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Guidelines for Management of Small Pulmonary Nodules

Principal Investigator
Name
Heber MacMahon
Degrees
MB,BCh.
Institution
University of Chicago
Position Title
Professor of Radiology
Email
About this CDAS Project
Study
NLST (Learn more about this study)
Project ID
NLST-118
Initial CDAS Request Approval
Feb 5, 2015
Title
Guidelines for Management of Small Pulmonary Nodules
Summary
The Fleischner Society has published guidelines for management of small pulmonary nodules, detected incidentally on CT scans. The first of these, primarily for solid nodules, was published in 2005. More recently, guidelines for non-solid nodules were published in 2013. Now, we are working on updated Fleischner Society Guidelines that will include recommendations for management of both types of nodules.
In order to determine the risk of cancer in small nodules, the authors will consider data from lung cancer screening trials, including NLST, Of particular interest will be nodule size, morphology, location and growth rates, when and if available, for cancers and benign nodules. Based on these data, new size thresholds and follow-up intervals for nodules are expected to be developed.
Aims

The specific aim of the project is to develop a more robust basis for determining the risk of cancer in small pulmonary nodules that are detected incidentally on CT scans. Based on the estimated risk, appropriate size thresholds for incidental nodules that may require further follow-up or investigation will be determined. Analysis of the NLST dataset is expected to provide information regarding risk of cancer in nodules of specific sizes and morpholgy a high risk subset of patients. In selected cases, images may be reviewed to confirm size and morphological characteristics. Because size is a critical criterion in risk assessment, different measurement techniques will be applied in order to determine a reproducible method, for solid, part-solid and ground glass nodules.
We expect the project will be completed in the next 12-24 months.

Collaborators

David Naidich MD, New York University
Alex Bankier MD, Harvard Medical School
Wlliam Travis, MD, Memorial Sloan Kettering Cancer Center

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