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Solitary Pulmonary Nodule

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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/


Diagnosis

Solitary Pulmonary Nodule



Solitary Pulmonary Nodule Solitary-Pulmonary-Nodule-Guidelines-from-the-Fleischner-Society

Solitary-Pulmonary-Nodule-Guidelines-from-the-Fleischner-Society

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