A Breath of Fresh Air
Get up to date with all of the changes in lung cancer screening with these resources.
Over the course of the past year, many exciting developments have occurred in the world of lung cancer screening. According to Ella A. Kazerooni, MD, FACR, principal investigator at the University of Michigan in the National Lung Screening Trial (NLST), "We're committed to widespread coverage for lung cancer screening, and providing an array of tools radiologists need to make that happen."
Given all of the changes taking place, there is no better time than now to get caught up on what lung cancer screening resources are available through the ACR and elsewhere to comply with best practices. The following are some of the most important:
ACR CT Accreditation and Designated Lung Cancer Screening Center program.
The ACR's CT Accreditation Program involves the acquisition of clinical and phantom images, dose measurements, and the submission of scanning protocols. Providers that bill under part B of the Medicare Physician Fee Schedule must be accredited in order to receive technical component reimbursement from Medicare.
In addition to the CT Accreditation Program, the ACR also offers the Lung Cancer Screening Center designation. This is a unit-specific credential that demonstrates to patients that your facility meets best practice standards for lung cancer screening. All sites applying for the certification must have active ACR CT accreditation in at least the chest module on the designated units and must meet additional requirements outlined by the ACR. All facilities that meet the prescribed conditions will be identified as being an ACR Designated Lung Cancer Screening Center on the ACR's Accredited Facility Search web page. Between announcing the program in early May and the end of July, 147 facilities have applied for ACR's lung cancer screening designation, with 93 facilities approved and another 54 in process. For more information about the application process, visit Lung Cancer Screening Center.
The ACR's Lung-RADS is the product of the ACR Lung Cancer Screening Committee subgroup on Lung-RADS. This quality assurance tool is designed to standardize and structure lung cancer screening CT reporting and management recommendations, reduce confusion in lung cancer screening CT interpretations, and facilitate outcome monitoring. Forthcoming features include a lexicon of lung cancer screening CT terms and a reporting format meant to standardize the language used in lung cancer screening CT reports, along with an atlas that will include images that illustrate the lexicon and findings as well as a description of a medical audit and outcome monitoring process. More information on Lung-RADS may be found at acr.org.
ACR-STR Practice Parameter for the Performance and Reporting of Lung Cancer Screening Thoracic Computed Tomography.
This new document, developed collaboratively with the Society of Thoracic Radiology and adopted at AMCLC 2014, is an educational tool designed to assist practitioners in optimal performance of thoracic CT for lung cancer screening. It is not a compilation of inflexible rules or requirements of practice, but rather a guideline to help practitioners deliver safe and effective medical care. Click here for more information.
AAPM Protocols for Lung Cancer Screening.
Building on the foundation of the ACR-STR Practice Parameters, the AAPM developed lung cancer screening CT protocols across a wide array of CT scanner makes and models to facilitate scanner specific protocols in practice. Visit aapm.org to learn more.
New England Journal of Medicine article detailing NLST results.
Review the results of the NLST as reported in the New England Journal of Medicine. The NLST was conducted to determine whether screening with low-dose CT could reduce mortality from lung cancer. In all three rounds of the trial, there was a substantially higher rate of positive screening tests in the low-dose CT group than in the radiography group. In addition, the percentage of all screening tests that identified a clinically significant abnormality other than an abnormality suspicious for lung cancer was more than three times as high in the low-dose CT group as in the radiography group. Based on these and other results, the research team concluded that screening with the use of low-dose CT reduces mortality from lung cancer. To read the full text of the article click "Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening,"
By Chris Hobson, ACR Bulletin associate editor