Advertisement

Pulmonary Incidentalomas

  • Anne Cameron Coates
  • Robert G. Zwerdling
Chapter

Abstract

An incidentaloma is an unexpected finding unrelated to the patient’s primary problem or an expected finding that requires additional evaluation but is eventually found to be irrelevant to the management of the patient. Widespread use of advanced imaging techniques increases the risk of discovering such findings. As a result, clinicians face the dual problems of deciding on the best course of action with respect to these findings in asymptomatic patients and how to lessen the chance of finding them in the first place. Currently, there is a paucity of data or guidelines addressing this situation in the young. We should accomplish this in as safe, nontraumatic, and cost-effective manner as possible.

Keywords

Pulmonary Nodule Professional Society Advanced Imaging Technique Radiologic Community Misregistration Artifact 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Reed M. Imaging utilization commentary: a radiology ­perspective. Pediatr Radiol. 2008;38:660.CrossRefGoogle Scholar
  2. 2.
    van Klaveren RJ et al. Management of lung nodules detected by volume CT scanning. N Engl J Med. 2009;361(23):2221–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Felson B. Chest roentgenology. Philadelphia: W. B. Saunders Co; 1973.Google Scholar
  4. 4.
    Brenner DJ, Hall EJ. Computed tomography – an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–84.PubMedCrossRefGoogle Scholar
  5. 5.
    Forghani N, Cohen RA, Abbott MB. Radiation risks of CT scans. Pediatr Rev. 2006;27(2):79.PubMedCrossRefGoogle Scholar
  6. 6.
    White K. Helical/spiral CT scanning: a pediatric radiology perspective. Pediatr Radiol. 1996;26:5–14.PubMedCrossRefGoogle Scholar
  7. 7.
    Silva CT et al. CT characteristics of lung nodules present at diagnosis of extrapulmonary malignancy in children. Am J Roentgenol. 2010;194(3):772–8.CrossRefGoogle Scholar
  8. 8.
    MacMahon H et al. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner society. Radiology. 2005;237(2):395–400.PubMedCrossRefGoogle Scholar
  9. 9.
    Picano E. Sustainability of medical imaging. BMJ. 2004;328(7439):578–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Weinstein MC, Skinner JA. Comparative effectiveness and health care spending – implications for reform. N Engl J Med. 2010;362(5):460–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Baldwin J. New study questions marketing of spiral CT scanning to consumers. J Natl Cancer Inst. 2003;95(7):507–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Sorgen C. Local hospitals tout new technology. Washington: The Washington Post; 2010. http://www.washingtonpost.com/wp-dyn/content/article/2010/08/30/AR2010083002079.html Google Scholar
  13. 13.
    Berlin L. Failure to diagnose lung cancer: anatomy of a malpractice trial. Am J Roentgenol. 2003;180(1):37–45.Google Scholar
  14. 14.
    Mold J, Stein HF. The cascade effect in the clinical care of patients. N Engl J Med. 1986;314:512–4.PubMedCrossRefGoogle Scholar
  15. 15.
    Bleyer A. Helical CT and cancer resk. Panel discussion. Pediatr Radiol. 2002;32:242–4.CrossRefGoogle Scholar
  16. 16.
    Schneebaum N et al. Use and yield of chest computed tomography in the diagnostic evaluation of pediatric lung disease. Pediatrics. 2009;124(2):472–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Vrielynck S et al. Diagnostic value of high-resolution CT in the evaluation of chronic infiltrative lung disease in children. Am J Roentgenol. 2008;191(3):914–20.CrossRefGoogle Scholar
  18. 18.
    Punwani S et al. Paediatric CT: the effects of increasing image noise on pulmonary nodule detection. Pediatr Radiol. 2008;38(2):192.PubMedCrossRefGoogle Scholar
  19. 19.
    Gould MK et al. Evaluation of patients with pulmonary nodules: when is it lung cancer? ACCP evidence-based clinical practice guidelines (2nd Edition). Chest. 2007;132(3 suppl):108S–30.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Lucille Packard Children’s Hospital at StanfordPalo AltoUSA
  2. 2.UMass Memorial Medical CenterWorcesterUSA

Personalised recommendations