Management strategies for the solitary pulmonary nodule

Current Opinion in Pulmonary Medicine
David Ost, Alan M Fein

Abstract

The challenge of diagnosis and management of solitary pulmonary nodules is among the most common yet most important areas of pulmonary medicine. Ideally, the goal of diagnosis and management is to promptly bring to surgery all patients with operable malignant nodules while avoiding unnecessary thoracotomy in patients with benign disease. Effective management of the solitary pulmonary nodule depends upon an understanding of decision analysis principles so that diverse technologies can be integrated into a systematic approach. In almost all patients computed tomography (CT) is the best first step. Three key questions can then help guide the workup of the SPN. These are what is the pretest probability of cancer, what is the risk of surgical complications, and does the appearance of the nodule on CT scan suggest a benign or malignant etiology. In patients with average surgical risk, positron emission tomography (PET) scan is warranted when there is discordance between pretest probability of cancer and the appearance of the nodule on CT scan. Thus, when either the patient has a low risk of cancer and the CT suggests a malignant origin, or when there is high risk of cancer and the CT appears benign, PET scan will be cost effective. I...Continue Reading

References

Sep 16, 2000·American Journal of Respiratory and Critical Care Medicine·D Ost, A Fein
Jan 3, 2001·AJR. American Journal of Roentgenology·W G BergerR G Stern
Mar 17, 2001·JAMA : the Journal of the American Medical Association·M K GouldD K Owens
Feb 24, 2001·Thorax·UNKNOWN British Thoracic Society, UNKNOWN Society of Cardiothoracic Surgeons of Great Britain and Ireland Working Party
Jul 21, 2001·The New England Journal of Medicine·P B BachC B Begg
Feb 19, 2002·American Journal of Respiratory and Critical Care Medicine·Stephen J SwensenPeter C Pairolero
Jan 15, 2003·JAMA : the Journal of the American Medical Association·Parthiv J MahadeviaNeil R Powe
Jan 16, 2003·Chest·Bethany B TanUNKNOWN American College of Chest Physicians
Jan 16, 2003·Chest·Michael A BecklesUNKNOWN American College of Chest Physicians
May 6, 2003·Annals of Internal Medicine·Michael K GouldDouglas K Owens
Jun 20, 2003·The New England Journal of Medicine·David OstSteven H Feinsilver
Jul 12, 2003·Seminars in Roentgenology·Beatrice Trotman-Dickenson, Bernhard Baumert
Sep 10, 2003·Mayo Clinic Proceedings·John R Muhm, Ann E McCullough
Oct 14, 2003·IEEE Transactions on Medical Imaging·William J KostisClaudia I Henschke
Dec 12, 2003·The Annals of Thoracic Surgery·Eugenio PompeoTommaso C Mineo
Dec 12, 2003·The Annals of Thoracic Surgery·James W KlenaJoel A Johnson

❮ Previous
Next ❯

Citations

May 17, 2006·Surgical Endoscopy·D SortiniA Sortini
Aug 10, 2010·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Irawati LemonnierFrancis Guillemin
Apr 19, 2013·Molecular Imaging and Biology : MIB : the Official Publication of the Academy of Molecular Imaging·Rianot AmzatDavid M Schuster
Jun 24, 2011·Japanese Journal of Clinical Oncology·Eun Young HeoHo Il Yoon
May 24, 2012·Current Opinion in Pulmonary Medicine·Horiana B GrosuDavid Ost
Oct 25, 2006·American Journal of Respiratory and Critical Care Medicine·Prashant N Chhajed, Michael Tamm
Oct 8, 2011·American Journal of Respiratory and Critical Care Medicine·David E Ost, Michael K Gould
Jan 19, 2016·The Journal of Urology·Jennifer M LoboTracey L Krupski
Apr 7, 2007·Journal of the American College of Radiology : JACR·Arfa Khan
Dec 13, 2006·Radiologic Clinics of North America·Michelle S GinsbergRobert T Heelan
Mar 25, 2008·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Susan C van't WesteindeRob J van Klaveren
Feb 27, 2014·Asian Cardiovascular & Thoracic Annals·Yidan LinQiang Pu
Apr 12, 2019·Current Opinion in Pulmonary Medicine·Faria Nasim, David E Ost
Sep 18, 2020·General Thoracic and Cardiovascular Surgery·Ryusuke SumiyaSatoshi Nagasaka

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.