Current Practices in the Management of Pulmonary Ground-Glass Opacities: A Survey of SICT Members

Ann Thorac Surg. 2018 Nov;106(5):1504-1511. doi: 10.1016/j.athoracsur.2018.06.053. Epub 2018 Aug 4.


Background: Several gray areas and controversies exist concerning the management of pulmonary ground-glass opacities (GGOs), and there is a lack of consensus among clinicians on this topic. One of the main aims of the Italian Society of Thoracic Surgery is to promote education and research, so we decided to perform a survey on this topic to estimate current trends in practice in a large sample of thoracic surgeons.

Methods: A total of 160 thoracic surgeons responded, namely, completed our questionnaire (response rate, 53%; 160 of 302). The survey was composed of 36 questions divided into six subsections: (1) demographic characteristics of the respondents; (2) terminology and taxonomy; (3) radiologic and radiometabolic evaluation; (4) diagnostic approach and indications for surgery; (5) surgical management; and (6) radiologic surveillance.

Results: We observed some divergence of opinion regarding the definition of mixed GGOs, the role of 18F fluorodeoxyglucose positron emission tomography and computed tomography scans, indications for nonsurgical biopsy, intraoperative techniques for localizing GGOs, indications for surgery, extension of lung resection and lymph node dissection according to the radiologic scenario, use of intraoperative frozen section analysis, and radiologic surveillance of pure GGOs.

Conclusions: This topic warrants more investigation in the future. An upcoming consensus conference of Italian Society of Thoracic Surgery experts (also open to experts in other specialties) could provide updated indications for GGO management based on the literature, expert opinions, and the results of the present survey.

MeSH terms

  • Attitude of Health Personnel
  • Female
  • Health Care Surveys
  • Humans
  • Italy
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery
  • Male
  • Outcome Assessment, Health Care*
  • Positron-Emission Tomography / standards*
  • Positron-Emission Tomography / trends
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / trends
  • Risk Assessment
  • Societies, Medical
  • Surgeons
  • Surveys and Questionnaires*
  • Thoracic Surgery / standards
  • Thoracic Surgery / trends
  • Tomography, X-Ray Computed / standards*
  • Tomography, X-Ray Computed / trends