Pulmonary Nodule Lung-RADS v2022 Category — free guideline decision tool

Compute the Lung-RADS v2022 category from nodule type and size at baseline screening, with follow-up management. Instant, browser-side.

Solid: < 6 → 2, 6–< 8 → 3, 8–< 15 → 4A, ≥ 15 → 4B. Part-solid scored by solid component (< 6 → 3, 6–< 8 → 4A, ≥ 8 → 4B). Pure ground-glass: < 30 → 2, ≥ 30 → 3.

Classify a nodule on low-dose CT lung-cancer screening and set the follow-up.

For screening only — use Fleischner for incidental non-screening nodules. Additional suspicious features (spiculation, bubbly lucency, adenopathy) upgrade to 4X. New or growing nodules use lower thresholds (growth ≥ 1.5 mm). 4A → 3-month LDCT (add PET/CT if solid component ≥ 8 mm); 4B → diagnostic CT/PET/sampling. China reference line: the China National Lung Cancer Screening Guideline with LDCT (2025 Version), read side by side with Lung-RADS. A solid nodule, or the solid component of a part-solid nodule, with a mean diameter ≥ 6 mm is positive in both; a non-solid nodule is already a positive baseline at ≥ 8 mm in China (repeat CT at 6 months), whereas Lung-RADS places pure ground-glass in category 3 only at ≥ 30 mm. This tool's screening categories follow Lung-RADS v2022. The screening chapter of the Oncology Society of Chinese Medical Association lung cancer guideline (2026 edition) uses different criteria: risk assessment from age 45, a positive baseline at a solid nodule or solid component ≥ 5 mm (non-solid ≥ 8 mm), and annual screening, with intervals longer than 2 years not recommended. This tool does not calculate by those criteria. Quality control (Oncology Society of Chinese Medical Association, 2026): target mean effective dose for LDCT < 1 mSv; use iterative or deep-learning reconstruction where available; AI reads must be reviewed by a radiologist (false negatives occur in central and mediastinal lesions). Two site rules (not guideline text): low-dose CT from a health-check centre is treated as screening (Lung-RADS), while standard-dose health-check chest CT is treated as incidental (Fleischner); a trailing 5 rounds up (Lung-RADS keeps one decimal, so 5.95 mm counts as 6.0 mm; Fleischner rounds to whole millimetres, so 5.5 mm counts as 6 mm).

For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.

Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.

Inputs: Nodule type Part-solid, Mean diameter = (long axis + short axis) / 2 5.5 mm, Solid component diameter (if part-solid) 5 mm → Result: Category Lung-RADS 2（Category: Lung-RADS 2 (malignancy likelihood < 1%), Management: Benign appearance/behaviour: 12-month LDCT, continue annual screening, Read: Type: part-solid (solid component 5 mm), mean diameter 5.5 mm (baseline-screen thresholds)）