The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. OR Discussion of Procedures by Variant Variant 1: Routine chest imaging for hospital admission. No clinical concern for cardiopulmonary disease. Initial Imaging. CT Chest With IV Contrast There is no relevant literature to support the use of CT chest with intravenous (IV) contrast as routine imaging for hospital admission. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast as routine imaging for hospital admission. CT Chest Without IV Contrast CT chest is known to have a higher sensitivity than chest radiography for the detection of pulmonary infections and malignancies. Millor et al [9] performed a retrospective review of 6,516 adult patients who underwent a self-referred whole-body CT (including a CT chest without IV contrast), performed in the absence of specific symptoms and no history of malignancy. The authors found that the incidence of abnormal whole-body CT findings increased with age and found a higher rate of abnormal findings in men. Although most findings were benign, there was a 1.47% rate of primary neoplasm detection, the majority of which were found before metastatic spread.
Routine Chest Imaging. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org All elements are essential: 1) timing, 2) reconstructions/reformats, and 3) 3-D renderings. Standard CTs with contrast also include timing issues and reconstructions/reformats. Only in CTA, however, is 3-D rendering a required element. This corresponds to the definitions that the CMS has applied to the Current Procedural Terminology codes. OR Discussion of Procedures by Variant Variant 1: Routine chest imaging for hospital admission. No clinical concern for cardiopulmonary disease. Initial Imaging. CT Chest With IV Contrast There is no relevant literature to support the use of CT chest with intravenous (IV) contrast as routine imaging for hospital admission. CT Chest Without and With IV Contrast There is no relevant literature to support the use of CT chest without and with IV contrast as routine imaging for hospital admission. CT Chest Without IV Contrast CT chest is known to have a higher sensitivity than chest radiography for the detection of pulmonary infections and malignancies. Millor et al [9] performed a retrospective review of 6,516 adult patients who underwent a self-referred whole-body CT (including a CT chest without IV contrast), performed in the absence of specific symptoms and no history of malignancy. The authors found that the incidence of abnormal whole-body CT findings increased with age and found a higher rate of abnormal findings in men. Although most findings were benign, there was a 1.47% rate of primary neoplasm detection, the majority of which were found before metastatic spread.