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Biopsy or another CT in 3 months


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Hi all:

I am new here and writing on behalf of my husband. In July, he had a voluntary CT calcium to check his heart vessels. A lung nodule measuring 1.4cm was found.

Since that time he has has two CTs and a PET scan.  Right hilar adenopathy 2.3cm was detected with an SUV of 3.2. None of the lung nodules were reactive. He has been given a choice of biopsy of the hilar node or another CT in 3 months. I am wanting him to have the biopsy but he is very passive. I am afraid of further growth, etc. 

I would appreciate any thoughts. 

Thank you! 

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Welcome here.

Unfortunately, a nodule the size of 2.3 cm can be a hard target for a guided needle biopsy. Moreover a SUV of 3.2 may not be suggestive of metastatic activity, but the nodule growth from discovery at 1.4 cm is of concern. Here is some information about PET scans and SUVs that might be helpful. 

A biopsy is the only conclusive way we have for diagnosing lung cancer, but small nodules often don't yield adequate biopsy results. So sadly we are left with the "watch and wait" approach to diagnosis. Having been where your husband is, several times, I well understand your concern but I don't have a definitive recommendation.

Stay the course.


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Welcome to our forums.  Sorry you need to be here though. The majority of lung nodules (60%) are not malignant, and one way they determine that is if it does not grow during the "waiting period" between scans.  Most benign nodules don't continue to increase in size, but at times even benign nodules can come and go, so that alone is still not the benchmark for determining cancer.  CT and PET Scans can provide preliminary information about a nodule, but frankly the real determinant is a biopsy.  There is a collection of information on Lungevity regarding "Diagnosing Lung Cancer" and it can be found here.  For my money a biopsy is the real test to determine if there is a malignancy.  If you do decide to go that route please ask for "biomarker testing" as that information may prove valuable at a later date.  Early detection is a Godsend with this disease so speak with your husband and he with his doctor.  Others will no doubt share their thoughts on this, but the more thorough and timely the diagnosis the better results that can occur.  Best of luck and please provide us with an update and any questions you may have.


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Sorry you have to be here Lisa, but welcome to this awesome forum.

I remember using some online calculators for risk of nodules when mine was found (used it just to get a sense of what I should expect before biopsy was done). Here are a few:


I think I used the first one in the list and it was very evident to me that my biopsy will turn out to  be cancer. These are just models but they seem to be useful/informatives (but still, as estimates). 

Wishing the best of luck to your husband!

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