Fleischner Society Guidelines Calculator
Apply the 2017 Fleischner Society recommendations for incidentally detected pulmonary nodules on CT, for solid and subsolid nodules in patients aged 35 and older.
What is Fleischner?
The Fleischner Society guidelines give CT follow-up recommendations for incidental pulmonary nodules in adults aged 35 and older who are not in a lung cancer screening program or immunocompromised. Recommendations depend on nodule size, type (solid or subsolid), number, and patient risk. This calculator returns the matching 2017 recommendation.
Incidental Pulmonary Nodules
2017 Fleischner Society Guidelines for Incidental Nodules
The Fleischner Society Guidelines provide recommendations for follow-up and management of incidentally detected pulmonary nodules on CT images. Enter the nodule characteristics below to get the recommended management approach.
Frequently asked questions
When do the Fleischner guidelines apply?
They apply to incidentally detected pulmonary nodules on CT in patients 35 years or older. They do not apply to lung cancer screening, patients with known cancer, or immunocompromised patients, where dedicated pathways such as Lung-RADS are used instead.
How do solid and subsolid nodules differ in follow-up?
Solid nodules are managed mainly by size and risk, often needing little or no follow-up under 6 mm. Subsolid (ground-glass and part-solid) nodules may require longer surveillance — typically extending to about 5 years — because of their indolent but potentially malignant behavior.
What size of solid nodule needs follow-up?
For a solitary solid nodule under 6 mm, routine follow-up is generally not required in low-risk patients; 6–8 mm typically warrants CT at 6–12 months; and nodules over 8 mm may need CT at 3 months, PET/CT, or tissue sampling depending on risk.
Do the Fleischner guidelines apply to multiple nodules?
Yes. For multiple nodules the most suspicious nodule usually drives management, with size and risk thresholds similar to solitary nodules. The calculator lets you select nodule number to apply the appropriate recommendation.