3.

Fleischner学会关于CT检查发现的肺内伴实性结节的随访建议

Recommendations for the management of subsolid pulmonry nodules detected at CT: A statement from the Fleischner scocity

Nodule type	Management recommendations	Additional remarks
GGN, ground glass nodule; These guidelines assume meticulous evaluation, optimally with contiguous thin sections (1 mm) reconstructed with narrow and/or mediastinal windows to evaluate the solid component and wide and/or lung windows to evaluate the nonsolid component of nodules, if indicated. The use of a consistent low-dose technique is recommended. With serial scans, always compare with the original baseline study to detect subtle indolent growth.
Solitary pure GGNs
≤5 mm	No CT follow-up required	Obtain contiguous 1 mm thick sections to confirm that nodule is truly a pure GGN
> 5 mm	Initial follow-up CT at 3 months to confirm persistence then annual surveillance CT for a minimum of 3 years	FDG PET is of limited value, potentially misleading, and therefore not recommended
Solitary part-solid nodules	Initial follow-up CT at 3 months to confirm persistence. If persistent and solid component < 5 mm，then yearly surveillance CT for a minimum of 3 years. If persistent and solid component ≥5 mm，then biopsy or surgical resection	Consider PET/CT for part-solid nodules > 10 mm
Multiple subsolid nodules
Pure GGNs ≤5 mm	Obtain follow-up CT at 2 and 4 years	Consider alternate causes for multiple GGNs ≤5 mm
Pure GGNs > 5 mm without a dominant lesion (s)	Initial follow-up CT at 3 months to confirm persistence and then annual surveillance CT for a minimum of 3 years	FDG PET is of limited value, potentially misleading, and therefore not recommended
Dominant nodule (s) with part-solid or solid component	Initial follow-up CT at 3 months to confirm persistence. If persistent biopsy or surgical resection is recommended, especially for lesions with > 5 mm solid component	Consider lung-sparing surgery for patients with dominant leision (s) suspicious for lung cancer