For example, diffuse, central, laminated, or popcorn calcifications patterns are predictors of benign etiology (odds ratio [OR] = 0.07-0.20) [28]. Macroscopic fat is another indicator of benign etiology typical of hamartomas, which cannot be appreciated on radiographs. The mean attenuation value of indeterminate benign and malignant nodules on unenhanced CT is not significantly different and therefore not useful in their differentiation. However, multiple imaging features that increase the risk of malignancy are best characterized on CT, including nodule size, morphology, location, multi- plicity, or the presence of emphysema or fibrosis. Unsuspected associated processes such as lymphadenopathy can sometimes be detected on CT, and CT can help with planning next steps such as biopsy when indicated [2]. CT Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic contrast-enhanced CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. IV contrast is not required to identify or initially characterize pulmonary nodules on CT [27]. CT Chest With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. IV contrast is not required to identify or initially characterize pulmonary nodules on CT [27]. Cancer staging, an incidental mass workup, and nodules with associated lymphadenopathy fall outside of the scope of this document. FDG-PET/CT Whole Body There is no relevant literature to support the use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. FDG-PET/MRI Whole Body There is no relevant literature to support the use of FDG-PET/MRI in the evaluation of incidentally detected indeterminate pulmonary nodules.
Incidentally Detected Indeterminate Pulmonary Nodule PCAs. For example, diffuse, central, laminated, or popcorn calcifications patterns are predictors of benign etiology (odds ratio [OR] = 0.07-0.20) [28]. Macroscopic fat is another indicator of benign etiology typical of hamartomas, which cannot be appreciated on radiographs. The mean attenuation value of indeterminate benign and malignant nodules on unenhanced CT is not significantly different and therefore not useful in their differentiation. However, multiple imaging features that increase the risk of malignancy are best characterized on CT, including nodule size, morphology, location, multi- plicity, or the presence of emphysema or fibrosis. Unsuspected associated processes such as lymphadenopathy can sometimes be detected on CT, and CT can help with planning next steps such as biopsy when indicated [2]. CT Chest Without and With IV Contrast There is no relevant literature to support the use of dynamic contrast-enhanced CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. IV contrast is not required to identify or initially characterize pulmonary nodules on CT [27]. CT Chest With IV Contrast There is no relevant literature to support the use of contrast-enhanced CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. IV contrast is not required to identify or initially characterize pulmonary nodules on CT [27]. Cancer staging, an incidental mass workup, and nodules with associated lymphadenopathy fall outside of the scope of this document. FDG-PET/CT Whole Body There is no relevant literature to support the use of fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG)-PET/CT in the initial evaluation of incidentally detected indeterminate pulmonary nodules on chest radiographs. FDG-PET/MRI Whole Body There is no relevant literature to support the use of FDG-PET/MRI in the evaluation of incidentally detected indeterminate pulmonary nodules.