🫁 Lung Nodule Malignancy Risk (Brock / Mayo / Herder) + BTS Pathway
UseSolitary or multiple CT-detected lung nodules when deciding between CT surveillance, PET-CT and biopsy/excisi…
SourceCallister MEJ, et al. BTS guidelines for pulmonary nodules. Thorax 2015;70 Suppl 2:ii1-ii54
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Brock and Mayo shown together.
When to use
Solitary or multiple CT-detected lung nodules when deciding between CT surveillance, PET-CT and biopsy/excision.
How it works
Brock logit = −6.7892 + 0.0287(age−62) + 0.6011 female + 0.2961 family history + 0.2953 emphysema − 5.3854[(size/10)^−0.5 − 1.5811] + type (GGN −0.1276, part-solid 0.377) + 0.6581 upper lobe − 0.0824(count−4) + 0.7729 spiculation. Mayo logit = −6.8272 + 0.0391 age + 0.7917 smoker + 1.3388 cancer history + 0.1274 diameter + 1.0407 spiculation + 0.7838 upper lobe. Herder logit = −4.739 + 3.691 × Mayo + PET (faint 2.322 / moderate 4.617 / intense 4.771).
Key points
- Brock and Mayo shown together.
- Herder refines risk after PET.
- BTS thresholds: 10% and 70%.
- No follow-up below 5 mm.
References
- [Guideline / primary source]Callister MEJ, et al. BTS guidelines for pulmonary nodules. Thorax 2015;70 Suppl 2:ii1-ii54
- McWilliams A, et al. N Engl J Med 2013;369:910-919
- Swensen SJ, et al. Arch Intern Med 1997;157:849-855
- Herder GJ, et al. Chest 2005;128:2490-2496
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Age | 62 years |
|---|---|
| Sex | Male |
| Nodule maximum diameter (CT lung window) | 12 mm |
| Nodule type | Part-solid |
| Upper lobe | No |
| Spiculation | No |
| Total nodules on CT | 1 nodules |
| Emphysema | No |
| Family history of lung cancer | No |
| Ever smoker (current or former; Mayo) | Never |
| Extrathoracic cancer ≥5 years ago (Mayo) | No |
| PET-CT FDG uptake (Herder; leave blank if not done) | Faint (≤ mediastinal blood pool) |
→Herder9.8%
- Brock (PanCan)：7.1% (full model with spiculation)
- Mayo Clinic：5.3%
- Herder：9.8%
| Age | 62 years |
|---|---|
| Sex | Male |
| Nodule maximum diameter (CT lung window) | 12 mm |
| Nodule type | Solid |
| Upper lobe | No |
| Spiculation | No |
| Total nodules on CT | 1 nodules |
| Emphysema | No |
| Family history of lung cancer | No |
| Ever smoker (current or former; Mayo) | Never |
| Extrathoracic cancer ≥5 years ago (Mayo) | No |
| PET-CT FDG uptake (Herder; leave blank if not done) | Absent (≤ background) |
→Herder1.1%
- Brock (PanCan)：5.0% (full model with spiculation)
- Mayo Clinic：5.3%
- Herder：1.1%
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Lung Nodule Malignancy Risk (Brock / Mayo / Herder) + BTS Pathway?
- 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.
- Does Lung Nodule Malignancy Risk (Brock / Mayo / Herder) + BTS Pathway upload patient data? Where is it calculated?
- 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.
- How is Lung Nodule Malignancy Risk (Brock / Mayo / Herder) + BTS Pathway calculated in practice? Can you show a worked example?
- Inputs: Age 62 years, Sex Male, Nodule maximum diameter (CT lung window) 12 mm, Nodule type Part-solid, Upper lobe No, Spiculation No, Total nodules on CT 1 nodules, Emphysema No… → Result: Herder 9.8%（Brock (PanCan): 7.1% (full model with spiculation), Mayo Clinic: 5.3%, Herder: 9.8%） Inputs: Age 62 years, Sex Male, Nodule maximum diameter (CT lung window) 12 mm, Nodule type Solid, Upper lobe No, Spiculation No, Total nodules on CT 1 nodules, Emphysema No… → Result: Herder 1.1%（Brock (PanCan): 5.0% (full model with spiculation), Mayo Clinic: 5.3%, Herder: 1.1%）