Lung Nodule Management

Lung Nodule Management

Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines

https://pubmed.ncbi.nlm.nih.gov/23649456/

Guideline

Reference: Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e93S-e120S.

Summary: This is the 2013 successor to the second edition ACCP guidelines on management of pulmonary nodules from 2007. This guideline provides recommended follow up and interventions based upon the best evidence available at the time. Although the guideline was released after the 2011 NLST, this guideline does not discriminate between lung nodules identified incidentally or by screening. It does include a review of terminology and provides intervention recommendations with appropriate follow up based on findings from either CT or chest x-ray.


 

https://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf

Guideline

Reference: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Lung Cancer Screening. Version 1.2020, 05/14/19 © 2019 National Comprehensive Cancer Network® (NCCN®)

Summary: These are the frequently updated National Comprehensive Cancer Network algorithms providing next steps and interventions to findings from lung cancer screening CT scans. This includes risk stratification by history and by radiographic criteria. It also includes approaches to shared decision-making discussions with patients.


 Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017

https://pubmed.ncbi.nlm.nih.gov/28240562/

Guideline

Reference: Macmahon H, Naidich DP, Goo JM, et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology. 2017;284(1):228-243.

Summary: Fleischner Society guidelines for management and follow up of incidentally identified pulmonary nodules. This guideline provides a complete starting point for evaluation and determination of appropriate follow up imaging and management of incidental pulmonary nodules.


 Lung‐RADS® Version 1.1

https://www.acr.org/-/media/ACR/Files/RADS/Lung-RADS/LungRADSAssessmentCategoriesv1-1.pdf

Guideline

Reference: ACoR. Lung-Screening Reporting and Data System (LungRADS) Version 1.1. 2019. Accessed August 17 2020. Available online: https://www.acr.org/-/media/ACR/Files/RADS/Lung-RADS/LungRADSAssessmentCategoriesv1-1.pdf

Summary: The Lung CT Screening Reporting & Data System (Lung-RADS) was developed to standardize vocabulary and interpretation of thoracic imaging and as an extension, lung cancer screening. Version 1.0 was released in 2014 and updated to version 1.1 in 2019 through the American College of Radiology (ACR). The primary clinical use of the Lung-RADS database is in determining appropriate follow up CT scans for lung cancer screening and nodules identified via lung cancer screening. A retrospective validation of the Lung-RADS applied to the NLSTwas performed in this article:

  • Performance of Lung-RADS in the National Lung Screening Trial: a retrospective assessment (https://pubmed.ncbi.nlm.nih.gov/25664444/ )