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Radiology. 2017 Jul;284(1):228-243. doi: 10.1148/radiol.2017161659. Epub 2017 Feb 23.

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

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From the Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637 (H.M.); Department of Radiology, New York University Langone Medical Center, New York, NY (D.P.N.); Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea (J.M.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (K.S.L.); Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.N.C.L.); Department of Radiology, University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.); Department of Medicine, Cleveland Clinic, Cleveland, Ohio (A.C.M.); Department of Radiology, Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan (Y.O.); Pulmonary and Critical Care Medicine, ICAHN School of Medicine at Mount Sinai, New York, NY (C.A.P.); Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands (M.P.); Department of Radiology, Duke University School of Medicine, Durham, NC (G.D.R.); Department of Radiology, Meander Medical Center, Amersfoort, the Netherlands (C.M.S.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY (W.D.T.); Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium (P.E.V.S.); and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B).


The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small 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 guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. 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. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience. © RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on March 13, 2017.

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