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ARRT Seeks Comments on Proposed Changes to Registered Radiologist Assistant Documents

Published on Jul 29, 2026

The American Registry of Radiologic Technologists (ARRT) is seeking input from working professionals working as or with a Registered Radiologist Assistant (R.R.A.). We encourage you to review the proposed changes to the R.R.A. Examination Content Specifications and Didactic and Clinical Portfolio Requirements.

These updates aim to ensure the exam reflects the essential knowledge and skills required of entry-level Registered Radiologist Assistants (R.R.A.s). The revisions are based on a nationwide survey of 675 practicing R.R.A.s. An additional survey was sent to 10,000 radiologists to determine the level of supervision R.R.A.s have when performing various procedures.  Results from these surveys were used to update the content specifications and didactic and clinical portfolio requirements.

ARRT’s R.R.A. Practice Analysis Committee (composed of subject matter experts from throughout the nation) began working on these documents in January 2025 and will complete work on them later this year. After that, ARRT’s Board of Trustees will review the proposed changes. The revised R.R.A. documents have a scheduled implementation date of January 1, 2028.

We encourage you to review and provide feedback on these important updates.

SUMMARY OF MAJOR PROPOSED CHANGES TO THE EXAMINATION CONTENT SPECIFICATIONS:

Case Studies:

  • Percutaneous enteric tube evaluation – verification with contrast injections was added.
  • Small bowel study was removed.

Patient Care:

  • Hydromorphone was added under anesthetics and sedation/medications.
  • Ultrasound agents were added under contrast media.

Safety

  • Society of Interventional Radiology (SIR) was added under safety standards.
  • Det Norske Veritas - National Integrated Accreditation for Healthcare Organizations (DNV – NIAHO) and ACR – Quality Assurance were added under regulations.
  • Emergency procedures were added under MRI safety.

Procedures

  • Postprocessing for CT and MRI was removed from procedures.
  • In the Abdominal section under General Abdomen, masses, organomegaly, and trauma were added under pathophysiology. In the Gastrointestinal section, percutaneous enteric tube exchange was added under related procedures. Atresia and trauma were added under pathophysiology – esophagus and stomach. Under Pathophysiology – small and large intestine, atresia (intestine), and duodenal web were also added. In the Hepatobiliary, Pancreas, and Spleen pathophysiology section, biliary atresia, annular pancreas, organomegaly, and trauma were added. Under the Urinary Pathophysiology, developmental anomalies, diverticula, posterior urethral valves, strictures, and trauma were added. Under the Reproductive Pathophysiology section, uterine anomalies were also added.
  • In the Thoracic section, in both the General Thoracic and Cardiac pathophysiology sections, trauma was added.  Under the Pulmonary pathophysiology section, trauma, and inflammatory and infectious diseases were added.
  • In the Muscular and Endocrine sections, tendon sheath injection, bone marrow biopsy, and soft tissue masses were added.
  • In the Neurological, Vascular, and Lymphatic sections under Neurological, chemotherapy injection and nuclear medicine cisternogram were added under lumbar puncture. Under the Vascular and Lymphatic section, insert or exchange tunneled central venous catheter (not including ports), port placement for venous access, remove port, and ultrasound-guided IV placement were added. Open and closed head injuries and spinal cord injury were removed under neurological pathophysiology.

SUMMARY OF THE MAJOR PROPOSED CHANGES TO THE DIDACTIC AND CLINICAL PORTFOLIO REQUIREMENTS:

  • The following procedures were added as mandatory procedures: thoracentesis without drain placement and paracentesis without drain placement.
  • The following procedures were added as elective procedures: tendon sheath injection, placement of peritoneal or pleural drainage catheter (tunneled), percutaneous drainage without placement of catheter (excluding paracentesis and thoracentesis), remove percutaneous drainage catheter (tunneled), bone marrow biopsy, ultrasound-guided IV placement, exchange central venous catheter (tunneled or nontunneled), remove port, insert port for venous access, and insert tunneled center venous catheter.
  • The following procedures were moved from Mandatory to Elective: small bowel study – direct the study and spot TI, thoracentesis with drain placement, and paracentesis with drain placement.
  • The following procedures were removed: injection for sentinel node localization, perform CT postprocessing, and perform MR postprocessing. Form CR – 2E was deleted as it is for CT and MR postprocessing activities.
  • The number of mandatory procedures decreased from 375 to 265 procedures. The number of elective procedures increased from 125 to 235 procedures. The total number of required procedures remains the same at 500.

We invite you to review the proposed updates and submit your feedback via our online survey, open through September 3, 2026. This survey is the official method for collecting input. The Registered Radiologist Assistant (R.R.A.) Practice Analysis Committee will review all responses and may revise the documents accordingly.

Note: Additions are shown in blue; deletions are marked in red strikethrough.

Questions?

For questions about how these changes may affect your eligibility for certification and registration in R.R.A., call 651.687.0048 and select the option for earning an ARRT credential.

Thank you for reviewing these important documents!