ACR Appropriateness Criteria® Routine Chest Imaging

Area of Science:

• Radiology
• Cardiothoracic Imaging
• Evidence-Based Medicine

Background:

• Routine chest imaging is utilized to detect subclinical cardiothoracic conditions.
• Various imaging techniques exist for routine chest examinations.
• This review examines evidence supporting or refuting routine chest imaging in diverse clinical settings.

Approach:

• Guidelines are developed for routine chest imaging in specific scenarios: hospital admission, pre-noncardiothoracic surgery, and chronic cardiopulmonary disease surveillance.
• The American College of Radiology Appropriateness Criteria serve as evidence-based guidelines, updated annually by expert panels.
• Methodologies like Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and the RAND/UCLA Appropriateness Method are employed to assess evidence and determine procedure appropriateness.

Key Points:

• The study evaluates the efficacy of routine chest imaging across different clinical contexts.
• Guidelines are proposed for initial imaging during hospital admission and before noncardiothoracic surgery.
• The utility of surveillance imaging for managing chronic cardiopulmonary diseases is assessed.

Conclusions:

• The document provides recommendations for the appropriate use of routine chest imaging.
• Expert consensus may inform recommendations when peer-reviewed literature is limited.
• Systematic literature analysis and established methodologies underpin the guideline development process.