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Topics

CHEST 1

Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam.
ACR Select “Pathway”: Modality driven, x-ray, chest, search for “admit”

Topic Specific Resources

 

Choosing Wisely Topic Sponsors
Click on a logo to view a society's complete list of things physicians and patients should question.
      ACR logo    ACP logo 

Materials Provided by Societies or Organizations

Choosing Wisely Materials to Provide Your Patients

Chest X-Rays Before Surgery
Developed by Consumer Report Health in cooperation with the American College of Radiology

Clinician Educational Materials

Podcast: Preoperative Chest Radiography
This short podcast brings together a radiologist and referring physician to discuss the appropriate use of preoperative chest radiography. Physicians may earn up to 0.5 CME credits, and equivalent SA-CME for radiologists. For information about how to access, click here.

Choosing Wisely Video
In this video, Dr. Smith encounters a patient who asks for a preoperative chest x-ray.

ACR Appropriateness Criteria®: Routine Admission and Preoperative Chest Radiography
Routine chest radiography obtained at the time of admission to hospital and in the preoperative setting has been a common practice. This paper addresses the use and efficacy of this practice in both settings.

Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.

 

CHEST 2

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.
ACR Select “Pathway”: Modality/CT/Chest/search for pulmonary embolism

Topic Specific Resources

Choosing Wisely Topic Sponsors
Click on a logo to view a society's complete list of things physicians and patients should question.ACC Logo    ATS logo   ACR logo   ACEP

Materials Provided by R-SCAN Participants

Consensus Statement An Interdepartmental Consensus Statement on the Optimal Utilization of Enhanced Helical CT Scanning of the Chest for the Diagnosis of Pulmonary Embolism (CT-PA) at Penn State Milton S. Hershey Medical Center
Provided by: Michael A. Bruno, MD, MS, FACR, professor of radiology & medicine director of quality management services, Dept. of Radiology, et. al

Presentation American College of Radiology Appropriateness Criteria® — Acute Chest Pain: Suspected Pulmonary Embolism
Provided by: Ji Buethe, MD (PGY4); John Nazarian, MD (PGY5)
University Hospitals Case Medical Center, Case Western Reserve University, Department of Radiology

We encourage you to submit materials that have worked for you at RSCANinfo.org.
Note: The American College of Radiology posts these materials as general information. Radiology and quality assurance personnel developed these materials for the conduct of the ACR Value-Based PQI Project. The materials do not reflect ACR policy, positions, or guidelines.

Materials Provided by Medical Societies or Organizations

Choosing Wisely Video
Dr. Hallowell discusses imaging in low-risk PE with his resident (Cristian Coroian, MD, MBA).

ACR Appropriateness Criteria: Acute Chest Pain – Suspected Pulmonary Embolism
This paper addresses various modalities and their appropriate use in the diagnosis of pulmonary embolism.

Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.

 

CARDIO / EMERGENCY ROOM

Don’t use coronary CT angiography in high-risk* patients presenting in the emergency department with acute chest pain. *Risk defined by the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina/acute coronary syndromes.
ACR Select “Pathway”:
Indication driven, chest, search for “chest pain”

Topic Specific Resources

ACR Appropriateness Criteria: Chest Pain Suggestive of Acute Coronary Syndrome
This paper addresses various modalities and their appropriate use in the diagnosis of acute chest pain.
ACR logo
Five Things Physicians and Patients Should Question
This handout covers the top five imaging exams and other procedures that should be reconsidered given certain indications.
SCCT logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo

 

 

EMERGENCY ROOM

Avoid the routine use of “whole-body” diagnostic CT scanning in patients with minor or single-system trauma.

ACR Select “Pathway”: Modality driven, CT, whole body (body area).

