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Approach to Lung Nodules

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Lung Cancer

Part of the book series: Respiratory Medicine ((RM))

Abstract

Pulmonary nodules are commonly identified incidentally on imaging performed for patient symptoms or through low-dose computed tomography for lung cancer screening. Clinicians are challenged with managing these nodules, which can be difficult as these can represent a wide range of benign and malignant diseases. Expert recommendations on diagnostic evaluation and numerous validated models that integrate patient demographics, behaviors, and nodule characteristics can be used to predict probability of malignancy and guide nodule management. Diagnostic evaluation of pulmonary nodules requires considerations of individualized risks of malignancy and the risks inherent in the diagnostic work-up to optimize the benefit-to-risk ratio. Ideally, evaluation of pulmonary nodules balances the need to diagnose early lung cancer with minimizing the risks of invasive evaluations for benign nodules and the possible risks of delayed diagnosis. Understanding the approach to pulmonary nodules, including current techniques and future directions, is essential to providing the best personalized care for patients. In this chapter, we discuss the subtypes and classifications of pulmonary nodules, imaging techniques, landmark trials, and society recommendations on the approach to management, current diagnostic approaches, and future directions of the field, including promising diagnostic biomarkers for pulmonary nodules.

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Authors and Affiliations

  1. Division of Pulmonary, Critical Care, Sleep and Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Srikanth Vedachalam & Catherine R. Sears

  2. Division of Pulmonary, Department of Medicine, Critical Care, Allergy, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA

    Nichole T. Tanner

  3. Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Hospital, Charleston, SC, USA

    Nichole T. Tanner

  4. Pulmonary/Pulmonary Oncology, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA

    Catherine R. Sears

Authors
  1. Srikanth Vedachalam
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  2. Nichole T. Tanner
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  3. Catherine R. Sears
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Correspondence to Catherine R. Sears .

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Editors and Affiliations

  1. Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina, Chapel Hill, NC, USA

    Christina R. MacRosty

  2. Division of Pulmonary and Critical Care Medicine, University of Rochester Medical Center, Rochester, NY, USA

    M. Patricia Rivera

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CRS has served as a scientific/medical consultant for Bristol-Myers Squibb Company and received grant funding from Biodesix, the US Department of Veterans Affairs BLR&D (I01-BX005353) and VA CSP (#2005). The contents of this manuscript do not represent the views of the US Department of Veterans Affairs or the US Government. NTT has received grant funding from Biodesix, Nucleix, DELFI, Exact Sciences, and Eon. SV has no COI to declare.

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Vedachalam, S., Tanner, N.T., Sears, C.R. (2023). Approach to Lung Nodules. In: MacRosty, C.R., Rivera, M.P. (eds) Lung Cancer. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-031-38412-7_4

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