Introducing a New Resource for Readers of ONCOLOGY: The American College of Radiology Appropriateness Criteria

August 15, 2013

The ACR Appropriateness Criteria®, and their mission to improve the knowledge of practicing oncologists and the level of care our patients receive, is wholly consistent with the goals of ONCOLOGY. We are hopeful that our readership will find the ACR Appropriateness Criteria® a valuable resource in their day-to-day practice. I personally look forward to future guidelines in this series.

On behalf of the Editorial Board of ONCOLOGY, I am pleased to introduce the American College of Radiology (ACR) Appropriateness Criteria® to our readership. On page 786 of this issue is the first in an ongoing series of ACR Appropriateness Criteria® that will be published in ONCOLOGY on a quarterly basis. Now in their third decade, the ACR Appropriateness Criteria® aim to provide an expert and up-to-date review of the current literature in various areas of oncology practice in which radiotherapy figures prominently; where there is a lack of definitive evidence, the ACR Appropriateness Criteria® provide an expert opinion as to the appropriateness of the various treatment options. We hope our readers will find the ACR Appropriateness Criteria® a valuable resource that can help guide them in their day-to-day practice.

The ACR Appropriateness Criteria® are unique in the constellation of clinical guidelines because of their focus on discrete topics (to date, there are 186 topics covering radiation oncology, diagnostic imaging, and interventional radiology); they therefore deliver a relatively easy-to-digest introduction to a given topic and a current review of the pertinent literature. Where definitive evidence is lacking, the ACR Appropriateness Criteria® provide an expert consensus as to the current state of opinion on the issue. Also relatively unique among oncology guidelines is the focus on radiation oncology and the more specific recommendations that are provided on radiation dose and technique. Practicing radiation oncologists will find the ACR Appropriateness Criteria® an especially valuable resource, offering the most up-to-date and specific recommendations for the treatment of their patients. Medical and surgical oncologists will find in the ACR Appropriateness Criteria® a digestible document that will inform them and give them insight regarding the issues and treatment decisions that their radiation colleagues wrestle with on a day-to-day basis.

In this issue of ONCOLOGY, Bradford Hoppe and colleagues present the ACR Appropriateness Criteria® for localized nodal indolent lymphoma. Their article describes the current state of knowledge about the treatment of nodal indolent lymphoma, in particular early- and late-stage follicular lymphoma. The article also discusses the epidemiology, pathology, presentation, and prognosis of this radiosensitive disease. Of note, Dr. Hoppe and colleagues describe the currently accepted radiotherapy doses and field sizes, as well as the use of palliative radiation (in one or two treatments) in advanced-stage follicular lymphoma. The authors do an excellent job of summarizing the literature, and they provide five case examples (called “variants”) of indolent lymphoma, with levels of appropriateness for specific treatment recommendations for each variant.

The ACR Appropriateness Criteria®, and their mission to improve the knowledge of practicing oncologists and the level of care our patients receive, is wholly consistent with the goals of ONCOLOGY. We are hopeful that our readership will find the ACR Appropriateness Criteria® a valuable resource in their day-to-day practice. I personally look forward to future guidelines in this series.