Radiography Chest There is no relevant literature to support the use of chest radiographs in the evaluation or follow-up of incidentally detected indeterminate pulmonary nodules on chest CT. Radiograph sensitivity for detecting nodules is low, with a significant number of nodules missed [5]. Most nodules <1 cm are not visible in chest radiographs [9]. In addition, radiographs lack the resolution to adequately characterize nodules. Variant 4: Adult greater than or equal to 35 years of age. Incidentally detected indeterminate pulmonary nodule on incomplete thoracic CT (eg, CT abdomen, neck, spine, etc). Next imaging study. Lungs are partially seen on CT from other body parts including neck, spine, heart, and abdomen. Pulmonary nodules are frequently encountered on these studies and are described as the most common incidental finding by some authors [67-69]. Reported nodule incidence ranges from 8% to 23% for coronary CT angiography [7,69,70], 16.4% to 28.2% for patients undergoing CT for transcatheter aortic valve implantation [67,68,71], and 2.5% to 39.1% for abdominal CTs [72-74]. The most updated Fleischner Society guidelines address the management of nodules found on incomplete thoracic CT. Please refer to Appendix 3 for details. CT Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic contrast-enhanced CT in the evaluation of incidentally detected indeterminate pulmonary nodules encountered on incomplete thoracic CT. Incidentally Detected Indeterminate Pulmonary Nodule CT Chest With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT in the evaluation of incidentally detected indeterminate pulmonary nodules encountered on incomplete thoracic CT. Cancer staging, an incidental mass workup, and nodules with associated lymphadenopathy fall outside of the scope of this document.
Incidentally Detected Indeterminate Pulmonary Nodule PCAs. Radiography Chest There is no relevant literature to support the use of chest radiographs in the evaluation or follow-up of incidentally detected indeterminate pulmonary nodules on chest CT. Radiograph sensitivity for detecting nodules is low, with a significant number of nodules missed [5]. Most nodules <1 cm are not visible in chest radiographs [9]. In addition, radiographs lack the resolution to adequately characterize nodules. Variant 4: Adult greater than or equal to 35 years of age. Incidentally detected indeterminate pulmonary nodule on incomplete thoracic CT (eg, CT abdomen, neck, spine, etc). Next imaging study. Lungs are partially seen on CT from other body parts including neck, spine, heart, and abdomen. Pulmonary nodules are frequently encountered on these studies and are described as the most common incidental finding by some authors [67-69]. Reported nodule incidence ranges from 8% to 23% for coronary CT angiography [7,69,70], 16.4% to 28.2% for patients undergoing CT for transcatheter aortic valve implantation [67,68,71], and 2.5% to 39.1% for abdominal CTs [72-74]. The most updated Fleischner Society guidelines address the management of nodules found on incomplete thoracic CT. Please refer to Appendix 3 for details. CT Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic contrast-enhanced CT in the evaluation of incidentally detected indeterminate pulmonary nodules encountered on incomplete thoracic CT. Incidentally Detected Indeterminate Pulmonary Nodule CT Chest With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT in the evaluation of incidentally detected indeterminate pulmonary nodules encountered on incomplete thoracic CT. Cancer staging, an incidental mass workup, and nodules with associated lymphadenopathy fall outside of the scope of this document.