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ACR Appropriateness Criteria® Pulmonary Hypertension

Brown, Kathleen MD*; Gutierrez, Antonio J. MD*; Mohammed, Tan-Lucien H. MD; Kirsch, Jacobo MD; Chung, Jonathan H. MD§; Dyer, Debra Sue MD§; Ginsburg, Mark E. MD; Heitkamp, Darel E. MD; Kanne, Jeffrey P. MD#; Kazerooni, Ella A. MD**; Ketai, Loren H. MD††; Parker, J. Anthony MD, PhD‡‡; Ravenel, James G. MD§§; Saleh, Anthony G. MD∥∥; Shah, Rakesh D. MD¶¶; Steiner, Robert M. MD##; Suh, Robert D. MD*Expert Panel on Thoracic Imaging

doi: 10.1097/RTI.0b013e31829191b5
Web Exclusive Content—ACR Appropriateness Criteria® Review

Pulmonary hypertension (PH) may be idiopathic or related to a variety of diseases. The diagnosis, accurate assessment of etiology and severity, prognosis, treatment response, and follow-up of PH can be achieved using a diverse set of diagnostic examinations. In this review, the role of imaging in the evaluation of PH as suggested by the American College of Radiology Appropriateness Criteria® Expert Panel on Thoracic Imaging has been discussed. The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The development and review of the guidelines include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

*Ronald Reagan UCLA Medical Center, Los Angeles, CA

Virginia Mason Medical Center, Seattle, WA

Cleveland Clinic, Weston, FL

§National Jewish Health, Denver, CO

Department of Surgery, Society of Thoracic Surgeons, Columbia University, New York, NY

∥∥The American College of Chest Physicians, New York Methodist Hospital, Brooklyn, NY

¶¶North Shore University Hospital, Manhasset, NY

Department of Radiology, Indiana University, Indianapolis, IN

#Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI

**Department of Radiology, University of Michigan Medical Center, Ann Arbor, MI

††University of New Mexico, Albuquerque, NM

‡‡Society of Nuclear Medicine, Beth Israel Deaconess Medical Center, Boston, MA

§§Department of Radiology, Medical University of South Carolina, Charleston, SC

##Department of Radiology, Temple University, Philadelphia, PA

The American College of Radiology (ACR) seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria®through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document.

This article is a revised version of the American College of Radiology Appropriateness Criteria® Pulmonary Hypertension. Practitioners are encouraged to refer to the complete version at with permission of the American College of Radiology.

Jeffrey P. Kanne is a consultant for PTC Therapeutics ($13,000) not relevant to ACR activities or imaging. For the remaining authors no conflicts of interest were declared.

Reprints: Kathleen Brown, MD, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191 (e-mail:

© 2013 by Lippincott Williams & Wilkins