This change has been made in recognition of the multiple factors that determine risk and that cannot be easily incorporated into a summary table, as well as the important role of patient preference for either more aggressive or more conservative management. Thus, a range of times rather than a specific interval for follow-up computed tomography (CT) is given for many scenarios. The purpose of these recommendations is to reduce the number of unnecessary follow-up examinations while providing greater discretion to the radiologist, clinician, and patient to make management decisions. These revised recommendations for incidentally discovered lung nodules incorporate several changes from the original Fleischner Society guidelines for management of solid or subsolid nodules ( 1, 2). This article was corrected on March 13, 2017. Online supplemental material is available for this article.Īn earlier incorrect version of this article appeared online. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. Since then, new information has become available therefore, the guidelines have been revised to reflect current thinking on nodule management. The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013.
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