Incidental Pulmonary Nodule Management (Fleischner 2017)
Incidental Pulmonary Nodule Management (Fleischner 2017): Incidental Pulmonary Nodule on CT → Nodule Morphology? → Solid Nodule Size? → Risk Assessment ...
Interactive Decision Tree
Algorithm Steps
- ▶Start
Incidental Pulmonary Nodule on CT
Solid or subsolid nodule discovered incidentally
- ◆Decision
Nodule Morphology?
Solid, part-solid, or pure ground glass
- Solid nodule
- Part-solid (GGO with solid component)
- Pure ground glass (GGO)
- ◆Decision
Solid Nodule Size?
- <6mm
- 6-8mm
- >8mm
- ◆Decision
Risk Assessment (<6mm)
- Low risk patient
- High risk patient
- ■End
No Routine Follow-up
Optional 12-month CT if high-risk features
- ■End
Optional 12-Month CT
Consider follow-up if risk factors present
- ●Action
6-8mm Follow-up
Low risk: 6-12mo, then 18-24mo; High risk: same + stability
- ●Action
>8mm Management
CT at 3 months, PET/CT, or tissue sampling
- ◆Decision
Part-Solid Size?
- <6mm
- ≥6mm solid component
- ■End
No Routine Follow-up
Consider 3-6mo CT if suspicious
- ●Action
3-6 Month CT
If persistent, PET/CT or biopsy based on solid component
- ◆Decision
Pure GGO Size?
- <6mm
- ≥6mm
- ■End
No Routine Follow-up
- ■End
CT at 6-12 Months
Then q2y for 5 years if persistent
Guideline Source
Fleischner Society 2017 Guidelines for Management of Incidental Pulmonary Nodules
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Does not apply to lung cancer screening populations
- Does not apply to immunocompromised patients
- Not for patients with known primary malignancy
- Age <35 may warrant different approach
Contraindicated Populations
Applicable Regions
AU: Follow ACR/Fleischner approach
UK: BTS guidelines similar but with slight threshold differences
US: Lung-RADS for screening populations differs from Fleischner
Next steps
Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.
Related Resources
Frequently Asked Questions
What is the Incidental Pulmonary Nodule Management (Fleischner 2017)?
The Incidental Pulmonary Nodule Management (Fleischner 2017) is a diagnostic clinical algorithm for Radiology. It provides a structured decision tree to guide clinical decision-making, based on Fleischner Society 2017 Guidelines for Management of Incidental Pulmonary Nodules.
What guideline is the Incidental Pulmonary Nodule Management (Fleischner 2017) based on?
This algorithm is based on Fleischner Society 2017 Guidelines for Management of Incidental Pulmonary Nodules (DOI: 10.1148/radiol.2017161659).
What are the limitations of the Incidental Pulmonary Nodule Management (Fleischner 2017)?
Known limitations include: Does not apply to lung cancer screening populations; Does not apply to immunocompromised patients; Not for patients with known primary malignancy; Age <35 may warrant different approach. Individual patient factors may require deviation from these recommendations.
Get AI-Powered Analysis Alongside This Algorithm
In AttendMe.ai, the Incidental Pulmonary Nodule Management (Fleischner 2017) appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.
Try AttendMe Free