Ella A. Kazerooni MD, Moderator: Nothing to Disclose

1) To learn why structured reporting is important in the practice of lung cancer screening with CT. 2) To learn what the LUNGRADS structured reporting categories are and what management is associated with each category. 3) To understand how to evaluate lung nodules for reporting in the LUNGRADS coding scheme. 4) To learn basic practice audit variables to collect and follow to evaluate a a lung cancer screening CT program.

Lung cancer is the leading cause of cancer death in the US for both men and women, exceeding the number of deaths from cancers of the breast, colon, and prostate combined. For each of these cancers, there are well established screening tests. Screening for current and former smokers with LDCT is the only method ever proven to reduce lung cancer mortality in this high risk population and it has also been shown to be cost effective. In December 2013 the USPSTF gave lung cancer screening with CT a grade ;B; recommendation for high risk older current and former smokers. To prepare radiologists to practice lung cancer screening with CT, the ACR Committee on Lung Cancer Screening formed a working group to develop LUNGRADS, which made it#39;s version 1.0;debut in 2014. Similar to BIRADS which is in ;, LUNGRADS provides practicing radiologists with a tool to use for categorizing abnormalities found on lung cancer screening CT exams, with management recommendations for each category. In this course we will review why structured reporting and management is important in lung cancer screening CT. As a public health screening tool, performing the exams with high quality, using standardized reporting and following standard management algorithms is important to minimize overdiagnosis, overutilization of diagnostic testing and interventional procedures ranging from percutaneous biopsy to bronchoscopy and surgery. The LUNGRADS categories try to follow BIRADS approach to coding when possible, recognizing that there are differences in screening for lung cancer and breast cancer. Exams are coded as incomplete (category 0), negative; for clinically active cancer (category 1), benign (category 2), probably benign (category 3) and suspicious (category 4). Additional modifers such as ;S; can be used for clinicially significant or potentially clinically signifiant findings (non lung cancer). Details of using this coding system and metrics to evaluate a screening practice will be discussed. 

Kazerooni, E, Lung Cancer Screening: Structured Reporting, Management and Practice Metrics (LUNGRADS).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000751.html