ACR Appropriateness Criteria® Imaging of Mediastinal Masses

Expert Panel on Thoracic Imaging

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Mediastinal masses can present with symptoms, signs, and syndromes or incidentally. Selecting the appropriate diagnostic imaging study for mediastinal mass evaluation requires awareness of the strengths and weaknesses of the various imaging modalities with regard to tissue characterization, soft tissue contrast, and surveillance. This publication expounds on the differences between chest radiography, CT, PET/CT, ultrasound, and MRI in terms of their ability to decipher and surveil mediastinal masses. Making the optimal imaging choice can yield diagnostic specificity, avert unnecessary biopsy and surgery, guide the interventionist when necessary, and serve as a means of surveillance for probably benign, but indeterminate mediastinal masses. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Original languageEnglish (US)
Pages (from-to)S37-S51
JournalJournal of the American College of Radiology
Issue number5
StatePublished - May 2021


  • AUC
  • Appropriate Use Criteria
  • Appropriateness Criteria
  • CT
  • MRI
  • Mediastinal cyst
  • Mediastinal mass
  • Soft tissue contrast
  • Tissue characterization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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