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
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
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.
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
(Items in bold are designation requirements - Failure to meet these requirements will result in deferral of designation)
Multidetector helical (spiral) detector rows ≥ 4
Non-helical and single detector scanners are not appropriate for lung cancer screening CT
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
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)
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.
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
MPR and MIP are encouraged
MPR: Multiplanar reformation
MIP: Maximum intensity projection
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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