mJohn H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois; American College of Physicians. nNational Institutes of Health, Bethesda, Maryland. oLoyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois; Commission on Radiation Oncology. pDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. qThe University of Texas MD Anderson Cancer Center, Houston, Texas. rSpecialty Chair, Ohio State University Wexner Medical Center, Columbus, Ohio. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Incidentally Detected Indeterminate Pulmonary Nodule Discussion of Procedures by Variant Variant 1: Adult greater than or equal to 35 years of age. Incidentally detected indeterminate pulmonary nodule on chest radiograph. Next imaging study. CT Chest Without IV Contrast For individuals with an indeterminate pulmonary nodule detected on chest radiograph, ACCP guidelines recommend reviewing prior studies to determine stability. If the nodule has been stable for at least 2 years, no further workup is advised. If stability cannot be determined, guidelines recommend performing a chest CT to better characterize the nodule [2]. There are advantages of using CT as the first step in the characterization of pulmonary nodules detected on radio- graphs. Overlapping structures that might be causing pseudonodules are removed. Certain nodule characteristics suggestive of benign etiology are better appreciated by CT and can avoid additional workup.
Incidentally Detected Indeterminate Pulmonary Nodule PCAs. mJohn H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois; American College of Physicians. nNational Institutes of Health, Bethesda, Maryland. oLoyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, Illinois; Commission on Radiation Oncology. pDuke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons. qThe University of Texas MD Anderson Cancer Center, Houston, Texas. rSpecialty Chair, Ohio State University Wexner Medical Center, Columbus, Ohio. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Incidentally Detected Indeterminate Pulmonary Nodule Discussion of Procedures by Variant Variant 1: Adult greater than or equal to 35 years of age. Incidentally detected indeterminate pulmonary nodule on chest radiograph. Next imaging study. CT Chest Without IV Contrast For individuals with an indeterminate pulmonary nodule detected on chest radiograph, ACCP guidelines recommend reviewing prior studies to determine stability. If the nodule has been stable for at least 2 years, no further workup is advised. If stability cannot be determined, guidelines recommend performing a chest CT to better characterize the nodule [2]. There are advantages of using CT as the first step in the characterization of pulmonary nodules detected on radio- graphs. Overlapping structures that might be causing pseudonodules are removed. Certain nodule characteristics suggestive of benign etiology are better appreciated by CT and can avoid additional workup.