Thoracic Imaging - Lung cancer

The Fleischner Society pulmonary nodule follow-up recommendations:

SUBSOLID NODULES

<i>Thoracic Imaging - Lung cancer<br></i><br>The&nbsp;<strong>Fleischner Society pulmonary nodule follow-up recommendations:<br></strong><br>SUBSOLID NODULES<br><br><div>Multiple subsolid nodules &lt;6 mm&nbsp;<strong>(</strong>&lt;100 mm³)<ul><li><div>{{c1::CT at 3-6 months, then if stable consider CT at 2 and 4 years in high-risk patients::f/u?}}</div></li></ul>Multiple subsolid nodules ≥6 mm (&gt;100 mm³)<ul><li><div>{{c2::CT at 3-6 months, then subsequent management based on the most suspicious nodule(s)::f/u?}}</div></li></ul></div>

<div> <div> <div><div><i>Source: Radiopedia&nbsp;<a href="https://radiopaedia.org/articles/fleischner-society-pulmonary-nodule-recommendations-1?lang=us">Fleischner Society pulmonary nodule recommendations | Radiology Reference Article | Radiopaedia.org</a></i></div><br><div>The&nbsp;<strong>Fleischner Society pulmonary nodule recommendations</strong>&nbsp;pertain to the follow-up and management of indeterminate&nbsp;<a href="https://radiopaedia.org/articles/pulmonary-nodule-1?lang=us">pulmonary nodules</a>&nbsp;detected incidentally on CT and are published by the&nbsp;<a href="https://radiopaedia.org/articles/fleischner-society?lang=us">Fleischner Society</a>. The guideline does not apply to lung cancer screening, patients younger than 35 years, or patients with a history of primary cancer or immunosuppression.</div><div>NB: This article reflects the 2017 revision&nbsp;⁴, which supersedes prior versions published in 2005&nbsp;^1&nbsp;and 2013&nbsp;².</div><br>Solid nodules</div><div>Single</div><div>Single solid nodule &lt;6 mm (&lt;100 mm³)<ul><li><div>low-risk patients: no routine follow-up required</div></li><li><div>high-risk patients: optional CT at 12 months (particularly with suspicious nodule morphology and/or upper lobe location; see "risk assessment" below)</div></li></ul>Solitary solid nodule 6-8 mm (100-250 mm³)<ul><li><div>low-risk patients: CT at 6-12 months, then consider CT at 18-24 months</div></li><li><div>high-risk patients:&nbsp;CT at 6-12 months, then CT at 18-24 months</div></li></ul>Solitary solid nodule &gt;8 mm (&gt;250 mm³)<ul><li><div>low-risk and high-risk patients: consider CT at 3 months,&nbsp;PET-CT, or tissue sampling</div></li></ul>Multiple</div><br><div>Multiple solid nodules &lt;6 mm (&lt;100 mm³)<ul><li><div>low-risk patients: no routine follow-up required</div></li><li><div>high-risk patients: optional CT at 12 months</div></li></ul>Multiple solid nodules &gt;6 mm (&gt;100 mm³)<ul><li><div>low-risk patients: CT at 3-6 months, then consider CT at 18-24 months</div></li><li><div>high-risk patients: CT at 3-6 months, then CT at 18-24 months</div></li></ul><div>When multiple nodules are present, the most suspicious nodule should guide further individualized management.</div>Subsolid nodules</div><div>Single</div><div>Single ground glass nodule &lt;6 mm (&lt;100 mm³)<ul><li><div>no routine follow-up required</div></li></ul>Single ground glass nodule ≥6 mm (&gt;100 mm³)<ul><li><div>CT at 6-12 months, then if persistent,&nbsp;CT every 2 years until 5 years</div></li></ul>Single part-solid nodule ≥6 mm (&gt;100 mm³)<ul><li><div>CT at 3-6 months, then if persistent and solid component remains &lt;6 mm, annual CT until 5 years</div></li></ul>Multiple</div><div>Multiple subsolid nodules &lt;6 mm&nbsp;<strong>(</strong>&lt;100 mm³)<ul><li><div>CT at 3-6 months, then if stable consider CT at 2 and 4 years in high-risk patients</div></li></ul>Multiple subsolid nodules ≥6 mm (&gt;100 mm³)<ul><li><div>CT at 3-6 months, then subsequent management based on the most suspicious nodule(s)</div></li></ul></div> </div> </div>

<img src="0036_2E.png">