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Lung Cancer Screening Center Designation (Revised 5-20-2024)

Revision History

The ACR Lung Cancer Screening Center designation is unit-specific. All sites applying for this designation must meet the requirements outlined below, including having active ACR CT accreditation that includes the chest module on the designated unit(s).

A facility is eligible to receive the ACR Lung Cancer Screening Center designation if it meets the following basic criteria:

  • ACR CT accreditation in the chest module

  • Screening protocol meets minimum technical specifications, as detailed in the table below including the following

    • The CT lung cancer screening protocol should be based on an average sized patient (5'7", 154 lbs)

    • The radiation exposure levels should be consistent with lung screening protocols and not routine chest scans; the protocol should have a CTDIvol of ≤ 3mGy for a standard size patient (5'7", 154 lbs using a 32 cm diameter CTDI phantom)

    • Exposure values must be reduced for smaller sized patients and increased for larger sized patients using either manual methods (operator adjustment of technique via a technique chart) or automated methods (such as automatic tube current modulations and/or kV selection). 

  • Participation in the ACR Lung Cancer Screening Registry

  • Personnel qualifications including:

    • Lung cancer screening interpreting physicians: a minimum of 200 chest CT cases in prior 36 months

    • Medical physicists and radiologic technologists continue to meet the requirements of the CT accreditation program

  • Performance of lung cancer screening studies on the recommended screening population

  • Majority of patients screened are between the ages of 55 and 80

  • Have a smoking history of 30 pack years

  • If no longer smoking, stopped smoking in the past 15 years

  • Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery

  • Must use ACR Lung Imaging Reporting and Data System (Lung-RADS)

  • If the screening facility elects to accept self-referral individuals, they must have procedures for referring them to qualified health care providers if abnormal findings are present

  • Must follow the ACR Practice Parameter for Communication of Diagnostic Imaging Findings

  • Must have a mechanism in place to refer patients for smoking cessation counseling or provide smoking cessation materials

  • The CT equipment specification and performance must meet state and federal requirements and applicable ACR Practice Parameters and Technical Standards

  • CT scanners used for the purpose of lung cancer screening must be multidetector helical (spiral) CT scanners. (Non-helical and single detector CT scanners are not appropriate for lung cancer screening CT.)

  • The facility must maintain compliance with the Quality Control (QC) program as detailed in the ACR CT Quality Control Manual

  • Recommend participation in the ACR Dose Index Registry

We will review the materials to ensure your facility’s screening protocol meets the minimum requirements for ACR designation (see the technical specifications detailed in the table below).

The process of becoming an ACR Designated Lung Cancer Screening Center is a 2-step process: 

Step 1: After achieving ACR CT accreditation including but not limited to the chest module, submit an online application including information regarding your Lung Cancer Screening Center characteristics (Lung Cancer Screening Supervising Physician and contact person), accredited CT unit information, Lung Cancer Screening Questionnaire and associated invoice/fee of $400. 

Step 2: Submit an online testing packet to include the CT Lung Cancer Screening Data Form. NOTE: Image submission is not required. 

After completing our review, we will send a confidential report for each unit to the CT modality-specific supervising physician at the practice site. The report includes evaluation results, defines areas that can be improved and provides recommendations for the facility.

Facilities meeting the designation requirements will be identified as ACR Designated Lung Cancer Screening Centers by a symbol on the ACR Accredited Facility Search page. 


Designation Renewals

The ACR Lung Cancer Screening Center designation will remain effective for the duration of the unit’s CT accreditation period, as long as the unit maintains ACR CT accreditation of the chest module. Renewal of the designation will occur after the renewal of the CT accreditation is complete. Designation renewal requires submission of a new application, attestation, clinical data form and fee.


Payment Policy and Fees

The ACR Designated Lung Cancer Screening Center Fee is $400 per facility. Payment must be included with the application. Applications received without payment will not be processed. The following payment options are available:

  • Pay by Check: Make checks payable to the American College of Radiology and reference your ACR CT modality identification number on the check or stub.

