Journal of the American College of Radiology最新文献

{"title":"ACR Appropriateness Criteria® Radiologic Management of Pulmonary Nodules and Masses: Update 2025","authors":"Expert Panel on Interventional Radiology,&nbsp;Shenise Gilyard MD ,&nbsp;Osmanuddin Ahmed MD ,&nbsp;Charles Y. Kim MD ,&nbsp;Anupama Chundury MD ,&nbsp;Edwin F. Donnelly MD, PhD ,&nbsp;Erica M. Knavel Koepsel MD ,&nbsp;Jules Lin MD ,&nbsp;Mina S. Makary MD ,&nbsp;Parth Mehta MD ,&nbsp;Eric J. Monroe MD ,&nbsp;Matthew J. Scheidt MD ,&nbsp;Elliot Servais MD ,&nbsp;Nicholas Fidelman MD","doi":"10.1016/j.jacr.2026.01.027","DOIUrl":"10.1016/j.jacr.2026.01.027","url":null,"abstract":"<div><div>This document addresses the management of pulmonary nodules and masses, a frequent and clinically significant finding in thoracic imaging given the prevalence and mortality burden of lung cancer. The document was developed and updated by a multidisciplinary expert panel through systematic review of peer-reviewed literature and supplemented as needed by expert consensus. Clinical variants considered in this document include stable solitary pulmonary nodules, enlarging nodules, centrally versus peripherally located nodules, nodules in patients with prior malignancy, and persistent ground-glass opacities suspicious for adenocarcinoma. For each scenario, available imaging and procedural options—such as follow-up CT, PET/CT, percutaneous or endobronchial biopsy, ablation, stereotactic body radiotherapy, and surgery—were systematically evaluated. Key recommendations emphasize the role of tissue sampling in enlarging or suspicious nodules, the selective role of PET/CT in characterization and treatment planning, and the importance of balancing diagnostic yield with procedure-related risks such as pneumothorax and hemorrhage.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 915-927"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146260112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Artificial Intelligence Integration in Radiology Education: Addressing Performance Gaps and Future Directions","authors":"Shangxuan Li MMed,&nbsp;Zekai Yu BEng,&nbsp;Weihao Cheng BEng","doi":"10.1016/j.jacr.2025.11.028","DOIUrl":"10.1016/j.jacr.2025.11.028","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 753-754"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Access to Same-Day Breast Biopsy: Factors Associated With Same-Day Procedure Scheduling After Program Standardization","authors":"Abigail Lin MD ,&nbsp;Derek L. Nguyen MD ,&nbsp;Lars J. Grimm MD, MHS ,&nbsp;Sora C. Yoon MD","doi":"10.1016/j.jacr.2026.01.008","DOIUrl":"10.1016/j.jacr.2026.01.008","url":null,"abstract":"<div><h3>Objective</h3><div>To assess factors associated with offering patients same-day procedures after implementation of a standardized same-day procedure program.</div></div><div><h3>Methods</h3><div>This quality improvement study reviewed data from all patients at our single-site academic institution who were recommended for a breast procedure from March 20, 2024, to June 3, 2024. Patient and diagnostic examination characteristics and time between diagnostic examination and procedure appointments were recorded. Enacting add-on procedures, defined as the creation of an additional same-day procedure slot through overbooking, was also recorded. Associations between patient sociodemographic characteristics and diagnostic examination characteristics with same-day procedures logistics were evaluated using a nominal logistic model.</div></div><div><h3>Results</h3><div>Of 315 patients (mean age 53.8 ± 16.4 years), 168 (53%) were offered a same-day biopsy appointment based on procedure availability. Another 35 patients (11%) were offered an add-on procedure; 8 (3%) were for urgent BI-RADS 2 findings (such as abscess). On multivariable analysis, factors associated with increased likelihood of being offered same-day biopsy appointment were morning recommendation time (<em>P</em> &lt; .001) and ultrasound-guided biopsy (<em>P</em> = .027). Time to biopsy was not significantly different across race or ethnicity. On univariable analysis, patients had higher likelihood of being offered an add-on procedure for ultrasound-guided aspirations (<em>P</em> &lt; .001) and fluid collections (seroma or abscess; <em>P</em> &lt; .001), as well as for BI-RADS 5 final assessment (<em>P</em> &lt; .001).</div></div><div><h3>Discussion</h3><div>Scheduling diagnostic workups should be considered earlier in the day at institutions that offer same-day procedure services, particularly for cases involving highly suspicious lesions, abscesses, or seromas or patients with psychosocial factors that could otherwise delay care.