Korelasi Kategori Lung-Rads Versi 2022 Berdasarkan Modalitas CT Scan Toraks Tanpa Kontras dengan Derajat Keganasan Lesi Paru

Alberta Vania Handoko, dr. Yana Supriatna, Ph.D, Sp.Rad, SubSp. RI (K).; dr. Wigati Dhamiyati, Sp.Rad, Sp.Onk.Rad(K)

2025 | Tesis-Spesialis | S2 Radiologi

Latar Belakang: Skrining kanker paru menggunakan CT dosis rendah terbukti menurunkan mortalitas,  namun masih menghadapi tantangan berupa tingginya angka hasil positif palsu. Sistem klasifikasi Lung Imaging Reporting and Data System (Lung-RADS) dikembangkan untuk menstandarkan pelaporan dan meningkatkan akurasi penilaian lesi paru. Meskipun performa statistik Lung-RADS telah banyak diteliti, kajian mengenai korelasinya dengan temuan histopatologi sebagai standar emas diagnosis masih terbatas, khususnya untuk Lung-RADS versi 2022.

Tujuan: Mengetahui korelasi antara kategori Lung-RADS versi 2022 pada CT scan toraks tanpa kontras dengan temuan histopatologi lesi paru.

Metode: Penelitian analitik observasional dengan desain potong lintang dilakukan secara retrospektif di RSUP Dr. Sardjito Yogyakarta. Subjek penelitian adalah 54 pasien berusia ?18 tahun dengan lesi paru pada CT toraks tanpa kontras yang memiliki hasil histopatologi. Kategori Lung-RADS versi 2022 ditentukan secara independen oleh dua dokter spesialis radiologi dan diuji reliabilitas interobserver menggunakan Cohen’s weighted kappa. Analisis korelasi antara kategori Lung- RADS dan temuan histopatologi dilakukan menggunakan uji korelasi Spearman.

Hasil: Reliabilitas interobserver penilaian kategori Lung-RADS menunjukkan kesepakatan sangat kuat (weighted kappa = 0,946; p < 0 xss=removed>

Kesimpulan: Terdapat korelasi yang kuat dan bermakna antara kategori Lung- RADS versi 2022 pada CT toraks tanpa kontras dengan temuan histopatologi lesi paru. Hasil ini mendukung validitas klinis Lung-RADS sebagai sistem pelaporan terstruktur dalam penilaian risiko keganasan lesi paru

Background: Low-dose computed tomography (CT) screening has been shown to reduce lung cancer mortality; however, a high false-positive rate remains a major limitation. The Lung Imaging Reporting and Data System (Lung-RADS) was developed to standardize reporting and improve diagnostic accuracy of pulmonary lesions. Despite extensive evaluation of its statistical performance, evidence regarding its correlation with histopathological findings as the diagnostic gold standard remains limited, particularly for Lung-RADS version 2022.

Objective: To evaluate the correlation between Lung-RADS version 2022 categories on non-contrast chest CT and histopathological findings of pulmonary lesions.

Methods: This retrospective cross-sectional analytical study was conducted at Dr. Sardjito General Hospital, Yogyakarta. A total of 54 patients aged ?18 years with pulmonary lesions on non-contrast chest CT and available histopathological results were included. Lung-RADS v2022 categories were independently assessed by two experienced  radiologists.  Interobserver reliability  was  analyzed  using Cohen’s weighted kappa. The correlation between Lung-RADS categories and histopathological outcomes was evaluated using Spearman’s correlation test.

Results: Interobserver agreement for Lung-RADS categorization was excellent (weighted kappa = 0.946; p < 0 r  =0.704;>

Conclusion: There is a strong and statistically significant correlation between Lung-RADS version 2022 categories on non-contrast chest CT and histopathological findings of pulmonary lesions. These results support the clinical validity of Lung-RADS as a structured reporting system for assessing malignancy risk in pulmonary lesions.

Kata Kunci : Lung-RADS 2022, CT toraks, lesi paru, histopatologi, kanker paru