Low-dose spiral CT (LDCT) is currently recommended by the professional community and is used to detect early lung cancer. Many people are very anxious after a CT exam reveals a small lung nodule. In fact, small lung nodules ≠ lung cancer, and you can click on the link at the end of this article to learn more.
On April 26, 2018, the National Comprehensive Cancer Network (NCCN) released new guidelines for non-small cell lung cancer (NSCLC). The new guidelines state that for small early-stage lung nodules detected by CT, the review interval can be extended if the risk of malignancy is low.
Specifically, for persistent, isolated, semisolid pulmonary nodules:
1) If smaller than 6 mm, no review is needed;
2) if ≥6 mm, no change on 3- to 6-month review, and solid component less than 6 mm in diameter, annual review for 5 years is recommended; if solid component ≥6 mm, PET-CT, or puncture biopsy may be considered.
So, what is “solid” or “semi-solid”?
What is a “solid” or “semi-solid” lung nodule? The latter includes non-solid [ground glass opacity (GGO)] and semi-solid (both GGO and solid components).
Nonsolid nodules are mainly adenocarcinoma in situ or microinvasive adenocarcinoma, where adenocarcinoma in situ is defined as ≤3 cm in diameter, with tumor cells growing against the alveolar wall and without invasion of the interstitium, blood vessels, or pleura. These patients have a 5-year survival rate of 100% after complete nodal resection. There are also data showing that many non-solid nodules can disappear on their own or do not progress to malignancy even after years of follow-up. Therefore, there is no need to be overly stressed. Solid and semisolid nodes, on the other hand, are at higher risk of malignancy and require more aggressive treatment.
It is important to note that the recommendations in the US guidelines are based on research and the US situation, and may not be appropriate for our patients. Please follow your doctor’s instructions regarding your specific condition.
If you would like to learn more, please read this article: