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:
ACR Lung Cancer Screening Center application form with facility demographics, supervising physician and CT unit information
Signed attestation form
Lung cancer screening protocol in a clinical data form, for each unit
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.
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 and will be returned if payment is not received within 30 days. Make checks payable to the American College of Radiology and reference your ACR CT modality identification number on the check or stub. 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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