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Semin Respir Crit Care Med 2022; 43(06): 851-861
DOI: 10.1055/s-0042-1753474
Review Article

Evaluation and Management of Indeterminate Pulmonary Nodules on Chest Computed Tomography in Asymptomatic Subjects: The Principles of Nodule Guidelines

Ju G. Nam
1   Department of Radiology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
,
Jin Mo Goo
1   Department of Radiology, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea
2   Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
3   Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
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Abstract

With the rapidly increasing number of chest computed tomography (CT) examinations, the question of how to manage lung nodules found in asymptomatic patients has become increasingly important. Several nodule management guidelines have been developed that can be applied to incidentally found lung nodules (the Fleischner Society guideline), nodules found during lung cancer screening (International Early Lung Cancer Action Program protocol [I-ELCAP] and Lung CT Screening Reporting and Data System [Lung-RADS]), or both (American College of Chest Physicians guideline [ACCP], British Thoracic Society guideline [BTS], and National Comprehensive Cancer Network guideline [NCCN]). As the radiologic nodule type (solid, part-solid, and pure ground glass) and size are significant predictors of a nodule's nature, most guidelines categorize nodules in terms of these characteristics. Various methods exist for measuring the size of nodules, and the method recommended in each guideline should be followed. The diameter can be manually measured as a single maximal diameter or as an average of two-dimensional diameters, and software can be used to obtain volumetric measurements. It is important to properly evaluate and measure nodules and familiarize ourselves with the relevant guidelines to appropriately utilize medical resources and minimize unnecessary radiation exposure to patients.

Keywords

lung nodule - lung cancer screening - lung nodule management - CT


Publication History

Article published online:
08 July 2022

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