NCCN guidelines for appended reports for low dose CT screening**
The dimensions of a nodule are measured as mean diameter = the mean of the longest diameter and its perpendicular diameter.
- A new finding of a solid or partial solid nodule has been identified, the recommend follow-up is dependent upon the size as follows:
<= 6 mm follow-up LDCT 1 year
6-8 mm LDCT at 3 months
> 8 mm consider PET Scan -> if negative repeat LDCT 3 months. If Positive refer for biopsy or excision
Solid endobronchial lesion-> Repeat LDCT at 1 month after expectorants -> if no resolution -> Bronchscopy- Solid Nodule - 1st follow-up
increase in size or PET suspicious of malignancy -> please refer to the pulmonary physician of choice for further invasive testing
No increase in size - LDCT in 6 months
Low Prob by PET- 3 month LDCT
Resolution -> go back to yearly LDCT
Solid endobroncial lesion persist-> please refer to the pulmonary physician of choice for further invasive testing
- Solid Nodule - 1st follow-up
- New ground glass opacity/GG nodule/non-solid lesions
< 5 mm LDCT in 12 months 5-10 mm LDCT 6 months
> 10 mm LDCT 3 months- Ground glass opacity/GG nodule/non-solid lesions 1st follow-up
Resolution or stable - return to annual LDCT
Increase in size and/or becoming more solid-> please refer to the pulmonary physician of choice for further invasive testing
- Ground glass opacity/GG nodule/non-solid lesions 1st follow-up
- New Radiographic finding compatible with infection or inflammation
- If symptoms suggest infection , please treat accordingly and repeat LDCT at 4- 8 weeks
- If no symptoms infection and solid or partially solid - will follow as solid per above
A new finding of a solid or partially solid nodule has been identified, the recommend follow-up is dependent upon the size as follows:
<= 4 mm follow-up LDCT 1 year
4-6 mm LDCT at 6 months
6-8 mm LDCT at 3 months
> 8 mm follow-up PET Scan Solid endobronchial lesion-> Repeat LDCT at 1 month after expectorants
Please advise us by return Fax if you wish to take other action- Solid Nodule - 1st follow-up
increase in size or PET suspicious of malignancy -> please refer to the pulmonary physician of choice for further invasive testing
No increase in size - LDCT in 6 months
Low Prob by PET- 3 month LDCT
Resolution -> go back to yearly LDCT
- Solid Nodule - 1st follow-up
- If no symptoms infection and ground glass or non solid
< 5 mm LDCT in 12 months
5-10 mm LDCT 6 months
> 10 mm LDCT 3 months- Ground Glass opacity 1st follow-up
Increase in size and/or becoming more solid-> please refer to the pulmonary physician of choice for further invasive testing
Resolution or no change - return to annual LDCT
- Ground Glass opacity 1st follow-up
**source: NCCN CLINICAL PRACTICE GUIDELINES IN ONCOLOGY: LUNG CANCER SCREENING, V 2.2015 nccn.org