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 in 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

  • Participation in the ACR Lung Cancer Screening Registry


Sites applying to be an ACR Designated Lung Cancer Screening Center, initial or renewal cycle, must submit the information listed below via the Lung Cancer Screening Designation Application. Please make sure you complete all sections of the application online:

  1. ACR Lung Cancer Screening Center application form with facility demographics, supervising physician and CT unit information

  2. Signed attestation form

  3. Lung cancer screening protocol in a clinical data form, for each unit

  4. Fee


If you are adding a new unit mid-cycle to a current designation, you do not need to submit the entire application. Please access the New Unit Data Form to provide the new unit information only. There is no additional fee. Please note this link is only for adding additional units to a current designation, it is not for the renewal of the designation. 


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).

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. Facilities that do not meet the designation requirements must submit corrective action within 30 days of the final report in order to be reconsidered.

 

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. To avoid a lapse in the designation, renewal should be submitted at the time of CT accreditation renewal. 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

Comments

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

kV

100 to 140 acceptable for standard sized patient

Should be set in combination with mAs to meet CTDIvol specifications

mAs

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

Respiration

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

CTDIvol

≤ 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

Comments

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

None


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

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Revision History for this Article

Date

Section

Description of Revision(s)

12-12-19

All

Article created; FAQs incorporated; No criteria changes

3-30-2020Payment Added new payment instructions