Thoracic Radiology

Question 1

Size limit for SPN, by definition?

Answer 1

<3cm

Question 2

Criteria for fat-containing SPN? Clinical implication?

Answer 2

Houndsfield units < -30.

Benign

Question 3

Describe the appearance of an intrapulmonary lymph node on CT

Answer 3

Triangular, subcarinal/peripheral, associated with linear opacities pointing toward left atrium.
<1cm

Question 4

What are patient-level exclusion criteria for Fleischner Society guidelines?

Answer 4

<35yo
Immunosuppressed
Screening exams (LUNG-RADS guidelines)

Question 5

Fleischner society guidelines for single, solid nodules? (Hint: low-risk and high-risk rarely matter)

Answer 5

<6mm: +/- 12mo f/u for high-risk
6-8mm, CT at 6-12mo, +/- repeat at 18-24
>8mm: CT at 3mo vs PET/Bx

Question 6

Fleischner society guidelines for multiple, solid nodules?

Answer 6

<6mm: +/- 12mo f/u for high-risk
>6mm: CT at 3-6mo, repeat at 18-24
May skip repeat for low-risk

Question 7

Fleischner society guidelines for GGOs?

Answer 7

<6mm: no f/u

>6mm, CT @ 6-12 months, then q2yrs until 5 years.

Question 8

Fleischner society guidelines for part-solid SPNs?

Answer 8

<6mm: no f/u
>6mm (solid <6mm): 3-6mo, then annual until 5 years
>6mm (solid >6mm): 3-6mo. If persistent, PET/Bx.