Solitary Pulmonary Nodule
Publication date: September 3, 2012 | Updated on June 27, 2017
Report
Diagnosis
Solitary Pulmonary Nodule
History
Fleischner Guidelines for pulmonary nodules - 2017
If solid nodule
<6mm
6-8mm
>8mm
Notes
Single
Low risk
No routine f/u
CT at 6-12 months, then consider CT at 18-24 months
Consider CT, PET/CT or biopsy at 3 months
<6mm do not require f/u, but high risk patient or nodule characteristics may warrant 12 month f/u.
High risk
Optional 12 month CT
CT at 6-12 months, then consider CT at 18-24 months
Consider CT, PET/CT or biopsy at 3 months
Multiple
Low risk
No routine f/u
CT at 3-6 months, then consider CT at 18-24 months
Use most suspicious nodule to guide management
High risk
Optional 12 month CT
CT at 3-6 months, then at 18-24 months
If partsolid (subsolid or groundglass) nodule
Sub-solid nodule
<6mm
≥6 mm
Notes
Single
Ground glass
No routine f/u
CT at 6-12 mo to confirm persistence, then q 2 years until 5 years
For suspicious nodules <6mm, consider 2 and 4 year f/u.
Part solid
No routine f/u
CT at 3-6 months to confirm persistence. If stable and <6mm solid component, then q12 months for 5 years
<6mm part solid nodules too small to be defined. Persistent part-solid nodules with >6mm solid component are highly suspicious.
Multiple
CT at 3-6 months. If stable, consider CT at 2 and 4 years
CT at 3-6 months. Subsequent management based on most suspicious nodule(s)
Multiple <6mm ground-glass nodules usually benign. May consider f/u at 2 and 4 years in high-risk patients.
http://pubs.rsna.org/doi/full/10.1148/radiol.2017161659#
https://radiology-universe.org/2017_Fleischner_Society_Pulmonary_Nodule_Follow-Up_New_Guidelines_Recommendations/