Taking Initiative

Committees under the Commission on Body Imaging are addressing such issues as incidental findings and colon cancer research.taking initiative

The Commission on Body Imaging is working hard on several initiatives of importance to the body imaging community and the patients it serves.

The commission is composed of several committees and subcommittees that focus on issues specific to various organ systems, socioeconomic topics, and clinical problems related to body imaging.

Economics Committee on Body Imaging

Together with the ACR Economics Commission, this committee supports the ACR Carrier Advisory Committee Network by reviewing and commenting on draft local coverage determinations, National Correct Coding Initiative edits, and medically unlikely edits.

The committee also supports the ACR Current Procedural Terminology (CPT®) activities by reviewing and providing guidance on the CPT code applications; it supports the Relative Value Update Committee process by gathering survey data for new codes. In addition, the committee also supports the Economics Committee on Coding and Nomenclature by reviewing coding questions and articles for publications. The Economics Committee on Body Imaging also provides data-driven responses to pending and future health-care legislation that affects body imaging. Also, the committee, in conjunction with ACR leadership and administration, seeks support from local chapters to educate and work with legislators on policies that impact patient care.

Incidental Findings Committee

The Incidental Findings Committee is charged with developing recommendations related to the follow-up and management of incidental findings that are commonly detected during body imaging examinations. (See "Chance Encounter" in the September issue of the Bulletin.) In 2010, the committee completed consensus development and published a landmark white paper in JACR® focused on incidental pancreatic cystic lesions, adrenal nodules, renal masses, and liver lesions.1 The committee is conducting further consensus development for incidental findings in other areas, including the spleen, lymph nodes, gallbladder, biliary tree, vascular system, and ovaries. In addition, the committee intends to extend its reach by developing interdisciplinary buy-in and consensus around its recommendations.

Thoracic Imaging Committee

This committee has been vigorous in responding to publications related to screening CT for lung cancer. The committee believes that information regarding both clinical outcomes and cost effectiveness of lung cancer screening should be spread throughout the imaging community. The committee is also strongly represented in professional societies and organizations focused on the emerging clinical application of computed tomography.

Colon Cancer Committee

The Colon Cancer Committee continues its efforts to expand both private and public payer reimbursement for CT colonography (CTC). At the national level, the committee seeks a Medicare national coverage determination for screening CTC. At the state level, the current focus is on encouraging enforcement of state laws mandating coverage in accordance with American Cancer Society guidelines (which include CTC). Members of the Colon Cancer Committee work with members of the ACR-led CT Colonography Coalition on positive press and online educational materials to increase use of CTC, which is especially important considering that many private payers now offer coverage. To further its efforts, the committee developed and distributed CT colonography jump drives. Each drive contains guidelines, publication lists, and current state laws regarding colorectal cancer screening. The goal is to quickly and efficiently provide information to individuals advocating for coverage at the state and local levels.

LI-RADS™ and PI-RADS™ Committees

The Liver Imaging-Reporting and Data System™ (LI-RADS™) Committee has launched LI-RADS, which is now publicly available as an ACR-sponsored standard. LI-RADS is intended to facilitate standardized interpretation and reporting of observations (such as nodules and other lesions) encountered in patients undergoing CT or MRI surveillance for hepato-cellular carcinoma. Currently, LI-RADS focuses only on extracellular agents; a future version of LI-RADS will be expanded to include hepatobiliary agents. Similarly, the MRI Prostate Imaging - Reporting and Data System™ (PI-RADS™) Committee has been formed to conduct a parallel effort for prostate imaging. This is being done in partnership with the International Prostate Imaging Workgroup and the AdMeTech Foundation.

The Body Imaging Commission is hard at work addressing many issues related to the field of body imaging, for the betterment of our patients and our profession alike. All ACR members are welcome to advise and participate in any current initiatives and to suggest future initiatives for the Commission.

1. Berland LL, Silverman SG, Gore RM, et al. “Managing Incidental Findings on Abdominal CT: White Paper of the ACR Incidental Findings Committee.” JACR 2010;7:754–73.

James BrinkBy James A. Brink, MD, FACR
Chair, Commission on Body Imaging

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