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 793-801"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACR Appropriateness Criteria® Chest Pain-Child","authors":"Expert Panel on Pediatric Imaging,&nbsp;Scott R. Dorfman MD ,&nbsp;Sherwin S. Chan MD, PhD ,&nbsp;Siraj Amanullah MD, MPH ,&nbsp;Brandon P. Brown MD, MA ,&nbsp;John Smith Hokanson MD ,&nbsp;George Koberlein MD ,&nbsp;Morgan P. McBee MD ,&nbsp;Anh-Vu H. Ngo MD ,&nbsp;HaiThuy N. Nguyen MD ,&nbsp;Emily S. Orscheln MD ,&nbsp;Elizabeth J. Snyder MD ,&nbsp;Shawn D. St. Peter MD ,&nbsp;George S. Wu MD ,&nbsp;Ramesh S. Iyer MD, MBA","doi":"10.1016/j.jacr.2026.01.022","DOIUrl":"10.1016/j.jacr.2026.01.022","url":null,"abstract":"<div><div>Chest pain is a common complaint in children and adolescents. The causes of chest pain are varied and include musculoskeletal, pulmonary or pleural, gastrointestinal, psychogenic, and cardiac etiologies. The etiology of pediatric chest pain is often benign but typically generates evaluation in the emergency room, urgent care, or outpatient setting. Diagnostic imaging is often used in the evaluation of pediatric chest pain. This document will discuss various clinical scenarios for children presenting with chest pain and will highlight initial imaging that is usually or may be appropriate, based on the best available evidence or expert consensus. Chest pain limited to the chest wall, from suspected pneumothorax or pneumomediastinum, secondary to suspected pulmonary embolism, from known or suspected cardiac disease, in the setting of sickle cell disease, and from suspected psychogenic causes, will be reviewed.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 874-886"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147273220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Year Lung Cancer Incidence Among Patients Who Receive a Radiologist Recommendation for Chest CT in Neck CT and MRI Reports","authors":"Masoud Hassanzadeh DDS, MS ,&nbsp;Hanjoo Lee MS ,&nbsp;Ronilda Lacson MD, PhD ,&nbsp;Mark M. Hammer MD ,&nbsp;Sebastien Haneuse PhD ,&nbsp;Ramin Khorasani MD, MPH ,&nbsp;Jeffrey P. Guenette MD, MPH","doi":"10.1016/j.jacr.2025.11.030","DOIUrl":"10.1016/j.jacr.2025.11.030","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to estimate the 2-year incidence of lung cancer diagnosed as a result of radiologist recommendations for chest CT in neck CT and MRI reports.</div></div><div><h3>Methods</h3><div>A retrospective observational cohort study was conducted, including all patients without histories of lung cancer with recommendations for chest CT in neck CT and MRI reports from June 1, 2021, to May 31, 2022, in a multi-institution health care system. Outcome data were extracted up to December 31, 2024. Two-year lung cancer incidence was estimated using a person-time calculation to acknowledge censoring with confidence intervals based on quasi-likelihood. Odds of fulfillment of the recommended chest CT for pulmonary nodules relative to other pulmonary abnormalities were estimated using logistic regression.</div></div><div><h3>Results</h3><div>Two hundred seventy-six of 28,707 (1.0%) consecutive neck, brachial plexus, and parathyroid CT and MRI reports in 273 of 22,173 patients (1.2%) (mean age, 62.5 ± 1 years, 52% women) contained recommendations for chest CT in the absence of prior lung cancer diagnoses. The median follow-up time was 34 months (interquartile range, 24-40 months). One patient (estimated 2-year incidence rate, 0.40%; 95% confidence interval, 0.05%-3.55%) was diagnosed with an incidental indolent adenocarcinoma. Recommended CT was performed in 171 of 273 patients (62.6%) and was less likely to be performed for pulmonary nodules than other pulmonary abnormalities (odds ratio, 0.46; 95% confidence interval, 0.27-0.77).</div></div><div><h3>Conclusions</h3><div>One year of recommendations for chest CT examinations in neck CT and MRI reports across a multi-institution health care system led to the identification of only a single incidental lung cancer, an indolent adenocarcinoma. These results suggest that the frequency of recommendations for chest CT should likely be substantially decreased, but analysis of larger datasets is needed to inform best practices.