Version June 2024
| Nodule type and size (mm) | Recommendation | Comments |
| Solitary pure ground-glass | ||
| <6 | No routine follow-up. | Consider CT at two and four years if patient is considered high risk for cancer. |
| ≥6 | CT at 6 to 12 months to confirm persistence. If unchanged, then CT every two years until five years. Growing nodules should undergo histologic sampling.* | Histologic sampling requires resection as ground glass nodules are not amenable to needle biopsy. |
| Solitary part-solid | ||
| <6 | No routine follow-up. | In practice, part-solid nodules <6 mm cannot be defined as such until ≥6 mm. Consequently, these should be managed as a pure ground-glass nodule. |
| ≥6 | CT at three to six months to confirm persistence. If unchanged and solid component remains <6 mm, annual CT should be performed for five years. Nodules with solid component >8 mm or growing nodules should undergo histologic sampling.* | For nodules with solid component ≤8 mm, histologic sampling requires resection as they are not amenable to needle biopsy. |
| Multiple | ||
| <6 | CT at three to six months. If stable, no routine follow-up. | Consider CT at two and four years if patient is considered high risk for cancer. |
| ≥6 | CT at three to six months. If stable, subsequent evaluation is based on the most suspicious nodule (largest nodule for pure ground-glass and largest solid component for part-solid). | |
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