Jared Christensen, Ashley Elizabeth Prosper, Carol C Wu, Jonathan Chung, Elizabeth Lee, Brett Elicker, Andetta R Hunsaker, Milena Petranovic, Kim L Sandler, Brendon Stiles, Peter Mazzone, David Yankelevitz, Denise Aberle, Caroline Chiles, Ella Kazerooni
J Am Coll Radiol . 2024 Mar;21(3):473-488. doi: 10.1016/j.jacr.2023.09.009. Epub 2023 Oct 10.
The ACR created the Lung CT Screening Reporting and Data System (Lung-RADS) in 2014 to standardize the reporting and management of screen-detected pulmonary nodules. Lung-RADS was updated to version 1.1 in 2019 and revised size thresholds for nonsolid nodules, added classification criteria for perifissural nodules, and allowed for short-interval follow-up of rapidly enlarging nodules that may be infectious in etiology. Lung-RADS v2022, released in November 2022, provides several updates including guidance on the classification and management of atypical pulmonary cysts, juxtapleural nodules, airway-centered nodules, and potentially infectious findings. This new release also provides clarification for determining nodule growth and introduces stepped management for nodules that are stable or decreasing in size. This article summarizes the current evidence and expert consensus supporting Lung-RADS v2022.