This review article, published in Radiologic Clinics of North America, synthesizes the state of lung cancer screening (LCS) as of 2025. It examines risk-based eligibility criteria beyond fixed pack-year thresholds (including PLCOm2012 and Sybil), advances in low-dose CT (LDCT) technology (ultra-low-dose CT, deep learning-based image reconstruction), the Lung-RADS 2022 update, and the evolving role of AI-assisted tools for nodule detection and characterization. Notably, the review presents a comprehensive table (Table 1) of FDA-cleared commercial AI platforms in which AVIEW and AVIEW LCS (Coreline Soft) are listed as FDA-cleared Medical Image Management and Processing Systems (MIMPS) for nodule detection and classification. AI tools are highlighted for their contributions to nodule tracking, volumetric growth analysis, and potential 26% reduction of interpretation time, while emphasizing the ongoing need for radiologist oversight. Future directions include personalized screening intervals and improved equity in LCS programs.
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