Computed tomographic and positron emission tomographic scanning of pulmonary nodules
- Paul Stark, MD
Paul Stark, MD
- Professor of Radiology
- University of California San Diego
- Section Editor
- Nestor L Muller, MD, PhD
Nestor L Muller, MD, PhD
- Section Editor — Pulmonary Imaging
- Professor of Radiology
- University of British Columbia
- Deputy Editors
- Geraldine Finlay, MD
Geraldine Finlay, MD
- Deputy Editor — Pulmonary, Critical Care, and Sleep Medicine
- Associate Professor
- Tufts University School of Medicine
- Susanna I Lee, MD, PhD
Susanna I Lee, MD, PhD
- Deputy Editor — Radiology
- Associate Professor of Radiology
- Harvard Medical School
- Massachusetts General Hospital
Computed tomography (CT) is an important tool in the evaluation of solitary and multiple pulmonary nodules. It determines the morphology and attenuation characteristics of nodules, defines additional nodules that may not be visible on conventional radiography, and detects additional intrathoracic abnormalities, such as enlarged mediastinal lymph nodes. CT provides clues to the nature of the nodule(s), as well as global thoracic assessment that may help guide patient management. (See "High resolution computed tomography of the lungs".)
Positron emission tomography (PET) is a nuclear imaging modality that provides insight into the metabolic activity of a pulmonary lesion and, by inference, yields information about the probability of malignancy. (See "Thoracic positron emission tomography".)
The use of CT and PET in the evaluation of solitary or multiple pulmonary nodules will be presented here. General issues related to the differential diagnosis and evaluation of the solitary pulmonary nodule are discussed separately. (See "Diagnostic evaluation and management of the solitary pulmonary nodule".)
COMPUTED TOMOGRAPHY (CT)
CT is the imaging modality most often used to evaluate pulmonary nodules. In this section, we review technical aspects of CT and the use of CT in the evaluation of pulmonary nodules.
Technical aspects — Helical CT (ie, spiral CT) has several technical advantages in the evaluation of pulmonary nodules, compared to conventional, axial, step and shoot CT:
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