A practical algorithmic approach to the diagnosis and management of solitary pulmonary nodules: part 1: radiologic characteristics and imaging modalities

Chest. 2013 Mar;143(3):825-839. doi: 10.1378/chest.12-0960.


The solitary pulmonary nodule (SPN) is frequently encountered on chest imaging and poses an important diagnostic challenge to clinicians. The differential diagnosis is broad, ranging from benign granulomata and infectious processes to malignancy. Important concepts in the evaluation of SPNs include the definition, morphologic characteristics via appropriate imaging modalities, and the calculation of pretest probability of malignancy. Morphologic differentiation of SPN into solid or subsolid types is important in the choice of follow-up and further management. In this first part of a two-part series, we describe the morphologic characteristics and various imaging modalities available to further characterize SPN. In Part 2, we will describe the determination of pretest probability of malignancy and an algorithmic approach to the diagnosis of SPN.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / pathology
  • Algorithms
  • Calcinosis / pathology
  • Diagnosis, Differential
  • Diagnostic Imaging*
  • Fluorodeoxyglucose F18
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology
  • Lung Neoplasms / therapy
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Solitary Pulmonary Nodule / diagnosis*
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / pathology
  • Solitary Pulmonary Nodule / therapy
  • Tomography, X-Ray Computed


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18