Pulmonary nodule reference
Pulmonary nodules
First establish whether the nodule was detected in a screening programme or incidentally on CT. These are different systems.
Screening-detected nodule
Use the formal screening reporting system, not an incidental-finding rule.
ACR Lung-RADS v2022 is the current assessment and management system for lung cancer screening CT. Use the complete ACR category table, its notes and the local screening-programme workflow; this draft does not reproduce its criteria.
Open ACR Lung-RADS v2022 ↗Incidentally detected CT nodule
Use the complete incidental-nodule guideline and local follow-up pathway.
Fleischner Society 2017 provides the primary incidental-nodule tables for adults aged 35 years or older. Management depends on nodule type, size, multiplicity and clinical risk; the source deliberately permits clinical discretion. No current CAR incidental-nodule table was identified for safe local transcription.
Open Fleischner Society 2017 guideline ↗Outside the reference boundary
Known cancer, immunocompromise, age under 35, symptoms or a suspicious clinical presentation.
Do not force this finding through a generic incidental pathway. Use the applicable cancer, infection, respiratory or multidisciplinary assessment route and the local protocol that governs timing, escalation and responsibility.
Open CAR thoracic referral guidance ↗Evidence register
What governs this draft
Dated primary sources and their role in this draft.
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Evidence register
What governs this draft
Recommendation wording is condensed for point-of-care use. The dated primary source remains authoritative and must be rechecked before publication or institutional adoption.
Use only for screening-detected nodules; ACR identifies CC BY-ND 4.0 licensing and attribution requirements.
Open source ↗Fleischner 2017Guidelines for Management of Incidental Pulmonary Nodules Detected on CT ImagesPrimary incidental-nodule guidelineFor incidental CT nodules in adults 35 years or older, excluding screening, immunocompromise and known primary cancer. Copyright remains with RSNA.
Open source ↗CAR 2026Incidental Pulmonary Nodules: What Primary Care Providers Need to KnowCAR educational material · not an incidental management tableConfirms CAR educational relevance but is not used here as a source for simulated decision logic.
Open source ↗