Topic Specific Resources

Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo

 

GENITOURINARY

Do not recommend follow-up imaging for clinically inconsequential adnexal cysts.
ACR Select “Pathway”: Indication driven, female, pelvis, search for “adnexal”

Topic Specific Resources

Podcast: Imaging and Follow-up for Adnexal Cysts
This short podcast brings together a radiologist and referring physician to discuss imaging and follow-up for adnexal cysts. Additional Information: Physicians may earn up to 0.5 CME credits, and equivalent SA-CME for radiologists. For information about how to access, click here.
ACR logo

Choosing Wisely Video
In this video, Dr. Hallowell discusses proceedings for small ovarian cyst with his resident (Alireza Namini, MD).
ACR logo
ACR Appropriateness Criteria: Clinically Suspected Adnexal Mass
This paper addresses the modalities and appropriate indications for imaging adnexal masses.
ACR logo

Five Things Physicians and Patients Should Question

This handout covers the top five imaging exams that should be reconsidered given certain indications.
ACR logo

Imaging Tests for Ovarian Cysts—When You Need Them and When You Don’t
This handout is designed to be shared directly with your patients.
ACR logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo
Management of Asymptomatic Ovarian and Other Adnexal Cysts Imaged at US: Society of Radiologists in Ultrasound Consensus Conference
The Society of Radiologists in Ultrasound (SRU) convened a panel of specialists from gynecology, radiology, and pathology to arrive at this consensus statement.
SRU Logo

 

GENITOURINARY / NUCLEAR MEDICINE

Don’t perform PET, CT, and radionuclide bone scans in the staging of early prostate cancer at low risk for metastasis.

ACR Select “Pathway”: Indication driven, male, pelvis, search for “prostate”

Topic Specific Resources

ACR Appropriateness Criteria: Prostate Cancer--Pretreatment Detection, Staging, and Surveillance
This paper addresses the appropriate use of imaging in the pretreatment, detection, staging, and surveillance of prostate cancer.
ACR logo
10 Things Physicians and Patients Should Question
This handout covers the top 10 imaging exams, treatments, or procedures that should be reconsidered given certain indications.
ASCO logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo

 

MUSCULOSKELETAL / NEUROIMAGING

Don’t perform advanced imaging (eg, MRI) of the spine within the first 6 weeks in patients with nonspecific acute low back pain in the absence of red flags.
ACR Select “Pathway”: Indication driven, spine, search for “low back”

Topic Specific Resources

Choosing Wisely Topic Sponsors

NASS logo    ACP logo  
AAFP Logo 

Click on a logo to view a society's complete list of things physicians and patients should question. 

Materials Provided by R-SCAN Participants

Presentation High Value Care: Optimal Approach to Imaging for Low Back Pain
Provided by: Ilana Richman, MD, Primary Care and Outcomes Research Fellow and Anne Smeraglio MD, Resident in Internal Medicine

Proposal Reducing unnecessary imaging in patients with acute, nonspecific low back pain
Provided by: John Benson, MD, FACR, Department of Radiology, Mount Desert Island Hospital  and Clint Weiss, MHA, MS-3, Tufts University SoM

We encourage you to submit materials that have worked for you at RSCANinfo.org.
Note: The American College of Radiology posts these materials as general information. Radiology and quality assurance personnel developed these materials for the conduct of the ACR Value-Based PQI Project. The materials do not reflect ACR policy, positions, or guidelines.

Materials Provided by Medical Societies or Organizations

Choosing Wisely Materials to Provide Your Patients

Clinician Educational Materials

Podcast: Imaging for Low Back Pain
This short podcast brings together a radiologist and referring physician to discuss imaging for low back pain. Additional Information: Physicians may earn up to 0.5 CME credits, and equivalent SA-CME for radiologists. For information about how to access, click here.

Choosing Wisely Video
In this video, Dr. Pamela Duke meets with a patient who requests an MRI for his back pain.

ACR Appropriateness Criteria: Low Back Pain
This paper addresses the appropriate use and efficacy of imaging for acute low back pain.

Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.

