ARRT 2027 Content Specifications: What Changed

The ARRT Radiography exam gets a new content specification on March 1, 2027 — and if you test before that date, none of it applies to you. That one sentence settles most of the anxiety around this topic. The current specification, in effect since January 2022, governs every exam administered through the end of February 2027. The new one, board-approved in January 2026, takes over on March 1, 2027.

So the first question isn't "what changed" — it's "which exam will I sit?"

Which specification applies to you

Your test date decides, not your graduation date and not when you started your program.

• Testing before March 1, 2027: the current specification applies. You can stop reading now if you want — everything below is about an exam you will never take. (Here's what the current exam looks like.)
• Testing March 1, 2027 or later: the new specification applies, and the differences below are worth ten minutes of your attention.

If your eligibility window straddles the changeover, that's a real scheduling decision — the content differences are modest, but studying to one blueprint and sitting the other means some of your preparation lands on topics that moved.

What is not changing

Most of the exam's shape carries over untouched:

• 200 scored questions plus 30 unscored pilot questions — 230 total, same as today.
• The passing score is still a scaled 75 (which is not 75% — explained here).
• The same four content categories: Patient Care, Safety, Image Production, and Procedures, with the same subcategory structure inside each.
• The mix of item types — multiple choice plus the newer formats like multi-select and image-based items — continues.

The change is in the weighting of those categories and in the topic list inside them.

The weight shifts: Procedures gets bigger

Here's the scored-question count per category, current exam versus the new specification:

Two reads on that table matter for studying:

Procedures was already the biggest category, and it grew. At 72 of 200 scored questions, Procedures is now 36% of the exam. Every subcategory inside it gained: Head, Spine & Pelvis goes from 18 to 20 questions, Thorax & Abdomen from 20 to 22, and Extremity from 28 to 30. Extremity alone — fingers to shoulders, toes to hips — is now the single largest block of questions on the entire exam.

The Safety reduction comes entirely out of Radiation Protection. Radiation Physics & Radiobiology holds at 21 questions; Radiation Protection drops from 29 to 25. Physics didn't get lighter — protection did, slightly.

Image Production is unchanged at 51 (26 Image Acquisition & Evaluation, 25 Equipment Operation & QA), and Patient Care gives up two questions.

What's new on the topic list

The additions cluster around how radiography is actually practiced now:

• Weight-bearing projections get real emphasis. The new outline names weight-bearing views throughout the lower extremity — foot, ankle, knee — and adds the AP weight-bearing pelvis specifically. If your positioning course treated weight-bearing views as a footnote, the new exam doesn't.
• Thoracolumbar spine appears as its own named projection area.
• Fluoroscopy-guided line and tube placement joins the Procedures list — C-arm guided line placement (think PICC placement) and enteric tube placement under fluoro, reflecting what radiographers are actually asked to assist with.
• Myelography, lumbar puncture, and epidural procedures are named in the contrast-studies context.
• Digital-imaging vocabulary gets deeper. The Image Production outline now names concepts like Nyquist frequency and teleradiology — the sampling math behind digital detectors and the logistics of distributing images are both fair game.
• Dose-awareness campaigns — the Image Wisely and Image Gently programs — are now explicitly named as resources you're expected to know.

Image Production changes in the 2027 specs

Category weights tell you where more questions land. Image Production is also where the 2027 outline modernizes the topic list: cassette-based computed radiography comes out, and digital-detector language — including DQE, exposure latitude, and virtual grids — comes forward. ARRT published that overview May 1, 2026, for documents effective March 1, 2027.

CR / cassette-based systems

On the 2027 Radiography content specifications, all content pertaining to computed radiography (CR) is removed. Cassette-based CR workflows (PSP plates, plate readers, CR-specific erasure/plate QC framed as CR systems) are not what the new blueprint is built around.

If you test on or after March 1, 2027, spend Image Production time on digital detectors (direct and indirect conversion) instead of CR hardware drills. If you test before that date, the current specification still applies — don't abandon current materials early.

DQE and exposure latitude

The updated documents shift "image receptors" language toward digital detectors and name detective quantum efficiency (DQE) and exposure latitude as examples you should recognize.

Exam-useful, short version:

• DQE: how efficiently the detector turns incoming x-ray signal into a usable image signal.
• Exposure latitude: how wide a range of exposures can still produce a usable digital image — which is why a digital radiograph can look acceptable while still being noisy (too little signal) or higher-dose than needed.

You don't need a physics seminar; you need to know the terms, what they describe, and that they belong to digital-detector Image Production — not film-screen density tricks. See also the Image Production study guide.

Virtual grids and compensating filters

Virtual grids are added to the 2027 imaging-equipment content. Think: scatter control assisted by processing/software approaches named alongside traditional grid concepts — not a replacement for knowing why scatter hurts contrast.

Compensating filters are deleted from that equipment list. For 2027-dated exams, don't prioritize filter-boat detail the outline dropped.

(Related quality-language update in the same documents: image contrast and subject contrast are named in the factors affecting radiographic quality table — keep those two terms distinct.)

Free related tools: labeled x-ray tube diagram · ARRT formula sheet

What's removed

The most notable deletion: intravenous urography (IVU) is off the GU studies list. Cystography, cystourethrography, retrograde urography, and hysterosalpingography remain. This tracks clinical reality — CT urography displaced the classic IVU years ago, and the exam is finally catching up. If you're testing under the new specification, the IVU sequence (scout, nephrogram timing, ureteric compression) is no longer named exam content.

What this means for how you study

If you test before March 1, 2027: nothing changes. Study to the current exam, and be a little skeptical of any prep material that has already pivoted to the new outline — the current exam still has 66 Procedures questions and still lists IVU.

If you test after: the practical advice is mostly "lean even harder into Procedures." It was already a third of the exam; now it's 36%, positioning knowledge is the highest-yield thing you can drill, and weight-bearing views deserve specific attention. Our Procedures study guide covers the category's structure, and the free diagnostic will show you where you stand across all four categories in about 15 minutes.

Either way, don't let the changeover become a source of dread. The overlap between the two outlines is well over 90% — anatomy is anatomy, the 15% rule is the 15% rule, and a student who is genuinely ready for one version of this exam is a short adjustment away from ready for the other.