Lung-RADS

Lung-RADS is the scoring system radiologists use to report lung cancer screening CT scans. Each scan gets a category, from 0 (incomplete) through 1 and 2 (negative or benign-looking) to 3 and 4 (probably benign to suspicious), and each category comes with a recommended next step, such as a routine yearly scan, a short-term follow-up scan or further tests.

Origin

The American College of Radiology released Lung-RADS in 2014, modeled on the breast-imaging BI-RADS system, to make screening reports consistent and reduce unnecessary follow-up. It has been updated since, most recently in a 2022 version.

Significance in Asbestos Context

For an asbestos-exposed person in a screening program, the Lung-RADS category is the key line in the report. Category 1 or 2 usually means returning for the next yearly scan. Category 3 generally means a repeat scan in about six months. Category 4A, 4B or 4X means the finding is suspicious, and the next step may be a short-interval CT, a PET-CT or a biopsy. Most nodules found on screening are not cancer, so a higher category is a reason for prompt follow-up rather than a diagnosis. An "S" added to the category flags a significant finding other than lung cancer, which can include pleural plaques, fibrosis or a pleural effusion, findings relevant to asbestos disease. For a claim, a sequence of Lung-RADS reports can show when a nodule was first seen and how it changed, which can matter for dates of diagnosis and limitations periods.

Example Sentence

His screening CT was scored Lung-RADS 4A because of a new 9-millimeter solid nodule, with an "S" modifier for calcified pleural plaques.

Related Terms

Low-Dose CT Screening, Lung Cancer, CT Scan, PET-CT, Pleural Plaques, Biopsy

Notes

• Ask what your Lung-RADS category is and what follow-up it calls for, and keep to the schedule.
• Ask whether an "S" modifier was added and what it refers to.
• Keep every screening report; changes from one year to the next are important to your doctors.