Aggressiveness-guided nodule management for lung cancer screening in Europe—justification for follow-up intervals and definition of growth

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The ESTI nodule management recommendation emphasizes lesion aggressiveness and measurement error in lung cancer screening.
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Nodules are categorized into four risk categories to guide follow-up intervals and management decisions.
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Growth thresholds are established to minimize overtreatment while ensuring timely identification of fast-growing malignant nodules.
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Nodule size should primarily be assessed using volumetry, with manual measurements as a secondary option if volumetry fails.
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The recommendation aims to reduce major stage shifts in lung cancer by closely monitoring nodule growth and adjusting management accordingly.

European Radiology

by Mathias Prokop, Cornelia Schaefer-Prokop, Colin Jacobs, Annemiek Snoeckx, Jürgen Biederer, Thomas Frauenfelder, Fergus Gleeson, Hans-Ulrich Kauczor, Anagha P. Parkar, Rozemarijn Vliegenthart, Marie-Pierre Revel, Mario Silva, Helmut Prosch
July 1, 2025

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