What's new?

What's new in the seventh edition of the RCR radiology referral guidelines?

A new edition of iRefer guidelines will be published in Spring 2017.

This seventh edition of imaging referral guidelines from The Royal College of Radiologists (RCR) marks a significant leap forward in guideline development. The enhanced guidelines methodology has been accredited by NHS Evidence, managed by the National Institute for Health and Clinical Excellence (NICE).

The preparation of evidence-based guidelines is a demanding task; one that requires a rigorous approach to established practices and the assimilation of new evidence. In this edition of the guidelines, the Delphi process was used for every guideline further strengthening the evidence base. There has also been consideration of relevant clinical guidelines to inform the process and inclusion of important clinical (red flag) features where relevant.

The seventh edition features an updated 'Table 2. Typical effective doses from diagnostic medical exposure' based on the latest Health Protection Agency (HPA) survey from 2008.1

The seventh edition also contains the following brand new guidelines: 


CA23 – Colon cancer: diagnosis
CA24 – Colon cancer: staging
CA25 – Colon cancer: follow–up
CA26 – Rectal cancer: diagnosis
CA27 – Rectal cancer: staging
CA28 – Rectal cancer: follow–up
CA29 – Anal cancer: diagnosis
CA30 – Anal cancer: staging
CA31 – Anal cancer: follow–up
CA56 – Melanoma: diagnosis
CA57 – Melanoma: staging
CA58 – Melanoma: follow–up 

Gastrointestinal system 

G33 – Asymptomatic patients 50–75 years old with a positive faecal occult blood test on screening for
bowel cancer 

Urogenital & adrenal

U22 – Asymptomatic men with elevated PSA



Hart D, Wall BF, Hillier MC, Shrimpton PC. HPA-CRCE-012 – Frequency and collective dose for medical and dental X-ray examinations in the UK, 2008. Didcot: HPA, 2010.

http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1287148001641 (last accessed 8/12/11)