A practical algorithmic approach to the diagnosis and management of solitary pulmonary nodules: part 2: pretest probability and algorithm

Chest. 2013 Mar;143(3):840-846. doi: 10.1378/chest.12-1487.


In this second part of a two-part series, we describe an algorithmic approach to the diagnosis of the solitary pulmonary nodule (SPN). An essential aspect of the evaluation of SPN is determining the pretest probability of malignancy, taking into account the significant medical history and social habits of the individual patient, as well as morphologic characteristics of the nodule. Because pretest probability plays an important role in determining the next step in the evaluation, we describe various methods the physician may use to make this determination. Subsequently, we outline a simple yet comprehensive algorithm for diagnosing a SPN, with distinct pathways for the solid and subsolid SPN.

Publication types

  • Review

MeSH terms

  • Algorithms*
  • Bayes Theorem
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / therapy
  • Positron-Emission Tomography
  • Radiography
  • Risk Assessment
  • Solitary Pulmonary Nodule / diagnosis*
  • Solitary Pulmonary Nodule / diagnostic imaging
  • Solitary Pulmonary Nodule / epidemiology
  • Solitary Pulmonary Nodule / therapy