• Khan A, Davis SD, Goodman PC, Haramati LB, Leung AN, McLoud TC, Rosado de Christenson ML, Rozenshtein A, White CS, Kaiser LR, Expert Panel on Thoracic Imaging. Solitary pulmonary nodule. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. 5 p. [30 references]

This is the current release of the guideline.

This guideline updates a previous version: Henschke CI, Yankelevitz D, Westcott J, Davis SD, Fleishon H, Gefter WB, McLoud TC, Pugatch RD, Sostman HD, Tocino I, White CS, Bode FR, Swensen SJ. Work-up of the solitary pulmonary nodule. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000 Jun;215(Suppl):607-9.

The appropriateness criteria are reviewed annually and updated by the panel as needed, depending on introduction of new and highly significant scientific evidence.

ACR Appropriateness Criteria®

Clinical Condition: Solitary Pulmonary Nodule, Noncalcified.

Variant 1: Nodule >1 cm, low clinical suspicion for cancer.

Note: Abbreviations used in the tables are listed at the end of the "Major Recommendations" field.

Variant 2: Nodule >1 cm, moderate to high clinical suspicion for cancer.

Note: Abbreviations used in the tables are listed at the end of the "Major Recommendations" field.

Variant 3: Nodule <1 cm, low clinical suspicion for cancer.

Note: Abbreviations used in the tables are listed at the end of the "Major Recommendations" field.

Variant 4: Nodule <1 cm, moderate to high clinical suspicion for cancer.

Note: Abbreviations used in the tables are listed at the end of the "Major Recommendations" field.

In view of the variety of diagnostic tests available and the variable accuracy of the different diagnostic techniques, no single algorithm for work-up is generally accepted. It has been found to vary from institution to institution. This is probably appropriate given the varying prevalence of lung disease in different parts of the country, varying skill levels of operators, and varying availability of equipment.

Abbreviations

• CT, computed tomography
• HRCT, high resolution computed tomography
• PET, positron emission tomography

Algorithms were not developed from criteria guidelines.

The recommendations are based on analysis of the current literature and expert panel consensus.

• Khan A, Davis SD, Goodman PC, Haramati LB, Leung AN, McLoud TC, Rosado de Christenson ML, Rozenshtein A, White CS, Kaiser LR, Expert Panel on Thoracic Imaging. Solitary pulmonary nodule. [online publication]. Reston (VA): American College of Radiology (ACR); 2005. 5 p. [30 references]

Not applicable: The guideline was not adapted from another source.

1995 Sep (revised 2005)

American College of Radiology - Medical Specialty Society

American College of Radiology (ACR) provided the funding and the resources for these ACR Appropriateness Criteria®.

Committee on Appropriateness Criteria, Expert Panel on Thoracic Imaging

Panel Members: Arfa Khan, MD (Review author); Sheila D. Davis, MD (Panel chair); Philip C. Goodman, MD; Linda B. Haramati, MD; Ann N. Leung, MD; Theresa C. McLoud, MD; Melissa L. Rosado de Christenson, MD; Anna Rozenshtein, MD; Charles S. White, MD; Larry R. Kaiser MD

Not stated

This is the current release of the guideline.

This guideline updates a previous version: Henschke CI, Yankelevitz D, Westcott J, Davis SD, Fleishon H, Gefter WB, McLoud TC, Pugatch RD, Sostman HD, Tocino I, White CS, Bode FR, Swensen SJ. Work-up of the solitary pulmonary nodule. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000 Jun;215(Suppl):607-9.

The appropriateness criteria are reviewed annually and updated by the panel as needed, depending on introduction of new and highly significant scientific evidence.

None available

This summary was completed by ECRI on March 25, 1999. The information was verified by the guideline developer on September 9, 1999. The summary was updated on February 12, 2002. The information was verified again by the guideline developer on March 25, 2002. This NGC summary was updated by ECRI on January 4, 2006. The updated information was verified by the guideline developer on January 19, 2006.