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ACR Appropriateness Criteria® Chronic Dyspnea: Suspected Pulmonary Origin

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

doi: 10.1097/RTI.0b013e31829a2dc3
Web Exclusive Content—ACR Appropriateness Criteria® Review

Dyspnea, described as breathlessness or shortness of breath, is usually caused by cardiopulmonary disease. The role of imaging in chronic dyspnea (>1 mo in duration) with suspected pulmonary origin is reviewed as suggested by the American College of Radiology Appropriateness Criteria® Expert Panel on Thoracic Imaging. 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 guideline development and review 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.

*National Jewish Health, Denver, CO

Virginia Mason Medical Center, Seattle, WA

Cleveland Clinic, Weston, FL

§Robert Wood Johnson Medical School, New Brunswick, NJ

Ronald Regan UCLA Medical Center, Los Angeles, CA

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

‡‡Department of Radiology, 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

The American College of Radiology 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® Chronic Dyspnea—Suspected Pulmonary Origin. Practitioners are encouraged to refer to the complete version at Reprinted 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. The remaining authors declare no conflicts of interest.

Reprints: Debra Sue Dyer, MD, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191 (e-mail:

© 2013 by Lippincott Williams & Wilkins