# Lung-RADS — Lung CT Screening Reporting and Data System

> Structured assessment categories and management for low dose CT lung cancer screening.

**Situação:** vigente · **Órgão:** Tórax · **Órgão emissor:** American College of Radiology · **Versão:** v2022 · **Ano:** 2022

## Procedência e vigência
- Família: léxico
- Tipo de lógica: flat
- Modalidade: CT
- Fonte primária: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads
- Última verificação: 2026-07-24
- Última checagem: 2026-08-12

## Lógica de decisão
Use in screening only. Follow the cited outcome for management; category timing is measured from the exam currently being interpreted.

## Categorias

| Código | Rótulo | Critérios | Conduta | Risco | Localizador | Verificado |
| --- | --- | --- | --- | --- | --- | --- |
| 0 | Incomplete | Incomplete: a prior chest CT is being located for comparison, part or all of the lungs cannot be evaluated, or findings suggest an inflammatory/infectious process. | Obtain comparison with prior chest CT and/or additional lung-cancer-screening CT; for suspected infection/inflammation, 1-3 month LDCT. | Published estimated population prevalence ~1% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 0 row | ✓ |
| 1 | Negative | Negative: no lung nodules, or nodules with definitely benign features (complete/central/popcorn/concentric-ring calcification, or fat-containing). | Continue annual screening with 12-month LDCT. | Published estimated population prevalence 39% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 1 row | ✓ |
| 2 | Benign appearance or behavior | Benign by imaging features or indolent behavior. Includes: juxtapleural nodule under 10 mm with benign morphology; solid nodule under 6 mm at baseline or new under 4 mm; part-solid nodule with total mean diameter under 6 mm at baseline; non-solid (ground-glass) nodule under 30 mm at baseline/new/growing, or >=30 mm if stable/slowly growing; subsegmental airway nodule. | Continue annual screening with 12-month LDCT. | Published estimated population prevalence 45% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 2 row | ✓ |
| 3 | Probably benign | Probably benign. Includes: solid nodule 6 to under 8 mm at baseline (or new 4 to under 6 mm); part-solid nodule with total mean diameter >=6 mm and solid component under 6 mm at baseline (or new under 6 mm total); non-solid (ground-glass) nodule >=30 mm at baseline or new; thick-walled atypical cyst with a growing cystic component. | Short-interval follow-up with 6-month LDCT. If stable or decreased at that exam, reclassify as Lung-RADS 2 and obtain the next screening LDCT 12 months from the current exam. | Published estimated population prevalence 9% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 3 row | ✓ |
| 4A | Suspicious | Suspicious. Includes: solid nodule 8 to under 15 mm at baseline (or growing under 8 mm, or new 6 to under 8 mm); part-solid nodule with total mean diameter >=6 mm and solid component 6 to under 8 mm at baseline (or new/growing solid component under 4 mm); segmental or more proximal airway nodule at baseline; certain atypical pulmonary cysts (thick-walled, or multilocular at baseline, or one becoming multilocular). | 3-month LDCT; PET/CT may be considered when there is a solid nodule or solid component of 8 mm or larger. If stable or decreased at 3 months, reclassify as Lung-RADS 3 and obtain 6-month LDCT from that current exam; if again stable or decreased, step down to category 2 with 12-month LDCT from the latest exam. | Published estimated population prevalence 4% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 4A row | ✓ |
| 4B | Very suspicious | Very suspicious. Includes: solid nodule >=15 mm at baseline (or new/growing >=8 mm); part-solid nodule with solid component >=8 mm at baseline (or new/growing solid component >=4 mm); certain growing/atypical cysts; slow-growing solid or part-solid nodule that demonstrates growth over multiple screening exams; segmental or more proximal airway nodule that is stable or growing. | Diagnostic chest CT with or without contrast; PET/CT may be considered when there is a solid nodule or solid component >=8 mm; tissue sampling and/or referral for further clinical evaluation. Management depends on comorbidities, patient preference, and probability of malignancy. Slowly growing nodules may be PET-negative, so biopsy or surgical evaluation may be more appropriate when feasible. | Published estimated population prevalence 2% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 4B row | ✓ |
| 4X | Very suspicious with additional features | Category 3 or 4 nodules that carry additional features or imaging findings increasing suspicion for lung cancer (e.g., spiculation, lymphadenopathy, frank metastatic disease, a ground-glass nodule that doubles in size within a year). | Referral for further clinical evaluation (managed as a very-suspicious finding). | Published estimated population prevalence under 1% (this is a prevalence figure, not a probability of malignancy). | Lung-RADS v2022 assessment categories table, Category 4X row | ✓ |
| S | Significant non-lung-cancer finding modifier | Optional exam modifier added to a numeric Lung-RADS category 0-4 when there is a clinically significant or potentially clinically significant finding unrelated to lung cancer. Do not keep applying S to a finding that is already known and has been or is being evaluated unless there is an unexpected concerning change. | Manage according to the specific non-lung-cancer finding, using applicable ACR Incidental Findings recommendations or another appropriate clinical pathway; S does not alter the numeric Lung-RADS nodule category. | Not a lung-cancer risk category. S flags a separate significant or potentially significant incidental finding. | Lung-RADS v2022 Note 15 (Exam Modifier) and v2022 Summary of Changes, section II.B (S Modifier) | ✓ |

### Citações por categoria
- **0**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 0 row
- **1**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 1 row
- **2**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 2 row
- **3**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 3 row
- **4A**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 4A row
- **4B**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 4B row
- **4X**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 assessment categories table, Category 4X row
- **S**: ACR Lung-RADS Committee. Lung CT Screening Reporting and Data System (Lung-RADS) version 2022 (2022) — https://www.acr.org/Clinical-Resources/Clinical-Tools-and-Reference/Reporting-and-Data-Systems/Lung-Rads · Lung-RADS v2022 Note 15 (Exam Modifier) and v2022 Summary of Changes, section II.B (S Modifier)

## Referências cruzadas
- _fronteira compartilhada_ → [BI-RADS — Breast Imaging Reporting and Data System, 5th edition](https://radcommons.laudos.ai/systems/bi-rads-2013.md) — Shares the ACR Reporting and Data System framework that BI-RADS established.
- _fronteira compartilhada_ → [Fleischner — Fleischner Society 2017 pulmonary nodule guidelines](https://radcommons.laudos.ai/systems/fleischner-2017.md) — Both address pulmonary nodules on CT. Lung-RADS governs screening, Fleischner governs incidental nodules.

## Histórico de versões

| Data | Evento | Detalhe | Situação |
| --- | --- | --- | --- |
| 2022-11-01 | revised | Lung-RADS v2022 released, updating v1.1 (2019). | confirmed |


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> Conteúdo de referência reescrito. Confira a publicação primária vigente. Não é dispositivo médico nem substitui o julgamento clínico. O radiologista responsável pelo laudo permanece o autor e o responsável.

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