We enclose a final draft of the BTS Guideline for the investigation and management of Pulmonary Nodules. This document has been prepared by a sub-committee of the BTS Standards of Care Committee (SOCC) in line with the Society’s policy for Guideline production (available on our website at: https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/).
The draft Guideline is now available for public consultation and a copy of the document is attached (the draft guideline and the appendices are also available to download from (https://www.brit-thoracic.org.uk/document-library/clinical-information/pulmonary-nodules/bts-guidelines-for-pulmonary-nodules/).
Introduction
Pulmonary nodules are well circumscribed, approximately rounded structures that appear on imaging as focal rounded opacities and by traditional definition are ?3cm in diameter and surrounded by aerated lung. They may be single or multiple and do not have associated abnormalities in the thorax such as lymphadenopathy or pleural disease. This definition is now commonly extended to include nodules in contact with the pleura. The now widespread use of helical multi-detector row CT (MDCT) has made it commonplace to detect, incidentally, nodules <1cm in diameter as well as sub-solid nodules (SSNs) that are partly or wholly ground glass opacities. These smaller and SSNs arguably present a greater clinical challenge than their larger counterparts and are therefore included in the scope of this guideline. Where appropriate, guidance is tailored to these distinct groups although it should be noted that in the literature precise definitions are not always given and a variety of terms are used. This is highlighted in the evidence review sections where necessary. This guideline proposes to standardise definitions and terms and these are shown in box 1.
