Table 2. Summary of the Fleischner Society guidelines for the management of subsolid pulmonary nodules (10).
Nodule type | Recommendation |
---|---|
Solitary pure GGN <5 mm (assessed with contiguous CT sections of <1 mm) | |
≤5 mm | No follow up |
>5 mm | Follow up with CT at 3 months, and then yearly monitoring for a minimum of 3 years if persistant and unchanged. (FDG-PET is of limited value and therefore not recommended) |
Subsolid GGNs | Follow up with CT at 3 months to confirm persistence |
<5 mm | If persistent and solid measuring <5 mm, then yearly CT monitoring for a minimum of 3 years |
≥5 mm | If persistent and solid measuring ≥5 mm, then biopsy or surgical resection should be considered. If subsolid nodules measure >10 mm FDG PET should be considered for further evaluation |
Multiple subsolid nodules | Follow up with CT at 3 months to confirm persistence |
Pure GGNs ≤5 mm | Follow up CT at 2 and 4 years to monitor. If persistent and solid measuring <5 mm, then yearly CT monitoring for a minimum of 3 years |
Pure GGNs >5 mm with no dominant lesion | If persistent biopsy or surgical resection should be considered, especially if lesion has a >5 mm solid component |
Dominant nodule with subsolid or solid component |
GGN, ground glass nodule; CT, computed tomography.