Table 2.
Comparison of current guidelines for solid nodule management [27].
| Nodule Dimensions |
The Fleischner Society [19] |
American College of Chest Physicians [24] |
British Thoracic Society [25] |
Lung CT Screening Reporting and Data System * [26] |
|---|---|---|---|---|
| <6 mm | LR, no FU HR, 12 mo FU |
LR, ≤4 mm no FU LR, >4–6 mm or HR, ≤4 mm, 12 mo FUHR, >4–6 mm, 6–12 mo FU |
<5 mm, no FU5–6 mm, 12–24 mo FU | <6 mm, AS (cat 2) |
| ≥6 mm to 8 mm | LR and HR, 6–12 mo FU, then re-evaluate |
LR, 6–12 mo FU HR, 3–6 mo FU |
3 mo FU then 12 mo FU | ≥6 mm or new nodules 4–6 mm, 6 mo LDCT (cat 3) |
| ≥8 mm | CT or PET/CT at 3 mo |
<5% risk, 3 mo FU; 5–65% risk, PET/CT and/or biopsy; >65% risk, treatment |
<10% risk, surveillance; >10% risk, PET/CT or consider resection | 8–15 mm, 3 mo LDCT (cat 4A) >15 mm (cat 4B) |
* Lung-RADS® version 1.1; assessment categories release date: 2019. High-risk factors include older age, heavy smoking, larger nodule size, irregular or spiculated margins, and upper lobe location. HR = high risk; LR = low risk; mo = months; FU = follow-up; AS = annual screening; cat = category; LDCT = low-dose computed tomography.