What guides your general approach to small lung nodules? A.Institutional guidelines B.National /...
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What guides your general approach to small lung nodules? A. Institutional guidelines B. National / Society guidelines C. Individualized approach D. Some combination of above mall Lung Nodules: What do They Really Do? ATS 2015, Seattle WA
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Transcript of What guides your general approach to small lung nodules? A.Institutional guidelines B.National /...
What guides your general approach to small lung
nodules?A. Institutional guidelinesB. National / Society
guidelinesC. Individualized approachD. Some combination of
above
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
What are acceptable approaches to small lung nodules for your patients?
A. Surgery onlyB. Surgery, SBRTC. Surgery, SBRT, RFAD. Surgery, SBRT, RFA,
and/or cryoablation
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#1
• 79 yoF, former smoker• 1.9cm subsolid RUL nodule; no PET• nodule enlarging x 9 months• Open to clinical trial enrollment• FEV1 1.8L, DLCO 72% predicted
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#1A. Observe, F/U CT scan
B. Image guided biopsyC. Sublobar resectionD. Completion lobectomy
(if Cancer)E. Clinical trial enrollment
(eg. CALGB 140503, others)
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#2
• 46 yoM, healthy, prior smoker• Nodule found ~1 year ago on
coronary screening CT scan• ~5mm then, now 9mm• No uptake on PET• FEV1 3.5L
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#2
A. Observe, F/U CT scanB. Image guided biopsyC. Sublobar resectionD. Completion lobectomy
(if Cancer)
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#3
• 55 yoM, long time smoker, now quit
• Bad emphysema• FEV1 1.1L, DLCO 42% predicted• RUL nodule 1.1 cm enlarging x 6
months• SUVmax 3.4
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#3
A. Observe, F/U CT scanB. Image guided biopsyC. Sublobar resectionD. Completion lobectomy
(if Cancer)
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#4
• Healthy 64 yoM, long time smoker, now quit
• 1.4cm RUL nodule; SUVmax 4.6• nodule enlarging x 6 months• Says no to clinical trial• FEV1 2.4L, DLCO 59% predicted
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
Small lung nodule case#4
A. Observe, F/U CT scanB. Image guided biopsyC. Sublobar resectionD. Completion lobectomy
(if Cancer)
Small Lung Nodules: What do They Really Do?AATS 2015, Seattle WA