            American College of Radiology

            P.O. Box 412722

            Boston, MA 02241-2722 

  • Credit card payments using VISA, MasterCard and American Express are accepted.

Fees are nonrefundable and are subject to change. 


Adult Lung Cancer Screening: Technical Specifications - Adult Chest for Lung Cancer Screening

Technique Parameters

(Items in bold are designation requirements - Failure to meet these requirements will result in deferral of designation)

Scan Parameter

Parameter Specification


Scanner Type

Multidetector helical (spiral) detector rows ≥ 4

Non-helical and single detector scanners are not appropriate for lung cancer screening CT

Required Series

No IV or oral contrast should be used


100 to 140 acceptable for standard sized patient

Should be set in combination with mAs to meet CTDIvol specifications


Should be set in combination with kVp to meet CTDIvol specifications

The mAs selected should result in diagnostic-quality images of the lungs Should take into account the patient’s body habitus and age, slice width, kVp, and unique attributes of the scanner and acquisition mode

Max. Tube Rotation Time

≤ 0.5 seconds

0.75 second is acceptable if a single breath hold ≤15 seconds can be achieved for scanners that cannot perform 0.5 second rotation time

Pitch (IEC Definition)

Between 0.7 and 1.5

Should be set with other technical parameters to achieve single breath hold scan and CTDIvol specifications


Single breath hold full inspiration

Scan Duration/Acquisition Time

≤ 15 seconds

Time to acquire the scan though entire lungs within a single breath

Reconstructed image width (nominal width of reconstructed image along z-axis)

≤ 2.5 mm

≤ 1 mm preferred

Reconstructed image spacing (Distance between two reconstructed images)

≤ slice width

Overlapping reconstructions are not necessary but are acceptable

Reconstruction Algorithm

Standard (mediastinum and lung) High spatial frequency (lung parenchyma) is optional.

Consistent with diagnostic CT studies; Iterative reconstruction algorithms encouraged


≤ 3 mGy for standard size patient

CTDIvol for a standard sized patient using the 32cm diameter CTDI phantom; standard sized patient is defined as 5'7" and 154 pounds

Adjustment in scanner output for patient size

Manual or automatic method (both are acceptable)

(1) manual adjustments in mAs for different sized patients or (2) use of automatic exposure controls including tube current modulation (CareDose4D, AutomA, etc.) and automated kV selection tools (CarekV)

Anatomical Coverage/Display

Scan Parameter

Parameter Specifications


Anatomical Coverage

Lung apex through the lung bases

The site should attempt to limit coverage to no more than 2 cm below the costophrenic sulci. Adrenals do not need to be imaged.

Gantry Tilt


Display Field of View

1 cm beyond the rib cage

Does not need to include entire chest wall thickness

Display Window Width/Level

Lung and Mediastinum

Lung: Allow adequate visualization of the lung parenchyma and intraparenchymal airways and vessels. WW = 1200 – 1500 HU WL = -550 – - 700 HU

Mediastinum: Allow visualization of the mediastinal and hilar vessels and allow distinction of the chest wall musculature from subcutaneous fat. WW = 250 – 450 HU WL = 40 – 80 HU

Additional Reformats

MPR and MIP are encouraged

MPR: Multiplanar reformation

MIP: Maximum intensity projection

This document is copyright protected by the American College of Radiology. Any attempt to reproduce, copy, modify, alter or otherwise change or use this document without the express written permission of the American College of Radiology is prohibited. 3-26-14

Revision History for this Article



Description of Revision(s)



Article created; FAQs incorporated; No criteria changes



Added new payment instructions


Edited process to apply for LCS Designation with new accreditation database


4th paragraph, changed first quarter of 2022 to first half of 2022


LCSD application process has been put on hold until the release of the new accreditation database


LCSD is available in the online accreditation system


Added personnel qualification criteria


Updated designation renewal section


Clarified designation requirements

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