Lung-RADS
ACR · v2022 · Updated v2022
Lung cancer screening reporting and data system. Category-based management of screening LDCT with growth, morphology, and modifier rules (S, C).
Category 4B/4X → tissue diagnosis; category 3 → 6 mo LDCT.
Asymptomatic adults 50–80 y in a lung cancer screening program · Low-dose CT (LDCT) screening exams
Diagnostic CT for symptoms · Incidental nodules outside a screening program (use Fleischner) · Patients with active or recently treated lung cancer
CT
ACR consensus — updated 2022
Categorical (0–4X) reporting for screening LDCT. Category ties directly to a management pathway; modifiers S and C flag significant incidental or prior-cancer findings.
Overview
Lung-RADS v2022 standardizes screening LDCT interpretation and drives management. Categories combine baseline vs. follow-up context, nodule morphology, size (mean of long and short axis, to the nearest mm) and growth thresholds. Category 3 and 4A/4B trigger short-interval CT, PET/CT or tissue sampling.
Quick reference
| Category | Management |
|---|---|
| 1 — Negative | Annual LDCT |
| 2 — Benign | Annual LDCT |
| 3 — Probably benign | 6-month LDCT |
| 4A — Suspicious | 3-month LDCT ± PET/CT |
| 4B — Very suspicious | PET/CT and/or tissue diagnosis |
| 4X — 4A/4B + malignant features | Same as 4B |
Structured report
Interactive template that produces a validated dictation ready for the report.
References
- OpenACR Lung-RADS v2022