Fleischner Criteria

MacMahon H, Naidich DP, Goo JM, et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Updated the follow-up intervals and size thresholds for solid and subsolid nodules used here, replacing the separate 2005 (solid) and 2013 (subsolid) Fleischner guidelines.

These recommendations are for an incidental nodule in an adult and do not apply to lung cancer screening (Lung-RADS applies there instead), a patient who is immunosuppressed, or a patient with a known primary cancer (where the nodule may be a metastasis and closer follow-up is usually appropriate). A nodule ≥ 3 cm is conventionally a mass and is managed as a suspected malignancy rather than followed per this guideline. For multiple nodules, use the most suspicious nodule to guide management; follow-up intervals may vary with its size and risk.