ACR CT Accreditation Program and the Lung Cancer Screening Program Designation

Kazerooni, Ella A.; Armstrong, Mark; Amorosa, Judith K.; Hernandez, Dina; Liebscher, Lawrence A.; Nath, Hrudaya; McNitt-Gray, Michael F.; Stern, Eric J.; Wilcox, Pamela

doi:10.1016/j.jacr.2015.12.010

Cited by 90 publications

(52 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since then, we have seen the creation of…  LI-RADS TM (Liver Imaging Reporting and Data System) (10) for standardization reporting in patients with chronic liver disease,  Lung-RADS TM (Lung CT Screening Reporting and Data System) for standardization reporting of patients undergoing CT lung screening in high-risk smokers (11) and  PI-RADS TM (Prostate Imaging Reporting and Data System) criteria to improve early diagnosis and treatment of prostate cancer using multiparametric MRI (12), among other efforts.…”

Section: Introductionmentioning

confidence: 99%

CAD-RADS™: Coronary Artery Disease – Reporting and Data System

Cury

Abbara²,

Achenbach

et al. 2016

Journal of the American College of Radiology

265

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

CAD-RADS™: Coronary Artery Disease – Reporting and Data System

Cury

Abbara²,

Achenbach

et al. 2016

Journal of the American College of Radiology

265

View full text Add to dashboard Cite

“…All readers, however, were well trained in thoracic CT and skilled in interpreting nodules, thus representing radiologists potentially involved in screening in the future. Parts of the observer variability, especially with respect to identification of the risk-dominant nodule, might still be related to lack of experience, suggesting that dedicated training is important, as also articulated by the ACR [20]. Interestingly, no significant differences in agreement were observed between residents and radiologists.…”

Section: Discussionmentioning

confidence: 98%

Observer variability for Lung-RADS categorisation of lung cancer screening CTs: impact on patient management

et al. 2018

View full text Add to dashboard Cite

Objectives Lung-RADS represents a categorical system published by the American College of Radiology to standardise management in lung cancer screening. The purpose of the study was to quantify how well readers agree in assigning Lung-RADS categories to screening CTs; secondary goals were to assess causes of disagreement and evaluate its impact on patient management. Methods For the observer study, 80 baseline and 80 follow-up scans were randomly selected from the NLST trial covering all Lung-RADS categories in an equal distribution. Agreement of seven observers was analysed using Cohen's kappa statistics. Discrepancies were correlated with patient management, test performance and diagnosis of malignancy within the scan year. Results Pairwise interobserver agreement was substantial (mean kappa 0.67, 95% CI 0.58-0.77). Lung-RADS category disagreement was seen in approximately one-third (29%, 971) of 3360 reading pairs, resulting in different patient management in 8% (278/3360). Out of the 91 reading pairs that referred to scans with a tumour diagnosis within 1 year, discrepancies in only two would have resulted in a substantial management change. Conclusions Assignment of lung cancer screening CT scans to Lung-RADS categories achieves substantial interobserver agreement. Impact of disagreement on categorisation of malignant nodules was low. Key Points • Lung-RADS categorisation of low-dose lung screening CTs achieved substantial interobserver agreement.• Major cause for disagreement was assigning a different nodule as risk-dominant.• Disagreement led to a different follow-up time in 8% of reading pairs.

show abstract

“…Cost-effectiveness mainly depends on the lung cancer risk of screened cohorts. The cost per QALY varied markedly according to subgroups, suggesting that screening was more cost-effective for current smokers, and those at higher risk and in women (66). It indicates that the risk-based selection of individuals eligible for lung cancer screening may be the key to improve the cost-effectiveness ratio (67).…”

Section: Who Should Be Selected For Screeningmentioning

confidence: 99%

Screening for early stage lung cancer and its correlation with lung nodule detection

Qian¹,

Yang²,

Chen³

et al. 2018

J. Thorac. Dis.

View full text Add to dashboard Cite

Currently, the most effective way of reducing lung cancer mortality is early diagnosis of lung cancer. The National Lung Screening Trial has proved the efficacy of lung cancer screening using lowdose computed tomography to reduce lung cancer mortality. However, many questions remain surrounding lung cancer screening implementation, among which include how to select the optimal risk population, the personalized screening interval based different levels of risk, methods to improve diagnostic discrimination between malignant and benign disease in detected lung nodules, and the roles of biomolecular markers in stratifying risk and in guiding the management of indeterminate nodules. This review concentrates on the latest developments of lung cancer screening and provides an overview of the main unanswered questions on lung nodule detection. J Thorac Dis 2018;10(Suppl 7):S846-S859 jtd.amegroups.com reviews the latest progress in lung cancer screening and the main unanswered questions on lung nodule detection, to discuss optimal strategies for implementation of lung cancer detection. How to conduct screening Screening by thoracic imageryThe NLST enrolled high-risk asymptomatic individuals: age, 55-74 years; current or former smokers who quit within 15 years with at least 30 pack-years of smoking history. From August 2002 through April 2004 individuals were randomly assigned to annual LDCT screening scans versus CXR for three consecutive years. After a median follow-up of 6.5 years, the study showed that screening lead to a significant reduction of 20% and 6.7% in lung cancer and overall mortality, respectively. LDCT showed better performance for the detection of early-stage lung cancer, with 57% of screening-detected lung cancer cases of stages I or II, compared to only 39% in the CXR arm (9). This has led to the American Cancer Society's guidelines now recommending LDCT screening in high risk individuals aged 55 to 80 years who have a 30-year pack smoking history and currently smoke or have quit within the past 15 years (12).The impact of LDCT screening versus usual care or CXR have been also compared by several large-scale European randomized trials: Dutch-Belgian Randomized Lung Cancer Screening (NELSON) trial (13) (19). So far, the three published trials have reported conflicting results against NLST. The DLCST showed higher rate of all-cause mortality in the CT screening arm compared with usual care [relative risk (RR) 1.03; 95% CI: 0.66-1.60] (20,21). In the DANTE trial, CT screening demonstrated no significant effect on reduce of mortality (RR 0.99; 95% CI: 0.69-1.43) (15). The MILD trial found no effect of biennial screening compared with usual care and a negative effect of annual screening with more detected cancers but also higher all-cause mortality (RR 1.99; 95% CI: 0.80-4.96) (16). It has raised questions about whether the much smaller patient sample size and the inclusion of patients at lower risk (less exposure to tobacco) for lung cancer in these trials diluted any potential benefits of LDCT s...

show abstract

ACR CT Accreditation Program and the Lung Cancer Screening Program Designation

Cited by 90 publications

References 3 publications

CAD-RADS™: Coronary Artery Disease – Reporting and Data System

CAD-RADS™: Coronary Artery Disease – Reporting and Data System

Observer variability for Lung-RADS categorisation of lung cancer screening CTs: impact on patient management

Screening for early stage lung cancer and its correlation with lung nodule detection

Contact Info

Product

Resources

About