R-SCAN Topics and Resources

Choose a topic for your project from the list below. All topics are related to outpatient and emergent care. Select a topic with a strong potential for ordering improvement.

We offer educational resources covering the spectrum of Choosing Wisely topics. They are included in each topic section below.

Log in to R-SCAN
The toolkit is a resource to help you implement your own quality project and build greater patient engagement into your image ordering workflow.

Abdominal Imaging: CT for Recurrent Renal Colic

Avoid ordering CT of the abdomen and pelvis in otherwise health emergency department (ED) patients (age <50) with known histories of kidney stones, or urolithiasis, presenting with symptoms consistent with acute uncomplicated renal colic.

Physician Resources

Choosing Wisely Topic: CT for Renal Colic

ACR Appropriateness Criteria: CT for Renal Colic

Choosing Wisely Case Review: Selecting the best imaging exam for kidney stones

Podcast: A discussion on ordering imaging exams for renal colic

Patient Resources

Choosing Wisely Handout: Why the doctor may not order a CT scan for kidney stones

Patient-Friendly Appropriateness Criteria Summary

Educational Flyer: CT Scans in the Emergency Department

Cardiac Imaging: CTA for Asymptomatic Patient at Low Risk for Coronary Artery Disease

Don’t routinely order coronary CT angiography for screening asymptomatic individuals.

Physician Resources

Choosing Wisely Topic: CTA for Asymptomatic Patient with Low Risk of Coronary Heart Disease

ACR Appropriateness Criteria: Asymptomatic Patient at Risk for Coronary Artery Disease

Article: R-SCAN: Cardiac CT Angiography for Acute Chest Pain

Choosing Wisely Case Review: Selecting the best imaging exam for acute chest pain

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Chest Imaging: Admission and Pre-op Chest X-ray

Chest Imaging: CTA for Pulmonary Embolism

Do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay.

Physician Resources

Choosing Wisely Topic: CTA for Pulmonary Embolism

Article: R-SCAN: CT Angiographic Imaging for Pulmonary Embolism

Video: Complementary ACR 2016 Video on Baylor Medical College's R-SCAN Implementation & Results

ACR Appropriateness Criteria: Acute Chest Pain – Suspected Pulmonary Embolism

Flyer: ACEP-ACR Partnership Delivers Resources to Help Prepare You for the Future

Article: Yield of CT Pulmonary Angiography in the ED When Providers Override CDS

Podcast: A discussion on ordering imaging exams for pulmonary embolism

Choosing Wisely Video: Radiologists Discuss Low Risk PE

Order Wisely Video: Appropriate Imaging for Pulmonary Embolism

Choosing Wisely Case Review: Selecting the best imaging exam for pulmonary embolism

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® - Pulmonary Embolism

Educational Flyer: CT Scans in the Emergency Department

ACR Appropriateness Criteria: Acute Chest Pain – Suspected Pulmonary Embolism

Article: Association of Lower Diagnostic Yield With High Users of CT Pulmonary Angiogram

Patient Resources

Educational Flyer: CT Scans in the Emergency Department

Choosing Wisely Handout: When you need a CT scan to check for a blood clot in your lungs

Patient-Friendly Appropriateness Criteria Summary

Article: ACP Evaluation of Patients With Suspected Acute Pulmonary Embolism

Genitourinary Imaging: Adnexal Cyst Follow-up

Genitourinary Imaging: Advanced Imaging for Early Prostate Cancer Staging

Head and Neck Imaging: Incidental Thyroid Nodules Follow-Up

Don't recommend ultrasound for incidental thyroid nodule in low-risk patients unless the nodule meets age-based size criteria or has suspicious features.

Note: This topic is completed via upload of data entered in an Excel spreadsheet only. The spreadsheet is available below.

