New framework launches to improve pulmonary embolism patient care

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by Radiological Society of North America

edited by Sadie Harley, reviewed by Andrew Zinin

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Stages of thromboembolism. (A) Pulmonary embolism (PE) chest axial CT angiography image demonstrating acute pulmonary embolus (arrows). (B) PE chest axial CT angiography image demonstrating subacute pulmonary embolus (arrow). (C) PE chest axial CT angiography image demonstrating webs/scarring from prior pulmonary embolus (arrows). Credit: Radiological Society of North America (RSNA)

The Pulmonary Embolism Reporting and Data Systems (PE-RADS) framework for diagnosing and classifying acute pulmonary embolism using CT and magnetic resonance (MR) angiography was published 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.

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 health care 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, North Carolina, 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 in 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.

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. Credit: Radiological Society of North America (RSNA)

"These are commonly performed exams that can be challenging to interpret, and imaging findings are critical to patient management," 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 health care providers but also creates a stronger foundation for studying outcomes, resource utilization and future improvements in pulmonary embolism care," 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 to facilitate effective communication between radiologists and referring physicians.

Publication details

Pulmonary Embolism Reporting and Data Systems (PE-RADSTM) v2026 for the Diagnosis of Acute Pulmonary Embolism on CT and MR Angiography, Radiology (2026).

Journal information: Radiology

Clinical categories

Diagnostic radiologyPulmonary medicine Provided by Radiological Society of North America Who's behind this story?

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Citation: New framework launches to improve pulmonary embolism patient care (2026, July 21) retrieved 21 July 2026 from https://medicalxpress.com/news/2026-07-framework-pulmonary-embolism-patient.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.