Lung-RADS review identifies radiologist 'blind spots'

Monday, December 2 | 12:15 p.m. – 12:45 p.m. | M5A-SPCH-4 | Learning Center

A review of the Lung-RADS v2022 metric has revealed radiologist "blind spots" when it comes to catching lung cancer on screening CT, according to findings to be presented Monday afternoon.

The research found that commonly missed lung nodules were juxtapleural, peribronchovascular, or obscured by abnormality, wrote presenter and medical student Ashita Tanwar of the University of California, Los Angeles, and colleagues in their study abstract.

"Lung cancer screening is associated with 20% reduction in lung cancer mortality, but an unanswered question is why many still die of lung cancer despite adherence to screening," the team noted.

The researchers analyzed gaps in screening practices at the individual radiologist and the Lung-RADS guideline levels via a review of National Lung Screening Trial (NLST) data from which they identified 91 participants whose first CT was negative but who died of lung cancer within seven years of this first exam. For their study, the group tasked four thoracic radiologists to use Lung-RADS v2022 to determine whether CTs that were deemed negative but had a visible nodule (that eventually became lung cancer) actually indicated suspicion for disease.

Tanwar's group found that 22 (24%) negative CT exams had retrospectively visible nodules rated Lung-RADS v2022 3/4 (i.e., "actionable" findings) that developed into lung cancer, and that 18 (20%) had visible nodules on negative screens that did not meet Lung-RADS criteria but later developed into cancer.

What else did the group find? Check out this poster session to get more details.

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