LUNG RADSJulianna M. Czum, MD

CTOP retreat - May 22, 2014

No COI

OBJECTIVES

1. Define Lung RADS and its purpose

2. Describe (+) vs (-) CT screening categories

3. Match recommendations with categories

ACR-STR Practice Parameter for the Performance and Reporting of Lung

Cancer Screening Thoracic CT - 2014

Lung RADS 1.

= Lung Reporting And Data System

• Who From?/Source: – American College of Radiology (ACR) Lung Cancer

Screening Committee subgroup  

• What For?/Purpose: – Standardization of screening CT practice and

communication of results

• What Does It Consist of?/Content: – Assessment categories and systematic management

recommendations for screen-detected lung nodules.

Other Imaging “RADS”:• BI-RADS:– For mammography since 1993– Breast US and MRI added more recently

• LI-RADS:– For liver/hepatocellular carcinoma: CT& MRI

• HI-RADS: – For head injury/traumatic brain: CT & MRI– In development

• PI-RADS:– For prostate MR imaging– European Society of Urogenital Radiology

Assessment Categories: 0 = incomplete

Assessment Categories: (-) CT screen

Assessment Categories: (-) CT screen

Assessment Categories: (+) CT screen

Assessment Categories: (+) CT screen

Negative vs positive screen 2.

• Negative (-) screen: categories 1 and 2

• Positive (+) screen: categories 3 and 4

• (Category 0 = incomplete)

“The Fine Print”

“1. Negative screen does not mean that an individual does not have lung cancer.”

In other words, the presence of only a category 1 or 2 finding on screening CT should not be interpreted as meaning “there is no lung cancer”, but rather that nothing is seen that meets criteria for possible or probable clinically active lung cancer and therefore, continued annual screening should take place.

3.

Designated Lung Cancer Screening Center

• ACR recognition of facilities committed to providing quality screening care to patients at the highest risk for lung cancer.

• Must have an active ACR chest CT accreditation• Must meet specific equipment, personnel, and

imaging protocol requirements.

Lung Screening Program: it’s not just

about CT & nodules