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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.