Learning objectives
The purpose of this presentation is to provide guidance for those imaging scenarios when a pulmonary nodule is encountered at CT in an otherwise asymptomatic patient.
Background
The pulmonary nodule is a rounded or irregular opacity,
which is well-marginated or poorly defined,
and it measuresup to 3 cm in diameter1.
Nodules are common findings during CT examinations of the chest or any other CT studies that in some way involve the thoracic region (e.g.: abdominal,
head and neck,
cardio).
Over 50% of smokers above the age of 50 have at least one pulmonary nodule,
most of which are benign (96.4%)2.The clinical importance of nodules is highlighted by the fact that numerous processes...
Findings and procedure details
I.
Acquire thin slices!
According to current recommendations,
thelung window series of a CT study should be reconstructed with a slice thickness of less than or equal to 1.5 mm,
so that measurement variability and the detrimental effect of partial volume avaraging can be minimized3.
Thin slices also allow for better characterization of nodule morphology (Figs.1.,2.).
II. Do not shy away frompostprocessing techniques!
Viewing only the lung and soft tissue series may not be the most adequate means to assess nodules in the lung.
However,...
Conclusion
Pulmonary nodules are common findings at CT,
and they often cause a diagnostic dillema.
Radiologist aspire todetectmalignant lesions as early as possible,
while also aiming to minimize unnecessary interventions and follow-up studies.
This illustrated review providessome general rules that may be followed in order to increase diagnostic confidence.
Personal information
Dr.
András Székely is a senior radiologist at the University of Debrecen Kenézy Gyula Hospital Department of Radiology with a special interest in thoracic imaging.
Dr.
Julianna Tar is a radiology resident working under the supervision of Dr.
Székely.
Dr.
Péter Bágyi is the head of the Department of Radiology at Kenézy Gyula Hospital.
For any questions or further information please feel free to contact the lead author:
e-mail address:
[email protected]
website: www.drszekelyandras.hu
References
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Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017.
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