What is your approach to radiographically suspicious lung nodules for which initial biopsy was negative for malignancy?
Answer from: Radiation Oncologist at Community Practice
It depends on how suspicious the nodule is for malignancy clinically and on the biopsy. The following criteria play into my decision-making:
If the kinetics (steady growth over multiple scans) and morphology (solid and spiculated) on CT as well as hypermetabolism on PET-CT are highly suggestive o...
Comments
Radiation Oncologist at UMass Memorial Medical Center Agree with Dr. @Park. Empiric treatment with any m...
Answer from: Radiation Oncologist at Community Practice
My approach is to remember that input from pulmonologists and radiologists is crucial for these challenging cases. Radiation oncologists have minimal to no formal training or board certification requirements in managing lung nodules.
I agree with Dr. @Park's approach, but I also ask myself the question, "What is the price of being wrong?". If the patient is 55 and has minimal co-morbidities, I would be very reluctant to treat without a proven tissue diagnosis so after a shared decision-making visit with the patient, I tend to ei...
Answer from: Medical Oncologist at Community Practice
Agree with all mentioned approaches; these cases strongly benefit from multi-D discussions, weighing risks and probability of nodules with malignant potential.Interventional pulmonologists in our practice/Lung multi-D utilize Nodify Lung testing on concerning lesions during diagnostic bronchoscopy/E...
Agree with Dr. @Park. Empiric treatment with any m...