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Telemedicine is becoming an increasingly important tool in the practice of medicine throughout the world. For radiologists, telemedicine translates to teleradiology. Because an increasing amount of imaging is now archived in a digital format, and with the application of more powerful computers in radiology, digital image transmission between display stations is becoming commonplace. The ability to move large diagnostic image data sets to display stations anywhere in the world using the Internet and other high-speed data links is solving some problems and creating others. Medicine and radiology will be challenged in many ways by the issues created from the application of this burgeoning technology. Our task force was charged with investigating the evolving practice of international teleradiology and with developing a pubic statement to be adopted by the ACR Council (). This white paper is our effort to define those issues we believe to be most pertinent to international teleradiology as we know them today. Will these issues be changing? Certainly. For some facets of the issue, there are currently more questions than answers. We describe several scenarios that we believe are acceptable practices of international teleradiology as well as some that are not. We believe that much will be written about international teleradiology in the future as the issues of credentialing, quality assurance, licensure, American Board of Radiology certification, the maintenance of certification, jurisdictional and medical liability issues, patient privacy, fraud and medical ethics are more precisely defined and shaped by state and federal legislation and medical jurisprudence. This white paper is our assessment of what we believe to be the major challenges that exist as of this writing.

Screening for disease using imaging technologies is a growing phenomenon. For some applications (e.g., mammography and breast cancer), there is solid evidence that imaging screening reduces disease-specific mortality. However, for other applications, the public interest in imaging screening is progressing despite a lack of valid scientific evidence that such screening improves the public's health. Clinical trials promise to eventually shed light on the value of imaging screening, but the results of these trials will not be known for several years. In the meantime, physicians and the public need guidance on whether specific imaging screening examinations are appropriate. The ACR charged the Methods Committee of its Task Force on Screening Technologies to advise the organization on how it could best use available evidence to make public recommendations on imaging screening technologies. This article is the outcome of the committee's deliberations, including recommendations for the method of arriving at a recommendation, the approach to dissemination, and to whom the recommendations should be targeted.