Fleischner · Tórax

Fleischner Fleischner Society 2017 pulmonary nodule guidelines

vigente

Management recommendations for incidentally detected pulmonary nodules on CT, organized by nodule type (solid, subsolid) and size, for patients 35 and older without known cancer or immunosuppression.

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Escala de categorias

solid-single-<6 solid-single-6to8 solid-single->8 solid-multiple-<6 solid-multiple->=6 ggn-single-<6 ggn-single->=6 partsolid-single->=6 subsolid-multiple

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Procedência e vigência

Órgão emissor: Fleischner Society
Versão: 2017
Ano: 2017
Família: algoritmo
Tipo de lógica: matrix
Modalidade: CT
Fonte primária: Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017 · doi:10.1148/radiol.2017161659
Última verificação: 2026-06-22
Última checagem: 2026-06-22

Lógica de decisão

Forma estruturada (matrix). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Cell recommendations and size thresholds pending sourcing with per-cell locators.

Mostrar a lógica estruturada (JSON)

{
  "axes": {
    "nodule_type": [
      "solid_single",
      "solid_multiple",
      "subsolid_ggn_single",
      "subsolid_partsolid_single",
      "subsolid_multiple"
    ],
    "size_band": [
      "<6mm",
      "6-8mm",
      ">8mm"
    ]
  },
  "cells": null
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
solid-single-<6	Solid single nodule, under 6 mm Single solid nodule under 6 mm (under ~100 mm3); recommendation differs by patient risk.	Low risk: no routine follow-up. High risk: optional CT at 12 months. The guideline notes that nodules under 6 mm generally need no routine follow-up, but selected high-risk patients with suspicious morphology and/or upper-lobe location may warrant a 12-month follow-up.	—	okfonte Fleischner 2017 Table 1, Section A (Solid Nodules), Single, <6 mm row
solid-single-6to8	Solid single nodule, 6 to 8 mm Single solid nodule 6-8 mm (~100-250 mm3); same management for low and high risk.	CT at 6-12 months, then consider CT at 18-24 months (applies to both low- and high-risk single nodules).	—	okfonte Fleischner 2017 Table 1, Section A (Solid Nodules), Single, 6-8 mm row
solid-single->8	Solid single nodule, over 8 mm Single solid nodule larger than 8 mm (over ~250 mm3); same management for low and high risk.	Consider CT at 3 months, PET/CT, or tissue sampling (applies to both low- and high-risk single nodules).	—	okfonte Fleischner 2017 Table 1, Section A (Solid Nodules), Single, >8 mm row
solid-multiple-<6	Solid multiple nodules, under 6 mm Multiple solid nodules with the largest under 6 mm; recommendation differs by patient risk. Use the most suspicious nodule to guide management.	Low risk: no routine follow-up. High risk: optional CT at 12 months.	—	okfonte Fleischner 2017 Table 1, Section A (Solid Nodules), Multiple, <6 mm row
solid-multiple->=6	Solid multiple nodules, 6 mm or larger Multiple solid nodules with at least one in the 6-8 mm or >8 mm band. Use the most suspicious nodule to guide management; intervals may vary with size and risk.	CT at 3-6 months, then consider CT at 18-24 months (same recommendation given for the 6-8 mm and >8 mm multiple-nodule columns, for both low and high risk).	—	okfonte Fleischner 2017 Table 1, Section A (Solid Nodules), Multiple, 6-8 mm and >8 mm columns
ggn-single-<6	Ground glass single nodule, under 6 mm Single pure ground-glass nodule under 6 mm.	No routine follow-up.	—	okfonte Fleischner 2017 Table 1, Section B (Subsolid Nodules), Single, Ground glass, <6 mm column
ggn-single->=6	Ground glass single nodule, 6 mm or larger Single pure ground-glass nodule 6 mm or larger.	CT at 6-12 months to confirm persistence, then CT every 2 years out to 5 years. If a solid component or growth develops, consider resection.	—	okfonte Fleischner 2017 Table 1, Section B (Subsolid Nodules), Single, Ground glass, >=6 mm column
partsolid-single->=6	Part solid single nodule, 6 mm or larger Single part-solid nodule 6 mm or larger. The guideline notes part-solid nodules are generally not defined as such below 6 mm, and persistent part-solid nodules with a solid component of 6 mm or more should be regarded as highly suspicious.	CT at 3-6 months to confirm persistence. If unchanged and the solid component stays under 6 mm, annual CT for 5 years.	—	okfonte Fleischner 2017 Table 1, Section B (Subsolid Nodules), Single, Part solid, >=6 mm column
subsolid-multiple	Multiple subsolid nodules Multiple subsolid nodules (ground-glass and/or part-solid). Multiple sub-6 mm pure ground-glass nodules are usually benign.	Under 6 mm: CT at 3-6 months; if stable, consider CT at 2 and 4 years. 6 mm or larger: CT at 3-6 months, with subsequent management based on the most suspicious nodule(s).	—	okfonte Fleischner 2017 Table 1, Section B (Subsolid Nodules), Multiple row

Referências cruzadas

fronteira compartilhadaLung-RADS. Lung CT Screening Reporting and Data SystemFleischner governs incidental nodules, Lung-RADS governs screening detected nodules.

Histórico de versões

Data	Evento	Detalhe	Situação
2017-07-01	revised	Fleischner Society 2017 guidelines published, updating the 2005 recommendations. evidência	confirmado

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