2021-2022 Diagnostic Imaging Referral Guidelines

Update – March 10, 2025

Guidelines for all 13 sections have been completed and are published and available in the links below. The recommendations are available in both English and French and are summarized in a table in Appendix 3A and 3B of the PDF documents.

• Breast Disease—CARJ publication
• Cardiovascular—CARJ publication
• Cancer Diagnostic Imaging—CARJ publication
• Central Nervous System—CARJ publication
• Head and Neck—CARJ publication
• Gastrointestinal System—CARJ publication
• Genitourinary Guideline—CARJ publication
• Musculoskeletal System—CARJ publication
• Obstetrics and Gynaecology—CARJ publication
• Pediatric—CARJ publication
• Spine—CARJ publication
• Thoracic—CARJ publication
• Trauma—CARJ publication

Background

In January 2021, the CAR, in collaboration with the Canadian Medical Association through an unrestricted sponsorship grant, is supporting the integration of diagnostic imaging referral guidelines into electronic Clinical Decision Support (CDS) systems in Canada.

The national diagnostic imaging referral guidelines are being developed in consultation with the radiology community and members from allied professionals’ groups such the Canadian Association of Emergency Physicians (CAEP), the College of Family Physicians of Canada, the Society of Rural Physicians of Canada, Choosing Wisely and the Nurse Practitioner Association of Canada (NPAC).

The CAR has established a Referral Guidelines Working Group (WG) co-chaired by Dr. Ryan Margau (Chief and Medical Director, Medical Imaging, North York General Hospital) and Dr. Paul Pageau (Director, Point of Care US, Department of Emergency Medicine, The Ottawa Hospital), who will provide leadership and oversight on this project in collaboration with 16 other WG members from across Canada.

Mandate

Canada’s radiology community and its referring clinicians will develop a comprehensive set of evidence-based, peer-reviewed referral guidelines to support clinical decision-making by referring clinicians. The primary objective is to promote the most appropriate diagnostic imaging procedure(s), so that patients receive these procedure(s) at the right time, resulting in better health outcomes.

In addition to the integration into CDS systems, these guidelines will be made freely available to enhance care and enable communication among physicians.

2012 CAR Diagnostic Imaging Referral Guidelines

Referral Guidelines at a Glance

• Section A:  Central nervous system
• Section B:  Head and neck
• Section C:  Spine
• Section D:  Musculoskeletal system
• Section E:  Cardiovascular
• Section F:  Thoracic
• Section G:  Gastrointestinal system
• Section H:  Urological, adrenal and genitourinary systems
• Section I:  Obstetrics and gynaecology
• Section J:  Trauma
• Section K:  Cancer
• Section L:  Pediatrics
• Section M: Breast disease

2018 Symposiums on DI Referrals and Appropriateness and CDS systems

The CAR convened two events in 2018 on diagnostic imaging referral guidelines, appropriateness, and electronic CDS systems. The goal was to open lines of communication and collaboration on issues and strategies related to imaging referrals and quality improvement.

January 2018 Symposium Report

June 2018 Symposium Report