The program design places emphasis on a standardized classification system for reporting low-dose CT lung screening findings, addressing several goals common to all comprehensive low-dose CT lung screening programs, said Dr. Brady McKee. Those goals include facilitating adherence to radiology recommendations for screening, structured training, communicating exam results, quality control, tracking findings, generating follow-up letters, and coding, he said.
The LUNG-RADS system assigns a single alphanumeric diagnosis label for each low-dose lung cancer screening exam. In the system, the letters P (positive) and N (negative) are used for potentially significant extrapulmonary findings. Numbers are used for lung-cancer-specific findings: 1 means negative; 2 is benign, such as a stable pulmonary nodule; 3 is positive, likely benign, but requiring short-term follow-up such as a stable solid nodule; 4 means a finding suspicious for cancer; and 5 is positive representing a known malignancy, according to the group.
Since the Lahey Institute started its screening program in January 2012, it has screened more than 500 patients, and LUNG-RADS has been used in every report, McKee said.