls could be prioritized — improving care delivery times.
ACR took the lead along with several other groups including the American College of Chest Physicians, which co-published the guidelines. Other groups represented included PERT (Pulmonary Embolism Response Team) Consortium, Society of Thoracic Radiology, Society of Interventional Radiology, American College of Emergency Physicians (ACEP), and Society for Cardiovascular Angiography and Interventions (SCAI).
The PE-RADS guidelines also complement the American College of Cardiology’s (ACC) new classification guidelines, providing critical interpretive tools for CT scans. The ACC released its guidelines on the classification of PE, which have gotten a lot of attention. The ACR guidelines are important in conjunction with that because those ACC guidelines just talk about management — they don’t necessarily help the clinician to know how to interpret the CT scan report, which is outside of their scope. So, the ACR’s guidelines come at a great time. With the new RADS, we can help people rethink the way they do everything in PE management today.
This PE-RADS is only for acute pulmonary embolism. Our hope is — as this is picked up and we get feedback from users — to do something with chronic pulmonary embolism. This is more difficult, like seeing phenotypes, but very important. For now, we know that patient management for PE requires multiple care teams, and we will continue to focus on better communication between all teams for better patient outcomes.
Interview by Chad Hudnall, senior editor, ACR Bulletin.
Access a new standardized reporting system that unifies how radiologists classify clot locations and right-heart findings in pulmonary embolism, streamlining decision-making and enhancing patient care.
Shape the future of radiology. ACR members get the support and resources critical to the success of the profession. Connect with nearly 40,000 ACR members and take advantage of volunteering and educational opportunities — plus insights to propel your career and make your voice heard.
Join todayPatient- and Family-Centered Care
As radiology evolves, the patient remains the compass guiding us through a changing healthcare landscape towards what comes next.
Read more
Master the Challenges of Gastrointestinal Imaging
The CPI Gastrointestinal Tract Radiology Module 2026 features image-rich, case-based learning that radiologists and trainees at all levels can learn from.
Read more
ROOT for Reform
The Radiology Outpatient Ordering Transmission Act is here to help aid workforce issues by improving radiologists’ decision-making environment.
Read more
