Seminars in ultrasound, CT, and MR
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Lung cancer is the leading cause of cancer death in both men and women in the United States. The National Lung Screening Trial (NLST) demonstrated that low-dose computed tomography (CT) screening reduces lung cancer mortality by 20% compared to screening with chest radiography. Currently, many institutions in the US are implementing lung cancer screening programs. ⋯ Lung-RADS will also facilitate outcome monitoring and future auditing of lung cancer screening programs, assist research, and consequently refine and improve lung cancer screening practices. Familiarity with lung-RADS version 1.0 is essential not only for radiologists interpreting low-dose computed tomography screening studies, but all medical personnel involved in multidisciplinary lung cancer screening programs. This article reviews the Lung-RADS categories and management recommendations using a case-based approach.
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The incidental pulmonary nodule is commonly encountered when interpreting chest CTs. The management of pulmonary nodules requires a multidisciplinary approach entailing integration of nodule size and features, clinical risk factors, and patient preference and comorbidities. Guidelines have been issued for the management of both solid and subsolid nodules, with the Fleischner Society issuing revised guidelines in 2017. This article focuses on the CT imaging characteristics and clinical behavior of pulmonary nodules, with review of the current management guidelines that reflect this knowledge.