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Special Features: Chest Imaging |

A Practical Algorithmic Approach to the Diagnosis and Management of Solitary Pulmonary NodulesAlgorithmic Approach to Solitary Pulmonary Nodules: Part 1: Radiologic Characteristics and Imaging Modalities

Vishal K. Patel, MBBS; Sagar K. Naik, MBBS; David P. Naidich, MD, FCCP; William D. Travis, MD, FCCP; Jeremy A. Weingarten, MD, FCCP; Richard Lazzaro, MD; David D. Gutterman, MD, FCCP; Catherine Wentowski, MD; Horiana B. Grosu, MD; Suhail Raoof, MBBS, FCCP
Author and Funding Information

From the New York Methodist Hospital (Drs Patel, Naik, Weingarten, Lazzaro, Wentowski, Grosu, and Raoof), Brooklyn, NY; New York University Langone Medical Center (Dr Naidich), New York, NY; Memorial Sloan-Kettering Cancer Center (Dr Travis), New York, NY; and Medical College of Wisconsin (Dr Gutterman), Milwaukee, WI.

Correspondence to: Suhail Raoof, MBBS, FCCP, New York Methodist Hospital, Department of Pulmonary and Critical Care, 506 Sixth St, Brooklyn, NY 11215; e-mail: suhailraoof@gmail.com


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):825-839. doi:10.1378/chest.12-0960
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The solitary pulmonary nodule (SPN) is frequently encountered on chest imaging and poses an important diagnostic challenge to clinicians. The differential diagnosis is broad, ranging from benign granulomata and infectious processes to malignancy. Important concepts in the evaluation of SPNs include the definition, morphologic characteristics via appropriate imaging modalities, and the calculation of pretest probability of malignancy. Morphologic differentiation of SPN into solid or subsolid types is important in the choice of follow-up and further management. In this first part of a two-part series, we describe the morphologic characteristics and various imaging modalities available to further characterize SPN. In Part 2, we will describe the determination of pretest probability of malignancy and an algorithmic approach to the diagnosis of SPN.


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