The Pulmonary Embolism Reporting and Data Systems (PE-RADS) framework for diagnosing and classifying acute pulmonary embolism using CT and magnetic resonance angiography was published in Radiology, a journal of the Radiological Society of North America, on July 21. Developed by the American College of Radiology in collaboration with representatives from six other leading medical groups, PE-RADS is intended to streamline communication and patient care for this potentially life-threatening condition.
Pulmonary embolism 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. CT pulmonary angiography remains the gold standard for diagnosis, while MR angiography serves as another noninvasive diagnostic option.
"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."
The new PE-RADS v2026 system introduces a simple 0-4 grading scale with a hierarchical framework for classifying clot location combined with right heart imaging features. This supports risk stratification and guides patient management across multidisciplinary teams. The system also includes modifiers indicating limitations due to image quality or non-pulmonary embolism causes affecting pulmonary arteries.
Development involved imaging specialists and clinicians caring for patients with suspected or diagnosed pulmonary embolism; half were selected by the American College of Radiology while others were nominated by organizations such as 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.
"Consistent terminology and reporting not only foster 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 began in 1992 to provide standardized frameworks for interpreting disease-oriented medical imaging results.
