The solitary pulmonary nodule (SPN) is a common medical problem for which management can be quite complex. Imaging remains at the center of management of SPNs, and computed tomography is the primary modality by which SPNs are characterized and followed up for stability. This manuscript summarizes the American College of Radiology Appropriateness Criteria® for radiographically detected solitary pulmonary nodules and briefly reviews the various imaging techniques available. The American College of Radiology Appropriateness Criteria® are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
*Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
†Cleveland Clinic Foundation, Cleveland, OH
‡Cleveland Clinic, Weston, FL
§Robert Wood Johnson Medical School, New Brunswick, NJ
∥Ronald Regan UCLA Medical Center, Los Angeles, CA
¶National Jewish Health, Denver, CO
#Department of Surgery, Society of Thoracic Surgeons, Columbia University, New York, NY
¶¶The American College of Chest Physicians, New York Methodist Hospital, Brooklyn, NY
##Department of Radiology, North Shore University Hospital, Manhasset, NY
**Department of Radiology, Indiana University, Indianapolis, IN
††Department of Radiology, University of Michigan Medical Center, Ann Arbor, MI
‡‡Department of Radiology, University of New Mexico, Albuquerque, NM
§§Society of Nuclear Medicine, Beth Israel Deaconess Medical Center, Boston, MA
∥∥Department of Radiology, Medical University of South Carolina, Charleston, SC
Jeffrey P. Kanne is a consultant for PTC Therapeutics ($13,000) not relevant to ACR activities or imaging. For the remaining authors none were declared.
The American College of Radiology (ACR) seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria® through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document.
This article is a revised version of the American College of Radiology Appropriateness Criteria® Radiographically Detected Solitary Pulmonary Nodule. Practitioners are encouraged to refer to the complete version at http://www.acr.org/ac.
Reprints: Jeffrey P. Kanne, MD, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191 (e-mail: firstname.lastname@example.org).