Management of pulmonary ground glass opacity: A review of current clinical practice guidelines

The wide application of computed tomography (CT) and lung cancer screening has increased the incidence of ground-glass opacities (GGOs). For those malignant potential of pulmonary lesions, several guidelines are conducted for radiologists or clinicians while encountering newly formed or persisted GGOs on CT scan. Active surveillance scanning instead of upfront surgical resection was mostly suggested as an initial decision of choice for small pulmonary lesions, except developing solid components or new growth. Standard surgical treatment has been lobectomy in the past decades for early-stage lung cancer, the feasibility of limited pulmonary resection based on radiologic features had investigated also recently. Several pivotal trials have been conducted using consolidation-to-tumor ratio, advocating the hypothesized advantages of preserving pulmonary function with equivalent oncologic outcome to lobectomy. After initial surgery for a main tumor, observation alone without further therapy is suggested for those residual GGOs which are not resected. Even though there might be no inferiority in postoperative survival outcomes, the evaluation made by experienced multidisciplinary team during follow-up is necessary. This paper is a review of the recent managements and guidelines for GGOs.