Pulmonary nodule medical therapy: Difference between revisions
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{{Solitary pulmonary nodule}} | {{Solitary pulmonary nodule}} | ||
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==Overview== | ==Overview== | ||
The optimal management approach of solitary pulmonary nodule will mainly depend on the nodule size and growth. Other parameters, such as: location, and distribution may also be helpful for the therapeutical management of solitary pulmonary nodule. Moreover, the solitary pulmonary nodule risk assessment is useful to determine the likelihood for malignancy and prompt treatment. Surgical resection is often recommended among patients with the malignant likelihood of solitary pulmonary nodule. On the other hand, solitary pulmonary nodules with benign features are eligible for periodic CT surveillance. | |||
==Medical Therapy== | ==Medical Therapy== | ||
===Recommendations for Follow-up and Management of Nodules <8 mm Detected Incidentally at Non-screening CT=== | ===Recommendations for Follow-up and Management of Nodules <8 mm Detected Incidentally at Non-screening CT=== | ||
Revision as of 21:33, 15 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
The optimal management approach of solitary pulmonary nodule will mainly depend on the nodule size and growth. Other parameters, such as: location, and distribution may also be helpful for the therapeutical management of solitary pulmonary nodule. Moreover, the solitary pulmonary nodule risk assessment is useful to determine the likelihood for malignancy and prompt treatment. Surgical resection is often recommended among patients with the malignant likelihood of solitary pulmonary nodule. On the other hand, solitary pulmonary nodules with benign features are eligible for periodic CT surveillance.
Medical Therapy
Recommendations for Follow-up and Management of Nodules <8 mm Detected Incidentally at Non-screening 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.[1]
- 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.
References
- ↑ Heber MacMahon, John H. M. Austin, Gordon Gamsu, Christian J. Herold, James R. Jett, David P. Naidich, Edward F. Patz, Jr, and Stephen J. Swensen. Guidelines for Management of Small Pulmonary Nodules Detected on CT Scans: A Statement from the Fleischner Society. Radiology 2005 237: 395-400.