Lung-RADS debuts in short form

The American College of Radiology has released its first edition of the Lung Imaging Reporting and Data System (Lung-RAD®), a quality assurance tool for the standardized reporting of lung-cancer CT screening studies. A key component in a low-dose CT lung-cancer screening infrastructure being developed by the ACR, Lung-RADS® features a number-based rating method similar to the college’s successful BI-RADS® for mammography reporting.

“This first version of Lung-RADS® is designed to improve patient care by providing standardized assessment structure and management recommendations for CT lung cancer screening,” said Ella Kazerooni, MD, chair of the ACR Committee on Lung Cancer Screening, in a statement issued by the ACR. A more robust version of the system that includes complete lexicon and Atlas, with standardized lung-screening terminology and report organization, will be released in the coming months.

The United States Preventive Services Task Force gave low-dose CT lung-cancer screening a grade B recommendation in December for adults aged 55 to 80 years of age with 30 pack-year smoking history (both smokers and former smokers who quit in the past 15 years). ACA requires coverage by private insurers of all procedures receiving a B or better recommendation from the USPSTF.

The announcement comes one day after the Medicare Evidence Development and Coverage Advisory Committee (MEDCAC) gave low-dose CT lung cancer screening a vote of low confidence. The committee met to consider the evidence on LDCT lung-cancer screening at the request of CMS, but the agency is not bound by MEDCAC recommendations.

The ACR expressed dismay at the decision and expressed concern that the lack of national Medicare coverage will create a two-tier system, with privately insured patients guaranteed to receive the screening and Medicare patients denied coverage.

The Medical Imaging & Technology Alliance (MITA) re-emphasized its support for the USPSTF recommendation and expressed confidence that CMS ultimately will approve coverage. “Making LDCT available to Medicare beneficiaries is in the best interest of the Medicare program and the patients it serves,” said Gail Rodriguez, executive director of MITA, in a statement. “We believe CMS will consider the overwhelming evidence and make this life-saving service available to beneficiaries.”