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Recommendations for the Management of Subsolid Pulmonary Nodules Detected at CT: A Statement from the Fleischner Society

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By Jason Mann No BS pulmonary critical care fellow
Sébastien Bommart, Arnaud Bourdin, Grégory Marin, Jean Philippe Berthet, Jean Louis Pujol, Isabelle Serre, Nicolas Molinari, Charles Marty-Ané, Hélène Kovacsik
BACKGROUND: The management of occult lung lesions, particularly subsolid opacities, is a new challenge because they are difficult to localize during surgery and the number of lesions detected by computed tomography (CT) is increasing. METHODS: Between February 2008 and December 2011, preoperative CT-guided marking with coils was systematically carried out to localize presumed impalpable nodules before video-assisted thoracoscopic surgery (VATS). The procedure feasibility, reliability, and safety as well as its impact on the resection volume and on the pathologic examination strategy were examined...
February 2014: Annals of Thoracic Surgery
David P Naidich, Alexander A Bankier, Heber MacMahon, Cornelia M Schaefer-Prokop, Massimo Pistolesi, Jin Mo Goo, Paolo Macchiarini, James D Crapo, Christian J Herold, John H Austin, William D Travis
This report is to complement the original Fleischner Society recommendations for incidentally detected solid nodules by proposing a set of recommendations specifically aimed at subsolid nodules. The development of a standardized approach to the interpretation and management of subsolid nodules remains critically important given that peripheral adenocarcinomas represent the most common type of lung cancer, with evidence of increasing frequency. Following an initial consideration of appropriate terminology to describe subsolid nodules and a brief review of the new classification system for peripheral lung adenocarcinomas sponsored by the International Association for the Study of Lung Cancer (IASLC), American Thoracic Society (ATS), and European Respiratory Society (ERS), six specific recommendations were made, three with regard to solitary subsolid nodules and three with regard to multiple subsolid nodules...
January 2013: Radiology
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