New Framework Launches to Improve Pulmonary Embolism Patient Care
First standardized reporting system aims to improve communication, risk stratification and care coordination for acute pulmonary embolism
The Pulmonary Embolism Reporting and Data Systems (PE-RADSTM) framework for diagnosing and classifying acute pulmonary embolism using CT and magnetic resonance (MR) angiography was published today in Radiology.
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.
“The goal of PE-RADS is to improve communication between healthcare providers who care for patients with acute pulmonary embolism,” said Lynne M. Koweek, MD, professor of radiology and associate professor of medicine at Duke University School of Medicine in Durham, NC, and chair of the ACR PE-RADS committee. “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 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.”
Acute pulmonary embolism (PE) with right ventricle (RV) enlargement and clot-in-transit. PE chest axial CT angiography images demonstrate pulmonary embolus in the right pulmonary artery (white solid arrow), an enlarged RV (dotted arrow), and thrombus transiting through the right atrium (black arrows), Pulmonary Embolism Reporting and Data System (PE-RADS) 4/RV+/T+. The “4” refers to the PE‑RADS ordinal category for the most proximal clot location (central arteries). “RV+” indicates RV enlargement (RV to left ventricle ratio ≥ 1.0). “T+” indicates definitive thrombus identified in the right atrium and/or RV.
https://doi.org/10.1148/radiol.252721 ©RSNA 2026
Risk Stratification Through Structured Reporting
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.
For More Information
Access the Radiology study, “Pulmonary Embolism Reporting and Data Systems (PE-RADSTM) v2026 for the Diagnosis of Acute Pulmonary Embolism on CT and MR Angiography."
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