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{{familytree/start |summary= Imaging Approach for Solitary Pulmonary Nodule}} | {{familytree/start |summary= Imaging Approach for Solitary Pulmonary Nodule}} | ||
{{familytree | | | | | | A02 | | | | | | A02=<div style="width: 17em; padding:1em;text-align:left">'''Step 1: Assess likelihood of cancer''' | {{familytree | | | | | | A01 | | | | | | A01=<div style="width: 17em; padding:1em;text-align:center">'''Solitary Pulmonary Nodule Detected''' </div>}} | ||
{{familytree | | | | | | |!| | | | | | | }} | |||
{{familytree | | | | | | A02 | | | | | | A02=<div style="width: 17em; padding:1em;text-align:left">'''Step 1: Assess likelihood of cancer''' <br> ❑ [http://www.chestx-ray.com/index.php/calculators/spn-calculator Mayo Clinic Malignancy Risk Calculator] </div>}} | |||
{{familytree | | | | | | |!| | | | | | | | }} | {{familytree | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | |Z01|-|Z02| | | | | | Z01= '''Step 2: Review prior films'''<br> Is there a growth?|Z02= No previous films<br><SMALL>*Refer to step 2A</SMALL>}} | {{familytree | | | | | |Z01|-|Z02| | | | | | Z01= '''Step 2: Review prior films'''<br> Is there a growth?|Z02= No previous films<br><SMALL>*Refer to step 2A</SMALL>}} | ||
{{familytree | | | |,|-|-|^|-|-|.| | | | | }} | {{familytree | | | |,|-|-|^|-|-|.| | | | | }} | ||
{{familytree | | | B01 | | | | B02 | | | B01=Yes|B02=No}} | {{familytree | | | B01 | | | | B02 | | | B01=Yes, growing |B02=No, stable}} | ||
{{familytree | | | |!| | | | | |!| | | | | }} | {{familytree | | | |!| | | | | |!| | | | | }} | ||
{{familytree | | | C01 | | | | C02 | | | | C01=<div style="width: 17em; padding:1em;text-align:center">'''Step 2A'''<br>'''[[Solitary pulmonary nodule CT|'''Enhanced Computed Tomography''']] </div>|C02=<div style="width: 15em; padding:1em;">'''Step 2B'''<br>'''Surveillance'''</div>}} | {{familytree | | | C01 | | | | C02 | | | | C01=<div style="width: 17em; padding:1em;text-align:center">'''Step 2A'''<br>'''[[Solitary pulmonary nodule CT|'''Enhanced Computed Tomography''']] </div>|C02=<div style="width: 15em; padding:1em;">'''Step 2B'''<br>'''Surveillance'''</div>}} | ||
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{{familytree|boxstyle= border-top: 0px;| | | C04 | | | | | | | | | | | C04=<div style="width: 17em; padding:1em;text-align:left">'''Location'''<br> ❑ Upper lobe <br> ❑ Lower lobe <br> ❑ Middle lobe <br>'''Size'''<br> ❑ < 8mm <br> ❑ > 8mm <br>'''Lesion characteristics'''<br> ❑ Margins (irregular/regular)<br> ❑ Shape (spiculated/rounded)<br> ❑ Attenuation </div>}} | {{familytree|boxstyle= border-top: 0px;| | | C04 | | | | | | | | | | | C04=<div style="width: 17em; padding:1em;text-align:left">'''Location'''<br> ❑ Upper lobe <br> ❑ Lower lobe <br> ❑ Middle lobe <br>'''Size'''<br> ❑ < 8mm <br> ❑ > 8mm <br>'''Lesion characteristics'''<br> ❑ Margins (irregular/regular)<br> ❑ Shape (spiculated/rounded)<br> ❑ Attenuation </div>}} | ||
