Lung-RADS Reduces False Positives, But Also Sensitivity

Low-dose CT screening for lung cancer following Lung-RADS criteria may reduce false positives, but it also decreases sensitivity.

Lung cancer screening with low-dose computed tomography may substantially reduce the false-positive result rate, but sensitivity is also decreased, according to a study published in the Annals of Internal Medicine.

Researchers from several states performed a study to assess the retrospective application of the Lung-RADS criteria to the National Lung Screening Trial (NLST).

The study included 26,722 participants (aged 55 to 74) who had undergone three annual low-dose computed tomography (LDCT) scans. The subjects had at least a 30–pack-year history of smoking, and were current smokers or had quit within the past 15 years.

The results showed that 26,455 participants received a baseline screen and 48,671 screenings were performed after baseline.

 
At baseline
After baseline
False-positive rate for Lung-RADS
12.8%
5.3%
False-positive rate for NLST
26.6%
21.8%
Baseline sensitivity for Lung-RADS
84.9%
78.6%
Baseline sensitivity for NLST
93.5%
93.8%

 

 

 

 

 

 

The researchers concluded that while Lung-RADS may substantially reduce the false-positive result rate, sensitivity is also decreased. They suggest that the effect of using Lung-RADS criteria in clinical practice must be carefully studied.

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