2017 multimodality appropriate use criteria for noninvasive cardiac imaging: Expert consensus of the Asian society of cardiovascular imaging

ASCI Practice Guideline Working Group

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In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by aseparate rating committee on a scale of 1–9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.

Original languageEnglish
Pages (from-to)871-880
Number of pages10
JournalKorean journal of radiology
Issue number6
Publication statusPublished - 2017 Nov 1

Bibliographical note

Funding Information:
Received August 1, 2017; accepted after revision August 1, 2017. This Appropriate Use Criteria was developed through the Asian Society of Cardiovascular Imaging (ASCI) and has been published jointly by invitation and consent in both the Korean Journal of Radiology and the Cardiovascular Imaging Asia. This work was supported by the guideline development fund of the Asian Society of Cardiovascular Imaging. *These authors contributed equally to this work. Corresponding author: Hwan Seok Yong, MD, PhD, Department of Radiology, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea. • Tel: (822) 2626-1342 • Fax: (822) 863-9282 • E-mail: yhwanseok@naver.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright:
© 2017 The Korean Society of Radiology.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging


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