Julianna M. Czum, MD
CTOP retreat - May 22, 2014
1. Define Lung RADS and its purpose
2. Describe (+) vs (-) CT screening
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 screendetected lung nodules.
Other Imaging “RADS”:
– For mammography since 1993
– Breast US and MRI added more recently
– For liver/hepatocellular carcinoma: CT& MRI
– For head injury/traumatic brain: CT & MRI
– In development
– 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.
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

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