BACKGROUND: Pulmonary nodules are spherical radiographic opacities that measure up to 30 mm in diameter. Nodules are extremely common in clinical practice and challenging to manage, especially small, "subcentimeter" nodules. Identification of malignant nodules is important because they represent a potentially curable form of lung cancer. METHODS: We developed evidence-based clinical practice guidelines based on a systematic literature review and discussion with a large, multidisciplinary group of clinical experts and other stakeholders. RESULTS: We generated a list of 29 recommendations for managing the solitary pulmonary nodule (SPN) that measures at least 8 to 10 mm in diameter; small, subcentimeter nodules that measure < 8 mm to 10 mm in diameter; and multiple nodules when they are detected incidentally during evaluation of the SPN. Recommendations stress the value of risk factor assessment, the utility of imaging tests (especially old films), the need to weigh the risks and benefits of various management strategies (biopsy, surgery, and observation with serial imaging tests), and the importance of eliciting patient preferences. CONCLUSION: Patients with pulmonary nodules should be evaluated by estimation of the probability of malignancy, performance of imaging tests to characterize the lesion(s) better, evaluation of the risks associated with various management alternatives, and elicitation of patient preferences for treatment.
BACKGROUND: Pulmonary nodules are spherical radiographic opacities that measure up to 30 mm in diameter. Nodules are extremely common in clinical practice and challenging to manage, especially small, "subcentimeter" nodules. Identification of malignant nodules is important because they represent a potentially curable form of lung cancer. METHODS: We developed evidence-based clinical practice guidelines based on a systematic literature review and discussion with a large, multidisciplinary group of clinical experts and other stakeholders. RESULTS: We generated a list of 29 recommendations for managing the solitary pulmonary nodule (SPN) that measures at least 8 to 10 mm in diameter; small, subcentimeter nodules that measure < 8 mm to 10 mm in diameter; and multiple nodules when they are detected incidentally during evaluation of the SPN. Recommendations stress the value of risk factor assessment, the utility of imaging tests (especially old films), the need to weigh the risks and benefits of various management strategies (biopsy, surgery, and observation with serial imaging tests), and the importance of eliciting patient preferences. CONCLUSION:Patients with pulmonary nodules should be evaluated by estimation of the probability of malignancy, performance of imaging tests to characterize the lesion(s) better, evaluation of the risks associated with various management alternatives, and elicitation of patient preferences for treatment.
Authors: Michael M Slattery; Claire Foley; Dermot Kenny; Richard W Costello; P Mark Logan; Michael J Lee Journal: Eur Radiol Date: 2012-04-27 Impact factor: 5.315
Authors: Hamid Pahlevaninezhad; Anthony M D Lee; Alexander Ritchie; Tawimas Shaipanich; Wei Zhang; Diana N Ionescu; Geoffrey Hohert; Calum MacAulay; Stephen Lam; Pierre Lane Journal: Biomed Opt Express Date: 2015-09-30 Impact factor: 3.732
Authors: Paul J Nietert; James G Ravenel; William M Leue; James V Miller; Katherine K Taylor; Elizabeth S Garrett-Mayer; Gerard A Silvestri Journal: Chest Date: 2009-01-13 Impact factor: 9.410
Authors: Johan Coolen; Johan Vansteenkiste; Frederik De Keyzer; Herbert Decaluwé; Walter De Wever; Christophe Deroose; Christophe Dooms; Eric Verbeken; Paul De Leyn; Vincent Vandecaveye; Dirk Van Raemdonck; Kristiaan Nackaerts; Steven Dymarkowski; Johny Verschakelen Journal: Eur Radiol Date: 2013-10-31 Impact factor: 5.315