ABR study guide
ABR · Work through your exam, one topic at a time.
The American Board of Radiology (ABR) Diagnostic Radiology Qualifying (Core) Exam is the first of the two exams in the DR certification sequence; candidates who pass it later sit the computer-based Certifying Exam (2026 and 2027) or the new DR Oral Exam (after 2027). It is intended for radiology residents who have completed 36 months of residency, and it assesses fundamental knowledge and clinical judgment across all key diagnostic radiology and integrated interventional/diagnostic radiology areas - anatomy, pathophysiology, diagnostic imaging, interventional procedures, and physics. The ABR study guide has 12 sections and about 3,567 words.
01Breast Imaging
Almost every breast question resolves to the ACR BI-RADS lexicon, so know it cold. Screening mammography is performed in asymptomatic patients (typically annual from age 40 in the US); diagnostic mammography adds problem-solving views, spot compression, and ultrasound.
337 words, about 2 min02Cardiovascular Imaging
Cardiovascular questions cluster into four buckets: coronary CT angiography, cardiac function and viability by MRI, aortic disease, and vascular emergencies. For coronary CTA, know CAD-RADS: 0 (no stenosis), 1 (1–24%), 2 (25–49%), 3 (50–69%), 4A (70–99% in one vessel), 4B (≥70% in three vessels or left main ≥50%), 5 (total occlusion), plus S (stent), G (graft), and N (non-diagnostic) modifiers.
285 words, about 1 min03Gastrointestinal Imaging
GI imaging questions test pattern recognition in the acute abdomen, chronic liver disease, and pancreaticobiliary disease. For the acute abdomen, know CT signs of appendicitis (dilated appendix 6 mm, periappendiceal fat stranding, appendicolith, arrowhead sign), diverticulitis (left-sided, pericolic fat stranding, with Hinchey staging), and small bowel obstruction (transition point, bowel 3 cm, valvulae conniventes).
291 words, about 1 min04Genitourinary Imaging
GU questions concentrate on renal mass characterization, stone disease, and prostate/uterine imaging. The Bosniak classification (2019 update) is essential: I and II are benign (II includes homogeneous high-attenuation cysts <3 cm and mildly thick septa); IIF requires follow-up; III and IV require surgery or ablation.
312 words, about 2 min05Interventional Radiology
IR questions test indications, contraindications, technique steps, and complication recognition. Know the Seldinger technique (needle, wire, catheter, sheath) and the difference between diagnostic and embolic catheters.
294 words, about 1 min06Musculoskeletal Radiology
MSK questions fall into trauma, arthritis, tumor, and internal derangement. For fractures, describe location, displacement, angulation, and articular involvement; know Salter-Harris I–V in children and the classic adult fractures (scaphoid, femoral neck, posterior malleolus, Jones, Lisfranc).
267 words, about 1 min07Neuroradiology
Neuro questions focus on stroke, hemorrhage, tumors, infection, and spine. In acute ischemic stroke, noncontrast CT excludes hemorrhage before thrombolysis; early signs include loss of insular ribbon, obscured lentiform nucleus, and sulcal effacement.
302 words, about 2 min08Noninterpretive Skills
This domain tests quality, safety, communication, ethics, statistics, and informatics - topics that are easy to miss but reliably tested. Know informed consent elements, HIPAA, and contrast media safety: iodinated contrast in renal impairment, metformin considerations, and premedication for prior reactions.
306 words, about 2 min09Nuclear Radiology
Nuclear questions emphasize radiopharmaceuticals, indications, and pattern recognition. Know the tracer for each study: FDG (glucose metabolism, oncology, inflammation, myocardium), Tc-99m MDP (bone), Tc-99m sulfur colloid (liver/spleen, GI bleeding), Tc-99m mebrofenin (hepatobiliary), Tc-99m DTPA or MAG3 (renal), Tc-99m pertechnetate (thyroid, Meckel), I-123 (thyroid imaging), I-131 (therapy), and Ga-68 DOTATATE (neuroendocrine tumors).
279 words, about 1 min10Pediatric Radiology
Pediatric questions reward age-based pattern recognition and dose consciousness. Know the developmental milestones of ossification, the Salter-Harris classification, and normal variants that mimic disease (physiologic periosteal reaction, accessory ossification centers, thymus).
306 words, about 2 min11Thoracic Radiology
Thoracic questions cover the ICU chest, pulmonary embolism, interstitial lung disease, and lung cancer screening. Know the silhouette sign, air bronchograms, and the difference between alveolar and interstitial patterns.
302 words, about 2 min12Ultrasound
Ultrasound questions mix physics, artifacts, and clinical applications. Know frequency versus resolution and penetration: higher frequency gives better spatial resolution but less penetration.
286 words, about 1 min