Lung Nodules

Cat 1 · 30 days

appointment within 30 calendar days. Lung nodules are traditionally defined as ≤30 mm in diameter. This section is relevant to both screening detected and incidental (scan performed for a different reason) lung nodules. Any one of the following: National Lung Cancer Screening Program with: - High RIsk (Cat 5) or Very High Risk (Cat 6) nodules - Calculated risk of malignancy >30% Solid Part Solid Non-solid (Ground glass) Nodule Size (1) >8mm Solid component >8mm - Nodule Volume (2) ≥268 mm3 Solid component ≥268 mm3 - Change from precious scans (within 24 months) - Progressive growth over 3 or more scans - Increase in size of >1.5 mm or volume of >25% - Progressive growth over 3 or more scans - Solid component >4mm or >34mm3 which is new or growing - Doubling in size within 12 months Other features: - Growing nodule within a larger airway (segmental or more proximal) - Progressive atypical cyst compared to previous scan(s) - Regional lymphadenopathy - Frank metastatic disease with no other obvious source (1) Dimensions are average of long and short axes, rounded to the nearest millimetre. Where only the largest diameter is provided in the imaging Report, this measurement can be considered (2) Volume calculated from radiology volumetric software.

Cat 2 · 90 days

appointment within 90 calendar days. Any once of the following: National Lung Cancer Screening Program - Moderate Risk (Cat 4) nodules where community follow up is not possible or where additional clinical risk factors are present. True Solid Part Solid Non-Solid (Ground glass) Nodule Size (1) 6 - 8 mm Solid component 6 - 8 mm >30mm Nodule Volume (2) >113 to <268mm3 Solid component 113 to <268mm3 - Change from previous scans (within 24 months) Nodule 4 to <8 mm (113 to <268mm3) which is new or growing Solid component of nodule <4mm (<34mm3) which is new or growing Doubling in size within 12 months 3 True Other Features: - Nodule within a larger airway (segmental or more proximal) - Atypical pulmonary cyst (multilocular or thick walled) - Personal history of cancer - Request for Advice is available, if required, for small nodules that do not meet standard criteria. (1) Dimensions are average of long and short axes, rounded to the nearest millimeter. Where only the largest diameter is provided in the imaging Report, this measurement can be considered as a surrogate for the average. (2) Volume calculated from radiology volumetric software.

Cat 3 · 365 days

appointment within 365 calendar days. - There are no Category 3 criteria. Support for managing nodules <6 mm (that do not meet criteria for change from previous scans above) can be obtained by Request for Advice, if required.