Practice Parameters and Technical Standards

These parameters documents are educational tools designed to assist practitioners in providing appropriate radiologic care for patients. They are not inflexible rules or requirements of practice. The purpose of these parameters is to assist practitioners in following a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. 

ACR will periodically define new practice parameters and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice parameters and technical standards will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.

Each practice parameter and technical standard has undergone a thorough consensus process and extensive review, requiring the approval of ACR leadership and collaborating society boards. The practice parameters and technical standards recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document.

PP&TS are a valuable resource to assist practitioners in providing appropriate radiologic care for patients. These documents are not intended to establish, imply, or reflect “best practice” guidance, but are important to understanding the basic elements in providing quality radiological care. The practice of medicine involves not only science, but also the art of dealing with the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. It should be recognized; therefore, that adherence to these parameters will not assure an accurate diagnosis or a successful outcome. PP&TS are not intended, nor should they be used, to establish a legal standard of care. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. ACR cautions against the use of these parameters in litigation in which the clinical decisions of a practitioner are called into question.

The documents follow a well-organized development process which requires member's and collaborating society representative's active participation at each stage of drafting, reviewing and approving. For a more complete discussion of the program than is present in this FAQ, please review the Practice Parameters and Technical Standards Development Handbook.

A writing committee is constituted prior to drafting or revising documents for a given year. The documents go through an iterative review process until the committee reaches consensus. Literature searches are conducted to provide supporting evidence of recommendations of the documents. The documents that are collaborative with multiple medical specialty societies result in stronger recommendations that reduce potential bias and harmonize clinical recommendations.

After completion of the initial draft or revision of a practice parameter or technical standard document, the document undergoes “field review ”; the process where the draft document is available for any ACR member and collaborating society to provide comments. All practice parameters and technical standards must complete field review before being considered for adoption by the ACR. This is the opportunity stakeholders external to the document drafting/revision process to comment. The comments are collated by staff, and then reviewed by the Chair of the Comment Reconciliation Committee, to determine which editorial comments can be accepted, or if substantive, should be considered by the Comment Reconciliation Committee for inclusion in the final draft to be presented for adoption. When a document completes the comment reconciliation process, it is considered final and ready for approval.

The final documents are sent to the relevant collaborating societies for acknowledgement if they are going through the ACR Council approval process. The final version of the documents that Council has adopted or adopted as amended will be sent to the collaborating societies for each society’s final approval.

Documents that are not considered part of the Medical Physics approval process or the Radiation Oncology approval process are presented to the ACR Council for approval.

For more in-depth details on the approval process, please review the Practice Parameters and Technical Standards Development Handbook.

The overall process to develop or revise a practice parameter or technical standard document is completed in 18 months. View timeline.