[Local treatment of solitary intrapulmonary, malignant nodules]

Radiologe. 2017 Feb;57(2):97-104. doi: 10.1007/s00117-016-0200-0.
[Article in German]

Abstract

Definition: Intrapulmonary nodules generally represent an incidental finding in the roentgenogram or computed tomography (CT) scan of the chest. They are defined as single, well-circumscribed, radiographic opaque lesions that measures up to 3 cm in diameter and are surrounded completely by aerated lung. The probability of malignancy directly correlates with increasing diameter. Lesions that have a diameter of 1 cm or larger require direct evaluation.

Therapy: Surgery is the first option for patients with a malignant lesion, given an acceptable perioperative risk; for high-risk patients either radiofrequency ablation (RFA) or stereotactic body radiation therapy (SBRT) should be offered. In these cases the malignant histology has to be established beforehand or verified by radiologic proven growth.

Outcome: Complete surgical resection is superior to RFA and SBRT with respect to local tumor control.

Keywords: Cancer of the lung; Catheter ablation; Pulmonary coin lesion; Stereotactic body radiotherapy; Surgery.

Publication types

  • Review

MeSH terms

  • Catheter Ablation / methods*
  • Combined Modality Therapy / methods
  • Evidence-Based Medicine
  • Humans
  • Patient Selection
  • Pneumonectomy / methods*
  • Prognosis
  • Radiography, Thoracic / methods
  • Radiosurgery / methods*
  • Radiotherapy, Image-Guided / methods
  • Solitary Pulmonary Nodule / diagnostic imaging*
  • Solitary Pulmonary Nodule / therapy*
  • Surgery, Computer-Assisted / methods
  • Treatment Outcome