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Fleischner society pulmonary nodule recommendations
Recommendations for Follow-up and Management of Nodules Smaller than 8 mm Detected Incidentally at Nonscreening CT
| Nodule Size (mm) | Low risk patients | High risk patients |
|---|---|---|
| Less than or equal to 4 | No follow-up needed. | Follow-up at 12 months. If no change, no further imaging needed. |
| >4 - 6 | Follow-up at 12 months. If no change, no further imaging needed. | Initial follow-up CT at 6 -12 months and then at 18 - 24 months if no change. |
| >6 - 8 | Initial follow-up CT at 6 -12 months and then at 18 - 24 months if no change. | Initial follow-up CT at 3 - 6 months and then at 9 -12 and 24 months if no change. |
| >8 | Follow-up CTs at around 3, 9, and 24 months. Dynamic contrast enhanced CT, PET, and/or biopsy | Same at for low risk patients |
Note.—Newly detected indeterminate nodule in persons 35 years of age or older.
- Low risk patients: Minimal or absent history of smoking and of other known risk factors.
- High risk patients: History of smoking or of other known risk factors.