Incidental pulmonary nodules are a common finding on CT, often of uncertain significnce. This exhibit presents a practical algorithm for nodule management. It incorporates Fleischner Society guidelines in a conservative and condensed approach addressing difficulties in precise nodule measurement and lack of knowledge regarding smoking history.

The algorithm is organized by age, nodule size and risk factors including smoking, known malignancy and immunocompromised or febrile state. The algorithm provides guidance for nodule management based on CT characteristics including ground glass, mixed or solid morphology. Guidelines for the use of PET are given to assess for metabolically active nodules particularly in patients with comorbid states. Guidelines are presented for CT followup, needle biopsy or VATS. Case examples are incorporated.

This exhibit provides a practical easy-to-follow algorithm for radiologists and clinicians that simplifies the imaging and interventional recommendations for incidentally found pulmonary nodules on CT.