The pulmonary nodule is a common radiological abnormality often discovered incidentally at chest radiography or CT. Although almost all of these pulmonary nodules have a benign cause, 1-30% are malignant, many of them representing stage I lung cancer that must be distinguished from benign nodules in an expeditious and cost-effective manner. Cigarette smokers are at a greater risk for lethal cancers, and malignant nodules in smokers grow faster, on average, than those in non-smokers.
Thin collimation helical CT may characterize some nodules as definitely benign (presence of fat collection or benign calcifications), not requiring any further evaluation, or as of high suspicion of malignancy (spiculations, size > 20 mm, malignant calcifications) requiring lung biopsy or surgical resection.
For indeterminate nodules of small size (less than 20 mm), comparative volume analysis represents a non-invasive characterization method compared to needle biopsy, and can be used for nodules of 5 to 10 mm.
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Although almost all of these pulmonary nodules have a benign cause, 1-30% are malignant.
Thin collimation helical CT can may characterize some nodules as definitely benign not requiring any further evaluation.