Lung Reporting and Data System (Lung-RADS)

The Lung CT Screening Reporting and Data System (Lung-RADS) is an algorithm that can be used to classify lung nodules in patients with significant smoking histories.

Lung Reporting and Data System (Lung-RADS)

Category Descriptor

Criteria

Category

Management

Incomplete

0

Additional lung cancer screening CT images and/or comparison to prior chest CT examinations is needed

Negative

No nodules and definitely benign nodules (nodule(s) with specific calcifications: complete, central, popcorn, concentric rings and fat containing nodules).

1

Continue annual screening with low-dose CT (LDCT) in 12 months. Risk of cancer <1%

Benign Appearance or Behavior

Nodules with a very low likelihood of becoming a clinically active cancer due to size or lack of growth. Solid nodule(s) < 6 mm or new < 4 mm; part solid nodule(s) < 6 mm total diameter on baseline screening; non solid nodule(s) (ground glass nodules – GGN) < 20 mm OR >/= 20 mm and unchanged or slowly growing; category 3 or 4 nodules unchanged for >/= 3 months

2

Probably benign

Probably benign finding(s) – short term follow up suggested; includes nodules with a low likelihood of becoming a clinically active cancer. Solid nodule(s) >/= 6 to < 8 mm at baseline OR new 4 mm to < 6 mm; part solid nodule(s) >/= 6 mm total diameter with solid component < 6 mm OR new < 6 mm total diameter; non solid nodule(s) (GGN) >/= 20 mm on baseline CT or new

3

Repeat chest CT in 6 months. Risk of cancer 1-2%.

Suspicious

Findings for which additional diagnostic testing and/or tissue sampling is recommended.

  • 4A: Solid nodule(s) >/= 8 to < 15 mm at baseline OR growing < 8 mm OR new 6 to < 8 mm; part solid nodule(s) >/= 6 mm with solid component >/= 6 mm to < 8 mm OR with a new or growing < 4 mm solid component; endobronchial nodule
  • 4B: Solid nodule(s) >/= 15 mm OR new or growing, and >/= 8 mm; part solid nodule(s) with a solid component >/= 8 mm OR a new or growing >/= 4 mm solid component

 

4A

3 month LDCT; PET/CT may be used when there is a >/= 8 mm solid component. 5-15% risk of cancer

4B

Chest CT with or without contrast, PET/CT and/or tissue sampling depending on the probability of malignancy and comorbidities. PET/CT may be used when there is a >/= 8 mm solid component. >15% risk of cancer

Other

Clinically significant or potentially clinically significant findings (non lung cancer)

S

As appropriate to the specific finding

Prior Lung Cancer

Modifier for patients with a prior diagnosis of lung cancer who return to screening

C

 

 

 

 

References:

  1. Manos D, Seely JM, Taylor J, Borgaonkar J, Roberts HC, Mayo JR. The Lung Reporting and Data System (LU-RADS): a proposal for computed tomography screening. Can Assoc Radiol J. 2014 May;65(2):121-34. [Medline]
  2. van Riel SJ, Ciompi F, Jacobs C, Winkler Wille MM, Scholten ET, Naqibullah M, Lam S, Prokop M, Schaefer-Prokop C, van Ginneken B. Malignancy risk estimation of screen-detected nodules at baseline CT: comparison of the PanCan model, Lung-RADS and NCCN guidelines. Eur Radiol. 2017 Oct;27(10):4019-4029. [Medline]
  3. Martin MD, Kanne JP, Broderick LS, Kazerooni EA, Meyer CA. Lung-RADS: Pushing the Limits. Radiographics. 2017 Nov-Dec;37(7):1975-1993. [Medline]

 

 

Created Jan 08, 2018