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The Solitary Pulmonary Nodule¹

¹ From the Department of Radiology, Indiana University, Indianapolis, Ind. Received February 28, 2005; revision requested April 22; revision received April 28; accepted June 13; final version accepted August 11; final review and update by the author October 31. Address correspondence to the author, 11224 Clarkston Rd, Zionsville, IN 46077 (e-mail: hwinermu{at}iupui.edu).

The imaging evaluation of a solitary pulmonary nodule is complex. Management decisions are based on clinical history, size and appearance of the nodule, and feasibility of obtaining a tissue diagnosis. The most reliable imaging features are those that are indicative of benignancy, such as a benign pattern of calcification and periodic follow-up with computed tomography for 2 years showing no growth. Fine-needle aspiration biopsy and core biopsy are important procedures that may obviate surgery if there is a specific benign diagnosis from the procedure. In using the various imaging and diagnostic modalities described in this review, one should strive to not only identify small malignant tumors—where resection results in high survival rates—but also spare patients with benign disease from undergoing unnecessary surgery.

© RSNA, 2006

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