🫁 Pulmonary Nodule Lung-RADS v2022 Category
UseClassify a nodule on low-dose CT lung-cancer screening and set the follow-up.
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SourceACR Lung-RADS v2022. American College of Radiology
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
For screening only — use Fleischner for incidental non-screening nodules.
When to use
Classify a nodule on low-dose CT lung-cancer screening and set the follow-up.
How it works
Solid: < 6 → 2, 6–< 8 → 3, 8–< 15 → 4A, ≥ 15 → 4B. Part-solid scored by solid component (< 6 → 3, 6–< 8 → 4A, ≥ 8 → 4B). Pure ground-glass: < 30 → 2, ≥ 30 → 3.
Key points
- For screening only — use Fleischner for incidental non-screening nodules.
- Additional suspicious features (spiculation, bubbly lucency, adenopathy) upgrade to 4X.
- New or growing nodules use lower thresholds (growth ≥ 1.5 mm).
- 4A → 3-month LDCT (add PET/CT if solid component ≥ 8 mm); 4B → diagnostic CT/PET/sampling.
- China reference line: the China National Lung Cancer Screening Guideline with LDCT (2025 Version), read side by side with Lung-RADS. A solid nodule, or the solid component of a part-solid nodule, with a mean diameter ≥ 6 mm is positive in both; a non-solid nodule is already a positive baseline at ≥ 8 mm in China (repeat CT at 6 months), whereas Lung-RADS places pure ground-glass in category 3 only at ≥ 30 mm. This tool's screening categories follow Lung-RADS v2022.
- The screening chapter of the Oncology Society of Chinese Medical Association lung cancer guideline (2026 edition) uses different criteria: risk assessment from age 45, a positive baseline at a solid nodule or solid component ≥ 5 mm (non-solid ≥ 8 mm), and annual screening, with intervals longer than 2 years not recommended. This tool does not calculate by those criteria.
- Quality control (Oncology Society of Chinese Medical Association, 2026): target mean effective dose for LDCT < 1 mSv; use iterative or deep-learning reconstruction where available; AI reads must be reviewed by a radiologist (false negatives occur in central and mediastinal lesions).
- Two site rules (not guideline text): low-dose CT from a health-check centre is treated as screening (Lung-RADS), while standard-dose health-check chest CT is treated as incidental (Fleischner); a trailing 5 rounds up (Lung-RADS keeps one decimal, so 5.95 mm counts as 6.0 mm; Fleischner rounds to whole millimetres, so 5.5 mm counts as 6 mm).
References
- [Guideline / primary source]ACR Lung-RADS v2022. American College of Radiology
- [Guideline / primary source]Chinese Expert Group on Early Diagnosis and Treatment of Lung Cancer; China Lung Oncology Group. China National Lung Cancer Screening Guideline with Low-dose Computed Tomography (2025 Version) [in Chinese]. Zhongguo Fei Ai Za Zhi 2025;28(12):887-895. doi:10.3779/j.issn.1009-3419.2025.102.43
- [Guideline / primary source]Oncology Society of Chinese Medical Association. Oncology Society of Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2026 edition) [in Chinese]. Zhonghua Zhong Liu Za Zhi 2026;48(9):1023-1059. doi:10.3760/cma.j.cn112152-20260511-00228
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Nodule type | Part-solid |
|---|---|
| Mean diameter = (long axis + short axis) / 2 | 5.5 mm |
| Solid component diameter (if part-solid) | 5 mm |
→CategoryLung-RADS 2
- Category：Lung-RADS 2 (malignancy likelihood < 1%)
- Management：Benign appearance/behaviour: 12-month LDCT, continue annual screening
- Read：Type: part-solid (solid component 5 mm), mean diameter 5.5 mm (baseline-screen thresholds)
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Pulmonary Nodule Lung-RADS v2022 Category?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Pulmonary Nodule Lung-RADS v2022 Category upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Pulmonary Nodule Lung-RADS v2022 Category calculated in practice? Can you show a worked example?
- Inputs: Nodule type Part-solid, Mean diameter = (long axis + short axis) / 2 5.5 mm, Solid component diameter (if part-solid) 5 mm → Result: Category Lung-RADS 2（Category: Lung-RADS 2 (malignancy likelihood < 1%), Management: Benign appearance/behaviour: 12-month LDCT, continue annual screening, Read: Type: part-solid (solid component 5 mm), mean diameter 5.5 mm (baseline-screen thresholds)）