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 802-808"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACR Appropriateness Criteria® Female Infertility","authors":"Expert Panel on GYN and OB Imaging,&nbsp;Wendaline VanBuren MD ,&nbsp;Myra K. Feldman MD ,&nbsp;Esma A. Akin MD ,&nbsp;Adrian A. Dawkins MD ,&nbsp;Lisa Po-Lan Jones MD ,&nbsp;Kira Melamud MD ,&nbsp;Krupa K. Patel-Lippmann MD ,&nbsp;Gary M. Plant MD ,&nbsp;Kimberly L. Shampain MD ,&nbsp;Belinda J. Yauger MD ,&nbsp;Ashish P. Wasnik MD","doi":"10.1016/j.jacr.2026.01.020","DOIUrl":"10.1016/j.jacr.2026.01.020","url":null,"abstract":"<div><div>Infertility is defined as the inability to conceive spontaneously after 12 months of routinely unprotected intercourse in patients &lt;35 years of age, and after 6 months in patients ≥35 years of age. Infertility also refers to the inability to achieve a successful pregnancy based on the medical, sexual, and reproductive history; age, physical findings; diagnostic testing; the need for medical intervention; or a combination of these variables for a patient. In the United States, 13% of women 15 to 49 years of age have accessed assisted fertility services and it has been suggested that the rate of infertility has been increasing, without geographic bias. Understanding the initial imaging evaluation is essential to this often complex and/or multifaceted clinical circumstance, which may involve the ovaries, uterus, and fallopian tubes.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 907-914"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential for Expansion of Existing US Residency Programs in Diagnostic Radiology","authors":"Himi Begum BS ,&nbsp;Hannah Short MD ,&nbsp;Sara Pettey Sandifer MD ,&nbsp;Ross Cottrill BS ,&nbsp;Rebecca A. Jordan MA ,&nbsp;Michael A. Bruno MD, MS","doi":"10.1016/j.jacr.2026.01.015","DOIUrl":"10.1016/j.jacr.2026.01.015","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 834-836"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146097611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning to Patient-Centered Radiology: Exploring the Feasibility of Patient-Radiologist Video Imaging Review: A Pilot Study","authors":"Sharon Steinberger MD ,&nbsp;Deirdre Valinsky RRT ,&nbsp;Brooke O’Neill RN ,&nbsp;Charlene Thomas ,&nbsp;Alan C. Legasto MD ,&nbsp;Joanna G. Escalon MD ,&nbsp;Geraldine Brusca-Augello MD ,&nbsp;Francis Girvin MD ,&nbsp;Bradley B. Pua MD ,&nbsp;Lauren K. Groner DO","doi":"10.1016/j.jacr.2025.11.026","DOIUrl":"10.1016/j.jacr.2025.11.026","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the feasibility, acceptability, and efficacy of a patient-radiologist video image review.</div></div><div><h3>Methods</h3><div>In this prospective observational study, radiologist-led patient video visits were piloted from December 2021 to December 2023. Visits were offered to patients in our lung screening program and patients with incidental pulmonary nodules. All visits were conducted using Zoom virtual meeting platform (Zoom Communications, Inc. San Jose, California). At each visit, the radiologist reviewed the imaging findings and answered all questions. Our patient navigator scheduled the recommended follow-up by the radiologist and documented the visit in our institution’s electronic medical record. Visits concluded with a patient survey.</div></div><div><h3>Results</h3><div>In all, 156 video visits were offered to patients with a median age of 61 years (interquartile range, 54-67); 92 were women. Sixty-three (40%) of the video visits offered were declined by patients, 73 (78%) visits were completed by 71 patients, 10 (11%) patients did not attend the scheduled visit, and 10 (11%) patients were scheduled outside of our study time frame (after December 30, 2023). The mean video visit duration was 12 min. Of the 156 patients, 127 had follow-up imaging scheduled. Patients who completed a video visit were significantly more likely to return for follow-up imaging compared with those who declined video visits (62 of 66, 94%, versus 49 of 61, 80%) (<em>P</em> = .019). Of the 58 patients who completed the postvisit questionnaire, 95% (57 of 58) reported that the visit made them more likely to return for follow-up imaging, 59% (34 of 58) reported a decrease in their imaging-related anxiety, and 98% (57 of 58) wanted to use imaging review for future scans.</div></div><div><h3>Conclusion</h3><div>Radiologist-patient virtual image reviews are feasible when performed in conjunction with patient navigators. Virtual visits provide an opportunity to engage patients, address communication gaps, and impact imaging follow-up rates.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages 770-778"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table of Content","authors":"","doi":"10.1016/S1546-1440(26)00125-0","DOIUrl":"10.1016/S1546-1440(26)00125-0","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Pages A1-A5"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147756817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity in Interventional Radiology: Turning Awareness Into Action","authors":"Aura María Ramírez Cabrera MD","doi":"10.1016/j.jacr.2025.10.030","DOIUrl":"10.1016/j.jacr.2025.10.030","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 5","pages":"Page 755"},"PeriodicalIF":5.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}