Innovative framework streamlines communication for pulmonary embolism care

The Pulmonary Embolism Reporting and Data Systems (PE-RADS^TM) framework for diagnosing and classifying acute pulmonary embolism using CT and magnetic resonance (MR) angiography was published today in Radiology, a journal of the Radiological Society of North America (RSNA). Developed by the American College of Radiology (ACR) in collaboration with representatives from six other leading medical groups, PE-RADS aims to streamline communication and patient care for the potentially life-threatening condition.

Timely and accurate assessment of acute pulmonary embolism is essential. It is a sudden blockage in the blood vessels of the lungs that reduces blood flow, may strain the heart and can be fatal if untreated. Common symptoms include shortness of breath, chest pain and low blood pressure.

The goal of PE-RADS is to improve communication between healthcare providers who care for patients with acute pulmonary embolism. As the first standardized lexicon and structured reporting system for pulmonary embolism imaging, PE-RADS v2026 is designed to provide a framework for reporting CT and MR angiographic findings in a clear, consistent manner to guide next steps patient care."

Lynne M. Koweek, M.D., professor of radiology and associate professor of medicine, Duke University School of Medicine, Durham, North Carolina, and chair of the ACR PE-RADS committee

CT pulmonary angiography is the gold standard for diagnosing pulmonary embolism. MR angiography is another noninvasive, highly accurate test that can be used for diagnosis.

"These are commonly performed exams that can be challenging to interpret, and imaging findings are critical to patient management," Dr. Koweek said. "Standard terminology reduces variability in reporting and understanding the radiology report. We hope that all radiologists will use PE-RADS to enable clear communication and coordination with care teams."

PE-RADS v2026 provides a simple, 0-4 grading scale and hierarchical framework to classify clot location combined with right heart imaging features, supporting risk stratification and guiding patient management across multidisciplinary teams. The system also includes modifiers to indicate limitations in diagnosis due to image quality and non-pulmonary embolism causes of disease in the pulmonary arteries.

PE-RADS was developed by imaging specialists and clinicians who care for patients with suspected or diagnosed pulmonary embolism. Half of the specialists were selected by the ACR, and the other half were nominated by the American College of Emergency Physicians, American College of Chest Physicians, Pulmonary Embolism Response Team Consortium, Society of Thoracic Radiology, Society for Cardiovascular Angiography and Interventions, and Society of Interventional Radiology.

The new framework is aligned with existing pulmonary embolism guidelines and designed for easy adoption and future expansion and refinement as data assessing its impact on outcomes and resource utilization emerge.

"Consistent terminology and reporting not only fosters effective communication between healthcare providers, it also creates a stronger foundation for studying outcomes, resource utilization and future improvements in pulmonary embolism care," Dr. Koweek said. "PE-RADS provides a structured framework to standardize reports today and evolve as treatments and evidence advance."

The ACR RADS program originated in 1992 to provide standardized frameworks for the interpretation and reporting of disease-oriented medical imaging results and facilitate effective communication between radiologists and referring physicians.