{{familytree | | | |!| | | | | | | | | | | |}} | {{familytree | | | |!| | | | | | | | | | | |}} | ||
{{familytree | | | |`|-| D01 | | | | | | | | D01=<div style="width: 15em; padding:1em;">'''[[Solitary pulmonary nodule other diagnostic studies |'''Other Diagnostic Studies''']]'''<br> ❑ PET/CT scan <br> ❑ | {{familytree | | | |`|-| D01 | | | | | | | | D01=<div style="width: 15em; padding:1em;">'''[[Solitary pulmonary nodule other diagnostic studies |'''Other Diagnostic Studies''']]'''<br> ❑ PET/CT scan </div>}} | ||
{{familytree | | | | | | |!| | | | | | | |}} | |||
{{familytree | | | |,|-|-|+|-|-|-|.| | | |}} | |||
{{familytree | | |D01| | D02 | | D03 | | | |D01= '''Low risk'''<br> ❑ < 5%|D02= '''Intermediate risk'''<br> ❑ 5-65%|D03= '''High risk'''<br> ❑ > 65% }} | |||
{{familytree | | | |!| | |!| | | |!| | | | | }} | |||
{{familytree | | |Z01| | Z02 | | Z03 | | | Z01= Serial CT scans|Z02=[[Solitary pulmonary nodule biopsy|'''Non-surgical biopsy''']]|Z03= Surgical resection}} | |||
{{familytree | | | |`|-|-|+|-|-|-|'| | | | }} | |||
{{familytree | | | | | | |!| | | | | | | | }} | {{familytree | | | | | | |!| | | | | | | | }} | ||
{{familytree | | | | | | F01 | | | | | | | F01=<div style="width: 15em; padding:1em;">'''Step 3: [[Solitary pulmonary nodule therapeutic management|Treatment]]''' </div>}} | |||
{{familytree | | | | | | F01 | | | | | | | F01=<div style="width: 15em; padding:1em;">'''Step 3 | |||
{{familytree/end}} | {{familytree/end}} | ||
Revision as of 18:39, 16 March 2016
Solitary Pulmonary Nodule Detected | |||||||||||||||||||||||||||||||||
Step 1: Assess likelihood of cancer ❑ Mayo Clinic Malignancy Risk Calculator | |||||||||||||||||||||||||||||||||
| Step 2: Review prior films Is there a growth? | No previous films *Refer to step 2A | ||||||||||||||||||||||||||||||||
| Yes, growing | No, stable | ||||||||||||||||||||||||||||||||
Step 2A Enhanced Computed Tomography | Step 2B Surveillance | ||||||||||||||||||||||||||||||||
Imaging evaluation | |||||||||||||||||||||||||||||||||
Location ❑ Upper lobe ❑ Lower lobe ❑ Middle lobe Size ❑ < 8mm ❑ > 8mm Lesion characteristics ❑ Margins (irregular/regular) ❑ Shape (spiculated/rounded) ❑ Attenuation | |||||||||||||||||||||||||||||||||
Other Diagnostic Studies ❑ PET/CT scan | |||||||||||||||||||||||||||||||||
| Low risk ❑ < 5% | Intermediate risk ❑ 5-65% | High risk ❑ > 65% | |||||||||||||||||||||||||||||||
| Serial CT scans | Non-surgical biopsy | Surgical resection | |||||||||||||||||||||||||||||||
Step 3: Treatment | |||||||||||||||||||||||||||||||||
| Step 2: Review prior films Is there a growth? | |||||||||||||||||||||||||||||||
| Yes | No | ||||||||||||||||||||||||||||||
Surveillance | |||||||||||||||||||||||||||||||
Imaging evaluation | |||||||||||||||||||||||||||||||
Location ❑ Upper lobe ❑ Lower lobe ❑ Middle lobe Size ❑ < 8mm ❑ > 8mm Lesion characteristics ❑ Margins (irregular/regular) ❑ Shape (spiculated/rounded) ❑ Attenuation | |||||||||||||||||||||||||||||||
Step 3 Treatment | |||||||||||||||||||||||||||||||