R-SCAN Topics and Resources

Choose a topic for your project from the list below. All topics are related to outpatient and emergent care. Select a topic with a strong potential for ordering improvement.

We offer educational resources covering the spectrum of Choosing Wisely topics. They are included in each topic section below.

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The toolkit is a resource to help you implement your own quality project and build greater patient engagement into your image ordering workflow.

Abdominal Imaging: CT for Recurrent Renal Colic

Avoid ordering CT of the abdomen and pelvis in otherwise health emergency department (ED) patients (age <50) with known histories of kidney stones, or urolithiasis, presenting with symptoms consistent with acute uncomplicated renal colic.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: CT for Renal Colic

Choosing Wisely Case Review: Selecting the best imaging exam for kidney stones

Podcast: A discussion on ordering imaging exams for renal colic

Patient Resources

Choosing Wisely Handout: Why the doctor may not order a CT scan for kidney stones

Patient-Friendly Appropriateness Criteria Summary

Educational Flyer: CT Scans in the Emergency Department

Cardiac Imaging: CTA for Asymptomatic Patient at Low Risk for Coronary Artery Disease

Don’t routinely order coronary CT angiography for screening asymptomatic individuals.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Asymptomatic Patient at Risk for Coronary Artery Disease

Article: R-SCAN: Cardiac CT Angiography for Acute Chest Pain

Choosing Wisely Case Review: Selecting the best imaging exam for acute chest pain

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Chest Imaging: Admission and Pre-op Chest X-ray

Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Routine Chest Radiography

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® — Admission and Pre-op Chest X-ray

Article: R-SCAN: Admission and Preoperative Chest X-Rays for Ambulatory Patients With Unremarkable History and Physical Examination

Podcast: A discussion on ordering imaging exams for preoperative chest radiography

Choosing Wisely Case Review: Selecting the best imaging exam for preoperative chest radiography

Patient Resources

Choosing Wisely Video:

Choosing Wisely Handout:

Patient-Friendly Appropriateness Criteria Summary

Chest Imaging: CTA for Pulmonary Embolism

Do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay.

Physician Resources

Choosing Wisely Topic:

Article: Higher Imaging Yield When Clinical Decision Support Is Used

Article: R-SCAN: CT Angiographic Imaging for Pulmonary Embolism

Video:

ACR Appropriateness Criteria: Acute Chest Pain – Suspected Pulmonary Embolism

Flyer: ACEP-ACR Partnership Delivers Resources to Help Prepare You for the Future

Article:

Podcast: A discussion on ordering imaging exams for pulmonary embolism

Choosing Wisely Video:

Order Wisely Video:

Choosing Wisely Case Review: Selecting the best imaging exam for pulmonary embolism

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® - Pulmonary Embolism

Educational Flyer: CT Scans in the Emergency Department

ACR Appropriateness Criteria: Acute Chest Pain – Suspected Pulmonary Embolism

Article:

Patient Resources

Educational Flyer: CT Scans in the Emergency Department

Choosing Wisely Handout: When you need a CT scan to check for a blood clot in your lungs

Patient-Friendly Appropriateness Criteria Summary

Article:

Genitourinary Imaging: Adnexal Cyst Follow-up

Do not recommend follow-up imaging for clinically inconsequential adnexal cysts.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria:

Presentation: Characterization and Follow up of Simple Ovarian Cysts

Case Study: Shaping Change from Within (results of the Carle Physician Group's R-SCAN project)

Podcast: A discussion on ordering imaging exams for adnexal cysts*

Article:

Choosing Wisely Video:

Article: R-SCAN: Follow-Up for Adnexal Cysts

Choosing Wisely Case Review: Selecting the best imaging exam for adnexal cysts

Presentation: When to Image Based on Choosing Wisely® and Society of Radiologists in Ultrasound Consensus Conference Statement

O-RADS: Ovarian-Adnexal Imaging-Reporting-Data System

Patient Resources

Choosing Wisely Handout:

Patient-Friendly Appropriateness Criteria Summary

Genitourinary Imaging: Advanced Imaging for Early Prostate Cancer Staging

Head and Neck Imaging: Incidental Thyroid Nodules Follow-Up

Don't recommend ultrasound for incidental thyroid nodule in low-risk patients unless the nodule meets age-based size criteria or has suspicious features.

