Objective:

To provide a summary of essential evidence-based resources in radiology for imaging selection, safety, screening, diagnosis, treatment, and reporting.

Approach:

• ACR Appropriateness Criteria: Provides evidence-based guidance for imaging or treatment selection in specific clinical situations.
• ACR Manual on Contrast Media: Guides radiologists on managing risks associated with contrast media, including patient risk assessment and preparation for adverse events.
• ACR Manual on MR Safety: Offers safety practices for clinical and research MR environments, with recommendations subject to updates.
• ACR BI-RADS v2025: Supports breast imaging reporting and performance evaluation across various imaging modalities.
• GÖTEBORG-2 Prostate Cancer Screening Trial: Evaluated prostate cancer screening methods, showing reduced diagnoses of clinically insignificant prostate cancer with negative MRI results.
• SCEMAM Trial: Assessed the addition of contrast-enhanced mammography to digital breast tomosynthesis, identifying cancers but increasing false-positive rates.
• Floretyrosine F 18 (Pixclara): FDA-approved for distinguishing recurrent glioma from treatment-related changes in PET imaging.
• Lutetium Lu 177 Vipivotide Tetraxetan (Pluvicto): FDA-approved for use in combination with therapy for PSMA-positive metastatic prostate cancer.

Key Findings:

• ACR Appropriateness Criteria aids in imaging selection.
• Contrast media management is crucial for patient safety.
• BI-RADS v2025 enhances breast imaging reporting.
• GÖTEBORG-2 trial shows MRI can reduce unnecessary biopsies.
• SCEMAM trial indicates increased false positives with added contrast-enhanced mammography.
• FDA approvals for Pixclara and Pluvicto enhance diagnostic capabilities.

Sources:

• ACR
• The New England Journal of Medicine
• Radiology
• FDA