New Guidelines Introduced to Enhance Pulmonary Embolism Care

A new framework known as the Pulmonary Embolism Reporting and Data Systems (PE-RADS) has been released to enhance the diagnosis and classification of acute pulmonary embolism. This system, developed by the American College of Radiology (ACR) alongside contributions from six other prominent medical groups, was recently published in the journal Radiology by the Radiological Society of North America (RSNA).

The objective of PE-RADS is to improve communication among healthcare providers in managing acute pulmonary embolism, a condition characterized by a sudden blockage in the lung's blood vessels. This condition can be life-threatening if not treated promptly, making rapid assessment critical. Common symptoms include shortness of breath and chest pain, which can lead to heart strain and reduced blood flow.

Lynne M. Koweek, MD, professor of radiology and associate professor of medicine at Duke University, emphasizes the framework's benefits: "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."

CT pulmonary angiography represents the gold standard in diagnosing pulmonary embolism, while MR angiography provides a noninvasive and highly accurate alternative. These imaging tests, although common, can be difficult to interpret due to variability in findings. Dr. Koweek notes, "These are commonly performed exams that can be challenging to interpret, and imaging findings are critical to patient management. 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 incorporates a straightforward grading scale from 0 to 4 and a hierarchical framework to classify clot location along with right heart imaging features, thereby supporting risk stratification and guiding patient management. It also includes indicators for diagnostic limitations due to image quality and non-embolism-related lung conditions.

The development of PE-RADS involved imaging experts and clinicians specializing in pulmonary embolism, half of whom were selected by the ACR. The remaining specialists were appointed by leading organizations such as the American College of Emergency Physicians and the Society of Thoracic Radiology.

Incorporating this framework aligns with existing pulmonary embolism guidelines and is intended to facilitate future evaluation as data on its effects become available. The ACR aims to standardize reporting, creating a foundation for improved pulmonary embolism care and research over time.