High Resolution Chest

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You may be aware that the Fleischner Society recommendations for follow-up of lung nodules do not include:

Patients known to have or suspected of having malignant disease.

Patients with a cancer that may be a cause of lung metastases should be cared for according to the relevant protocol or specific clinical situation. Pertinent factors will include the site, cell type, and stage of the primary tumor and whether early detection of lung metastases will affect care. In this setting, frequent follow-up CT may be indicated.

Young patients

Primary lung cancer is rare in persons under 35 years of age (<1% of all cases), and the risks from radiation exposure are greater than in the older population. Therefore, unless there is a known primary cancer, multiple follow-up CT studies for small incidentally detected nodules should be avoided in young patients. In such cases, a single low-dose follow-up CT scan in 6-12 months should be considered.

Patients with unexplained fever

In certain clinical settings, such as a patient presenting with neutropenic fever, the presence of a nodule may indicate active infection, and short-term imaging follow-up or intervention may be appropriate.

Thanks,

Steve

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