Physician Resources

Article: Managing Incidental Thyroid Nodules Detected on Imaging: White Paper of the ACR Incidental Thyroid Findings Committee

Data Entry Excel Template for Incidental Thyroid Nodule Project

Musculoskeletal Imaging: Imaging for Low Back Pain

Neuroimaging: CT for Uncomplicated Rhinosinusitis

Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.

Physician Resources

Choosing Wisely Topic: CT for Uncomplicated Rhinosinusitis

ACR Appropriateness Criteria: Sinonasal Disease

Podcast: A discussion on ordering imaging exams for rhinosinusitis

Article: R-SCAN: Imaging for Uncomplicated Acute Rhinosinusitis

Choosing Wisely Case Review: Selecting the best imaging exam for rhinosinusitis

Presentation: When to Image Based on Choosing Wisely® and the ACR Appropriateness Criteria®

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Choosing Wisely Handout: Treating Sinusitis — English | Spanish

Neuroimaging: Imaging for Uncomplicated Headaches

Don’t do imaging for uncomplicated headache.

Physician Resources

Choosing Wisely Topic: Imaging for Uncomplicated Headaches

ACR Appropriateness Criteria: Headache

Order Wisely Video: Appropriate Imaging for Headache

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® — Uncomplicated Headache

Article: R-SCAN: Imaging for Headache

Patient Resources

Choosing Wisely Handout: Imaging Tests for Headaches — English | Spanish

ACP Patient FACTS: Migraine Headache — English | Spanish

Neuroimaging: CT for Minor Pediatric Head Injury

CT scans are not necessary in the immediate evaluation of minor head injuries; clinical observation/Pediatric Emergency Care Applied Research Network criteria should be used to determine whether imaging is indicated.

Physician Resources

Choosing Wisely Topic: CT for Minor Pediatric Head Injury

ACR Appropriateness Criteria: Head Trauma – Child

Article: R-SCAN: Imaging for Pediatric Minor Head Trauma

Case Study Video: CTs for Pediatric Patients With Minor Head Trauma – Implementing PECARN

Article: Identification of Children at Very Low Risk of Clinically-Important Brain Injuries After Head Trauma

Flyer: ACEP-ACR Partnership Delivers Resources to Help Prepare You for the Future

Podcast: A discussion on ordering imaging exams for pediatric head trauma

Article: Optimizing Communication With Parents on Benefits and Radiation Risks in Pediatric Imaging

Choosing Wisely Video: Request for CT After Pediatric Head Injury

Presentation: ACR Appropriateness Criteria – Head Trauma

Choosing Wisely Case Review: Selecting the best imaging exam for minor head trauma (pediatric)

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® — Minor Pediatric Head Trauma

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Website Resource: Think A-Head and Image Gently™

Choosing Wisely Handout: CT Scans for Children with Head Injuries — English | Spanish

A Shared Decision Making Tool for Discussing CT Head Injury with Patients

Choosing Wisely Handout: Brain Scans for Head Injuries — English | Spanish

Neuroimaging: CT for Adult Minor Head Trauma

Avoid CT scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.

Physician Resources

Choosing Wisely Topic: CT for Adult Minor Head Trauma

ACR Appropriateness Criteria: CT for Adult Minor Head Trauma

Choosing Wisely Case Review: Selecting the best imaging exam for minor head trauma (adult)

Presentation: CT for Adult Minor Head Trauma - When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria®

Podcast: A discussion on ordering imaging exams for adult minor head trauma

Article: The Canadian CT Head Rule for patients with minor head injury

Article: Computed Tomography Use for Adults with Head Injury

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

A Shared Decision Making Tool for Discussing CT Head Injury with Patients

Choosing Wisely Handout: Brain Scans for Head Injuries — English | Spanish

Choosing Wisely Handout: Do you need a CT scan for a head injury?

Neuroimaging: Advanced Imaging for Pediatric Febrile Seizures

Practice-Defined Topic

To meet unique practice needs and settings, learn how R-SCAN participants can define their own topic to optimize imaging care.

Define Your Own Topic