Note: This topic is completed via upload of data entered in an Excel spreadsheet only. The spreadsheet is available below.

Physician Resources

Article: Managing Incidental Thyroid Nodules Detected on Imaging: White Paper of the ACR Incidental Thyroid Findings Committee

Data Entry Excel Template for Incidental Thyroid Nodule Project

Musculoskeletal Imaging: Imaging for Low Back Pain

Don’t perform advanced imaging (e.g. MRI) of the spine within the first 6 weeks in patients with nonspecific acute low back pain in the absence of red flags.

Physician Resources

Introductory Information:

  • Choosing Wisely Topic:

CME Activities:

Additional Information:

  • Articles:
  • Videos:
  • Choosing Wisely Video:
  • Order Wisely Video:

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Choosing Wisely Handout:

ACP Health Tips - What You Can Do: Low Back Pain — |

Choosing Wisely Handout:

Neuroimaging: CT for Uncomplicated Rhinosinusitis

Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Sinonasal Disease

Podcast: A discussion on ordering imaging exams for rhinosinusitis

Article: R-SCAN: Imaging for Uncomplicated Acute Rhinosinusitis

Choosing Wisely Case Review: Selecting the best imaging exam for rhinosinusitis

Presentation: When to Image Based on Choosing Wisely® and the ACR Appropriateness Criteria®

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Choosing Wisely Handout: Treating Sinusitis — |

Neuroimaging: Imaging for Pediatric Headache

Follow evidence-based guidelines for pediatric headache imaging.

Physician Resources

ACR Appropriateness Criteria: Pediatric Headache

Clinical Decision Algorithms: General, Sinus, and Trauma Headache - PDF Version | PPT Version

Neuroimaging: Imaging for Adult Uncomplicated Headaches

Don’t do imaging for uncomplicated headache.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Headache

Order Wisely Video:

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® — Uncomplicated Headache

Article: R-SCAN: Imaging for Headache

Patient Resources

Choosing Wisely Handout: Imaging Tests for Headaches — |

ACP Patient FACTS: Migraine Headache — |

Neuroimaging: CT for Pediatric Minor Head Injury

CT scans are not necessary in the immediate evaluation of minor head injuries; clinical observation/Pediatric Emergency Care Applied Research Network criteria should be used to determine whether imaging is indicated.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Head Trauma – Child

Article: R-SCAN: Imaging for Pediatric Minor Head Trauma

Case Study Video:

Article:

Flyer:

Podcast: A discussion on ordering imaging exams for pediatric head trauma

Article:

Choosing Wisely Video:

Presentation: ACR Appropriateness Criteria – Head Trauma

Choosing Wisely Case Review: Selecting the best imaging exam for minor head trauma (pediatric)

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® — Minor Pediatric Head Trauma

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Website Resource:

Choosing Wisely Handout: CT Scans for Children with Head Injuries —  |

Choosing Wisely Handout: Brain Scans for Head Injuries — |

Neuroimaging: CT for Adult Minor Head Trauma

Avoid CT scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: CT for Adult Minor Head Trauma

Choosing Wisely Case Review: Selecting the best imaging exam for minor head trauma (adult)

Presentation: CT for Adult Minor Head Trauma - When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria®

Podcast: A discussion on ordering imaging exams for adult minor head trauma

Article: The Canadian CT Head Rule for patients with minor head injury

Article: Computed Tomography Use for Adults with Head Injury

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Choosing Wisely Handout: Brain Scans for Head Injuries — |

Choosing Wisely Handout:

Neuroimaging: Advanced Imaging for Pediatric Febrile Seizures

Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure.

Physician Resources

Choosing Wisely Topic:

ACR Appropriateness Criteria: Seizures - Child

Podcast: A discussion on ordering imaging exams for pediatric seizures

Article: Guideline for the Neurodiagnostic Evaluation of the Child With a Simple Febrile Seizure

Choosing Wisely Case Review: Selecting the best imaging exam for pediatric febrile seizures

Article:

Febrile Seizures:

Presentation: When to Image Based on Choosing Wisely® and ACR Appropriateness Criteria® - Febrile Seizure

Article: Optimizing

Patient Resources

Patient-Friendly Appropriateness Criteria Summary

Practice-Defined Topic

To meet unique practice needs and settings, learn how R-SCAN participants can define their own topic to optimize imaging care.

Define Your Own Topic