1. Julianna M. Czum, MD CTOP retreat - May 22, 2014
LUNG RADS
Julianna M. Czum, MD
CTOP retreat - May 22, 2014

2. No COI

3. OBJECTIVES 1. Define Lung RADS and its purpose
2. Describe (+) vs (-) CT screening categories
3. Match recommendations with categories

4. ACR-STR Practice Parameter for the Performance and Reporting of Lung Cancer Screening Thoracic CT

5. 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.

6. 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

7. Assessment Categories: 0 = incomplete

8. Assessment Categories: (-) CT screen

9. Assessment Categories: (-) CT screen

10. Assessment Categories: (+) CT screen

11. Assessment Categories: (+) CT screen

12. Negative vs positive screen 2.
Negative (-) screen: categories 1 and 2
Positive (+) screen: categories 3 and 4
(Category 0 = incomplete)

14. “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.

15. 3.

17. 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.

18. Lung Screening Program: it’s not just about CT & nodules