Incorporating Radiation Dose Assessments Into the ACR Appropriateness Criteria®

Abstract

In 2006, the ACR convened a group of radiologists, medical physicists, industry and regulatory agency representatives, and a patient advocate to address issues related to the risks of radiation exposure in medical imaging. This group, the Blue Ribbon Panel on Radiation Dose in Medicine, developed a series of recommendations aimed at optimizing radiologic image quality and radiation dose and preventing the inappropriate use of procedures involving ionizing radiation [ 1 Amis Jr, E.S. Butler P.F. Applegate K.E. et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007; 4: 272-284 Abstract Full Text Full Text PDF PubMed Scopus (699) Google Scholar ]. Several of their recommendations relate to educating referring physicians about radiation exposure risk. One recommendation in particular calls for the incorporation of radiation dose information into the ACR Appropriateness Criteria, a guide for the selection of proper imaging procedures for particular medical conditions. In response to this recommendation, relative radiation level (RRL) designations were added to the Appropriateness Criteria in September 2007. These designations indicate which imaging procedures expose patients to radiation and the relative magnitude of that exposure. By adding RRL designations, referring physicians using the Appropriateness Criteria will not only be advised of the appropriate imaging procedure for medical conditions but will also be steered toward procedures that minimize radiation dose to their patients.