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Incidentally Detected Indeterminate Pulmonary Nodule

Pulmonary nodules are small growths in the lungs. They are often found by chance (incidentally) during lung imaging tests, and most are benign. They are called indeterminate because it is not yet known whether they are benign or may be cancer.

For adults ages 35 years or older with an incidentally detected indeterminate pulmonary nodule on chest x-ray, the next imaging test that is usually appropriate is CT chest without IV (intravenous) contrast. Repeat x-ray chest may be appropriate.

For adults ages 35 years or older with an incidentally detected indeterminate pulmonary nodule less than 6 mm on chest CT, the next imaging test that may be appropriate is CT chest without IV contrast after a follow-up period.

For adults ages 35 years or older with an incidentally detected indeterminate pulmonary nodule equal to or bigger than 6 mm on chest CT, the next imaging tests that are usually appropriate are CT chest without IV contrast after a follow-up period and FDG-PET/CT whole body (radioactive sugar is injected into the veins to show areas of high uptake that may be cancer). Image-guided transthoracic needle biopsy (needle is inserted through the chest wall to get a piece of the nodule) may be appropriate.

For adults ages 35 years or older with an incidentally detected indeterminate pulmonary nodule on a CT with an incomplete view of the chest (thorax) such as CT abdomen, neck, or spine, the next usually appropriate imaging test is CT chest without IV contrast.

For more information, please visit the Lung Nodules page.

— By Elaine Liang and Gregory J. Czuczman, MD. This information originally appeared in the Journal of the American College of Radiology.

This page was reviewed on January 24, 2024

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