What to Do with a Pulmonary Nodule?

Using computed tomography (CT) to screen for lung cancer creates an inherent problem: what to do when a small, solitary, noncalcified pulmonary nodule is detected. Current recommendations call for judicious monitoring with follow-up scans when such nodules are <5 mm. However, images from CT scans currently are reviewed in an axial two-dimensional format, which makes assessing changes in nodule volume over time difficult; therefore, only unequivocal nodule growth triggers further evaluation. Dutch and Belgian investigators conducted serial volumetric CT imaging using specialized software that generated measurement of nodule volume rather than simply two-dimensional measurement to determine nodule volume and growth rate; these measurements th…