The pulmonary nodule: clinical and radiological characteristics affecting a diagnosis of malignancy

The role of computed tomography (CT) in the diagnosis of the solitary pulmonary nodule (SPN) is constantly expanding. CT helps to detect a growing number of increasingly small lesions, but, as with chest radiography, the primary goal in the evaluation of small pulmonary nodules is to exclude maligna...

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Bibliographic Details
Published in:Radiologia medica 2009-09, Vol.114 (6), p.871-889
Main Authors: Cardinale, L., Ardissone, F., Novello, S., Busso, M., Solitro, F., Longo, M., Sardo, D., Giors, M., Fava, C.
Format: Article
Language:English
Subjects:
Chest Radiology/Radiologia Toracica
Contrast Media
Diagnostic Imaging
Diagnostic Radiology
Humans
Image Enhancement - methods
Image Interpretation, Computer-Assisted - methods
Imaging
Interventional Radiology
Lung Neoplasms - diagnosis
Magnetic Resonance Imaging - methods
Medicine
Medicine & Public Health
Neuroradiology
Radiology
Solitary Pulmonary Nodule - diagnosis
Tomography, Emission-Computed - methods
Tomography, X-Ray Computed
Ultrasound
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Summary:The role of computed tomography (CT) in the diagnosis of the solitary pulmonary nodule (SPN) is constantly expanding. CT helps to detect a growing number of increasingly small lesions, but, as with chest radiography, the primary goal in the evaluation of small pulmonary nodules is to exclude malignancy. Despite the availability of numerous, variously invasive, diagnostic tests, diagnostic accuracy tends to decline as the size of the nodule decreases. The role of the radiologist is therefore to help the clinician determine the most appropriate management strategy by using all available modalities [CT, magnetic resonance (MR) imaging, positron emission tomography (PET)] and evaluating the patient’s clinical history and the imaging features leading to a diagnosis of benignity or malignancy. Imaging features include nodule size, margins, calcifications and fatty component, internal features (cavitations, pseudocavitations, air bronchogram, halo sign), as well as advanced techniques for characterisation (growth rate, contrast enhancement) and management (computer-aided diagnosis, Bayesian analysis, neural networks). The aim of this paper is to summarise the approach to pulmonary nodules from the point of view of the radiologist, oncologist and thoracic surgeon.
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-009-0399-1