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Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule.

Publication ,  Journal Article
Erasmus, JJ; McAdams, HP; Connolly, JE
Published in: Radiographics
2000

Various strategies may be used to evaluate indeterminate solitary pulmonary nodules. Growth rate assessment is an important and cost-effective step in the evaluation of these nodules. Clinical features (eg, patient age, history of prior malignancy, presenting symptoms, smoking history) can be useful in suggesting the diagnosis and aiding in management planning. Bayesian analysis allows more precise determination of the probability of malignancy (pCa). Decision analysis models suggest that the most cost-effective management strategy depends on the pCa for a given nodule. At contrast material-enhanced computed tomography, nodular enhancement of less than 15 HU is strongly predictive of a benign lesion, whereas enhancement of more than 20 HU typically indicates malignancy. At 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography, lesions with low FDG uptake are typically benign, whereas those with increased FDG uptake are typically malignant. Results of transthoracic needle aspiration biopsy influence management in approximately 50% of cases and, in indeterminate lesions with a pCa between 0.05 and 0.6, is the best initial diagnostic procedure. It is optimally used in peripheral nodules and has been reported to establish a benign diagnosis in up to 91% of cases. Although there is no one correct management approach, the ability to distinguish benign from malignant solitary pulmonary lesions has improved with the use of these strategies.

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Published In

Radiographics

DOI

ISSN

0271-5333

Publication Date

2000

Volume

20

Issue

1

Start / End Page

59 / 66

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Tomography, Emission-Computed
  • Solitary Pulmonary Nodule
  • Pneumonectomy
  • Nuclear Medicine & Medical Imaging
  • Lung Neoplasms
  • Humans
  • Disease Progression
  • Diagnosis, Differential
  • Decision Making
 

Citation

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Erasmus, J. J., McAdams, H. P., & Connolly, J. E. (2000). Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule. Radiographics, 20(1), 59–66. https://doi.org/10.1148/radiographics.20.1.g00ja0259
Erasmus, J. J., H. P. McAdams, and J. E. Connolly. “Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule.Radiographics 20, no. 1 (2000): 59–66. https://doi.org/10.1148/radiographics.20.1.g00ja0259.
Erasmus JJ, McAdams HP, Connolly JE. Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule. Radiographics. 2000;20(1):59–66.
Erasmus, J. J., et al. “Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule.Radiographics, vol. 20, no. 1, 2000, pp. 59–66. Pubmed, doi:10.1148/radiographics.20.1.g00ja0259.
Erasmus JJ, McAdams HP, Connolly JE. Solitary pulmonary nodules: Part II. Evaluation of the indeterminate nodule. Radiographics. 2000;20(1):59–66.
Journal cover image

Published In

Radiographics

DOI

ISSN

0271-5333

Publication Date

2000

Volume

20

Issue

1

Start / End Page

59 / 66

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Tomography, Emission-Computed
  • Solitary Pulmonary Nodule
  • Pneumonectomy
  • Nuclear Medicine & Medical Imaging
  • Lung Neoplasms
  • Humans
  • Disease Progression
  • Diagnosis, Differential
  • Decision Making