 

NEUROIMAGING

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

ACR Select “Pathway”: Indication driven, maxfac, search for “sinus”

Topic Specific Resources

ACR Appropriateness Criteria: Sinonasal Disease
Sinonasal imaging is performed in two major clinical scenarios: inflammatory rhinosinusitis or a suspected mass lesion. This paper addresses the use of imaging in such cases.
ACR logo
10 Things Physicians and Patients Should Question
This handout covers the tests, imaging exams, and treatments that should be reconsidered given certain indications.
AAAI Logo
Five Things Physicians and Patients Should Question
This handout covers additional imaging exams as well as other treatments that should be reconsidered given certain indications.
AAO HNSF Logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo

 

PEDIATRICS / NEUROIMAGING 1

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.

ACR Select “Pathway”: Change age, indication driven, head, search for “trauma”

Topic Specific Resources

Materials Provided by R-SCAN Participants

Presentation American College of Radiology Appropriateness Criteria® — Head Trauma
Provided by: Ji Buethe, MD (PGY4); John Nazarian, MD (PGY5) University Hospitals Case Medical Center, Case Western Reserve University, Department of Radiology

We encourage you to submit materials that have worked for you at RSCANinfo.org.
Note: The American College of Radiology posts these materials as general information. Radiology and quality assurance personnel developed these materials for the conduct of the ACR Value-Based PQI Project. The materials do not reflect ACR policy, positions, or guidelines.

Podcast: Pediatric Head Trauma
This podcast, based on ACR Appropriateness Criteria®, brings together an expert radiologist and a referring physician for a casual conversation to discuss common image ordering dilemmas related to pediatric head trauma. Additional Information: Physicians may earn up to 0.5 CME credits, and equivalent SA-CME for radiologists. For information about how to access, click here.
ACR logo

Choosing Wisely Video
In this video, Dr. Rhonda Acholonu meets with a worried mother whose son had a minor head injury. She asks if a CT should be performed on her son.
AAP logo
ACR Appropriateness Criteria: Head Trauma—Child
This paper addresses the common and appropriate indications for cranial imaging in children.
ACR logo
10 Things Physicians and Patients Should Question
This handout covers the tests, imaging exams, and treatments that should be reconsidered given certain indications.
AAP logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.

ACP logo
Identification of Children at Very Low Risk of Clinically-Important Brain Injuries After Head Trauma: a Prospective Cohort Study
CT imaging of head-injured children has risks of radiation-induced malignancy. The aim of this study was to identify children at very low risk of clinically-important traumatic brain injuries (ciTBI) for whom CT might be unnecessary.
PECARN Logo
The Effect of Observation on Cranial Computed Tomography
Utilization for Children After Blunt Head Trauma. Children with minor blunt head trauma often are observed in the emergency department before a decision is made regarding computed tomography use. The researchers studied the impact of this clinical strategy on computed tomography use and outcomes.
PECARN Logo

 

PEDIATRICS / NEUROIMAGING 2

Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure.
ACR Select “Pathway”: Change age, indication driven, head, search for “febrile”

Topic Specific Resources

ACR Appropriateness Criteria: Seizures—Child
This paper addresses the common and appropriate indications for imaging in children with seizures.
ACR logo
10 Things Physicians and Patients Should Question
This handout covers the tests, imaging exams, and treatments that should be reconsidered given certain indications.
AAP logo
Febrile Seizures: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure
This practice guideline provides recommendations for the neurodiagnostic evaluation of neurologically healthy infants and children 6 through 60 months of age who have had a simple febrile seizure and present for evaluation within 12 hours of the event.
AAP logo
Online High Value Care Cases
Learn how to eliminate unnecessary healthcare costs while improving patient outcomes with these interactive cases on high value care. CME available! Additional Information: Non-ACP members can create a complimentary account to gain free access to these resources by completing a short registration form located on the ACP website.
ACP logo