# References & Disclaimer All educational content in Nodule Navigator is grounded in published clinical guidelines. Full citations and the complete disclaimer are below. ## Educational disclaimer **Nodule Navigator is strictly an educational visualization tool.** It is not a medical device, clinical decision support system, or diagnostic aid of any kind. The content presented — including nodule characteristics, risk context, and guideline summaries — is provided solely for educational and informational purposes. It does not constitute medical advice, clinical risk prediction, diagnostic guidance, or a substitute for professional medical consultation. Risk percentages and clinical context referenced in this application are sourced from published guidelines and peer-reviewed literature. They describe population-level data and cannot be applied to individual patient situations. **If you have concerns about a lung nodule or your lung health, consult a qualified physician or pulmonologist.** This tool has not been reviewed or approved by the FDA or any regulatory body. It is not intended for general consumer use. ## Privacy notice - This application does not collect, store, or share your name, medical history, or any other personally identifiable information. No data ever leaves your device. - The risk calculator asks for values such as age and smoking history to compute an educational estimate. All calculations are performed entirely on your device — no values you enter are ever sent to a server, logged, or retained after you close your browser. - Nodule Navigator does not use cookies, tracking pixels, or any technology that collects or stores personal data about you. - Because this tool does not collect Protected Health Information (PHI), it falls outside the scope of HIPAA-covered entities. It is an educational resource with no patient-facing or clinical data functions. The expanded version of this notice is at [/privacy](https://nodule.app/privacy). ## Clinical guidelines and sources ### Fleischner Society Guidelines (2017) MacMahon H, Naidich DP, Goo JM, et al. *Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.* Radiology. 2017;284(1):228-243. Evidence-based recommendations for managing incidentally detected pulmonary nodules in patients aged 35 and over. These guidelines apply to nodules found during CT performed for reasons other than lung cancer screening. ### Lung-RADS v2022 American College of Radiology. *Lung-RADS Version 2022.* Available at: The standard reporting framework for CT lung cancer screening programmes. Provides category definitions, follow-up recommendations, and a structured approach to communicating screening findings. ### National Lung Screening Trial (NLST) National Lung Screening Trial Research Team. *Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening.* N Engl J Med. 2011;365(5):395-409. Landmark randomised controlled trial demonstrating a 20% reduction in lung cancer mortality with annual low-dose CT screening in high-risk individuals. ### USPSTF Lung Cancer Screening Recommendation (2021) US Preventive Services Task Force. *Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement.* JAMA. 2021;325(10):962-970. Current US screening guidelines recommending annual LDCT for adults aged 50–80 with a 20 pack-year smoking history who currently smoke or quit within the past 15 years. ### Mayo Clinic Malignancy Risk Model (1997, validated 2004) Swensen SJ, Silverstein MD, Ilstrup DM, Schleck CD, Edell ES. *The probability of malignancy in solitary pulmonary nodules. Application to small radiologically indeterminate nodules.* Arch Intern Med. 1997;157(8):849-855. Validated in: Swensen SJ et al. Radiology. 2004;231:606–614. Logistic regression model estimating malignancy probability from six clinical predictors: age, smoking status, prior extrathoracic cancer, nodule diameter, spiculation, and upper-lobe location. Validated for patients aged 40 and over with nodule diameter 4–30 mm and pre-test probability of 65% or less. ## 3D model credits Reference objects used in the size-comparison scenes remain under their own licences. | Model | Author | Source | Licence | |---|---|---|---| | [Rice Grains](https://sketchfab.com/3d-models/rice-grains-f1298427e8cd444eb724f6e02f51c478) | wiiyu.sze | Sketchfab | CC BY 4.0 | | [Scanned Cheerios](https://sketchfab.com/3d-models/scanned-cheerios-86782dcfcf344b90b141b707fe564df4) | theraplay | Sketchfab | CC BY-ND 4.0 | | [Penny (Coin)](https://sketchfab.com/3d-models/penny-coin-297daf2b48f24b228db4a793e6156a18) | Yanez Designs | Sketchfab | CC BY 4.0 | | [Golfball — Lowpoly](https://www.turbosquid.com/3d-models/golfball-lowpoly-2515171) | mist_3D | TurboSquid | Royalty Free | ## Methodology note 3D nodule models are created in Blender and rendered using Google's `model-viewer` web component. Models are stylised representations for educational visualisation — they are not derived from patient imaging data and do not represent any specific radiological finding. Teal colouring is used for visual clarity and reflects the app's design theme, not actual nodule appearance. On CT imaging, pulmonary nodules appear as white or grey opacities against dark lung tissue. AR placement uses WebXR on Android and Apple AR Quick Look on iOS Safari. All models are rendered at 1:1 real-world scale in AR mode. --- *Educational use only · Not a medical device.* This document mirrors the page at .