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Respiratory Medicine A

Mayo Clinic Solitary Pulmonary Nodule Malignancy Risk

Estimates probability of malignancy in a solitary pulmonary nodule (SPN) using 6 independent predictors. Validated in multiple cohorts.

Score interpretation

Low Malignancy Risk (<5%) 0–2

Low probability of malignancy. Watchful waiting and serial imaging appropriate.

→ CT surveillance per Fleischner guidelines. Low-dose CT at 12 months if no prior CT available.

Intermediate Risk (5–65%) 3–5

Intermediate probability. Tissue sampling or PET-CT often required.

→ PET-CT to assess metabolic activity. Consider image-guided biopsy or resection depending on fitness. Multidisciplinary lung cancer meeting referral.

High Risk (>65%) 6–10

High probability of malignancy.

→ Urgent respiratory/thoracic surgery referral. PET-CT and tissue diagnosis (bronchoscopy or CT-guided biopsy). Expedited MDT review.

Interpretation bands for the Mayo SPN Risk. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.