See below: I think a biopsy of a 7mm nodule would be very difficult to hit. Even using ENB and going right to the nodule, it would be difficult for a good sample at 7mm. Usually 1cm is the cut off for biopsy using guidance. I don't think it would be possible to biopsy something even 1cm without guidance unless you were just super lucky.
Answered 11/28/2017
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Fleischner Society: guidelines for a 7mm incidental nodule in a high risk patient suggest follow up CT at 6-12 months and then at 18-24 months if no change. Biopsy of a nodule this size technically difficult.
Answered 6/1/2017
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