Fleischner's

Lung nodule size < 3 centimeters (3mm) age > 35

Break up into Single vs Multiple then Solid verse subsolid then low, medium, high size

Multiple break up into Single multiple then ground glass or partly solid

 

Single Solid Nodule

single nodule low risk small nodule (<6) no routine follow up

single nodule low risk medium nodule (6-8mm) CT 6-12 month then CT 18-24 month

single nodule low risk large nodule (>8mm) CT at 3 month then PET/CT or tissue sampling

single nodule high risk small nodule (<6) optional CT at 12 month

single nodule high risk medium nodule (6-8mm) CT 6-12 month then CT 18-24 month

single nodule high risk large nodule (>8mm) CT at 3 months then PET/CT or tissue sampling

Multiple Solid Nodules

multiple nodule low risk small nodule (<6mm) no routine follow up

multiple nodule low risk medium nodule (6-8mm) CT 3-6 month then CT 18-24 month

multiple nodule low risk large nodule (>8mm) CT 3-6 month then CT 18-24 month

multiple nodule high risk small nodule (<6mm) optional CT at 12 month

multiple nodule high risk medium nodule (6-8mm) CT 3-6 month then CT 18-24 month

multiple nodule high risk large nodule (>8mm) CT 3-6 month then CT 18-24 month

Subsolid nodule

Single subsolid nodule ground glass < 6mm no routine follow up

Single subsolid nodule ground glass > 6mm CT at 6-12 month, CT q2year until 5 years

Single subsolid nodule partly solid < 6mm no routine follow up

Single subsolid nodule partly solid > 6mm CT at 3-6 month, CT q1year until 5 years

Multiple subsolid nodules < 6mm CT at 3-6 month, CT at 2 and 4 years

Multiple subsolid nodules > 6mm CT at 3-6 month, subsequent management based upon suspicion