Impact of lung-RADS classification system on the accurate diagnosis of pulmonary nodular lesions in oncology patients

Background Lung assessment is highly recommended in the management of oncology patients as it is the commonest affected site in metastatic dissemination. The low-dose CT with nodule reporting system based on Lung Reporting and Data System (lung-RADS) is a promising non-invasive tool for the characterization of incidentally detected pulmonary nodules. The authors aimed to assess the accuracy of the "lung-RADS" classification system as a non-invasive tool for the characterization of any newly developed pulmonary nodules among oncology patients. Ethics committee approval and informed written consent were obtained from the studied patients. A non-contrast LDCT study was performed on all patients with a nodule reporting system based on the lung-RADS classification system applied for evaluation of each detected pulmonary nodule. Diagnoses were established using the help of either histopathology or follow-up clinical results as a gold standard. Results In this prospective study, we enrolled 187 known malignancy patients with 200 suspicious newly developed pulmonary nodules. Their mean patient age was 48.4 +/- 9.7 years. The studied 200 pulmonary nodular lesions were categorized using a nodule reporting system based on the lung-RADS into 6 sub-groups with 122 lesions found to be malignant and 78 lesions were of benign etiology, which showed a high sensitivity of 92.08%, specificity of 78.79%, and accuracy of 85.50% with 81.58% positive predictive value and 90.70% negative predictive value in the diagnosis of pulmonary nodules in cancer patients. Conclusion Low-density CT with a nodule reporting system based on the lung-RADS classification system was found to be an accurate non-invasive tool to characterize and to risk stratify pulmonary nodules in oncology patients.