From the Department of Radiology and Medical Imaging, University of Virginia Medical Center, 1215 Lee St, PO Box 800170, Charlottesville, VA 22908 (J.B.); and Department of Radiology, University of Chicago, Chicago, Ill (L.L., J.H.C.).
Radiographics. 2018 Sep-Oct;38(5):1337-1350. doi: 10.1148/rg.2018180017.
The new guidelines for managing incidental pulmonary nodules published by the Fleischner Society in 2017 reflect an improved understanding of the risk factors and biologic features of lung cancer. Specific topics emphasized in the updated guidelines include a new threshold size for follow-up, the importance of the morphologic features of nodules, accurate nodule measurements, recognition of subsolid components, understanding interval growth or change in nodule morphology, and knowledge of patient risk factors. The updated guidelines enable greater personal flexibility in the decision-making process and encourage individualized management of pulmonary nodules. These factors may introduce new challenges for radiologists, who previously used solely nodule size to make management recommendations. The authors describe eight scenarios that illustrate the challenges potentially encountered when applying the new guidelines to pulmonary nodule management. RSNA, 2018.
2017 年，Fleischner 学会发布了新版管理偶发性肺结节指南，反映出对肺癌风险因素和生物学特征的理解有所提高。更新后的指南中强调的具体内容包括随访的新阈值大小、结节形态特征的重要性、准确的结节测量、亚实性成分的识别、对结节形态间隔生长或变化的认识，以及对患者风险因素的了解。更新后的指南使决策过程更具个性化灵活性，并鼓励对肺结节进行个体化管理。这些因素可能会给放射科医生带来新的挑战，他们之前仅使用结节大小来提出管理建议。作者描述了 8 种情况，说明了在将新指南应用于肺结节管理时可能遇到的挑战。RSNA，2018 年。
