"Currently, there are no guidelines for further evaluation of pulmonary nodules incidentally found on abdominal CT," said Dr. Carol Wu from Massachusetts General Hospital in Boston. "The abdominal radiologists at our institution and also radiologists in private practice have approached us regarding what should be done" with them.
The study looked at 413 abdominal scan patients with incidental lung nodules that were followed up at least once with chest CT. At an average 170 days, only 6% of the patients had a nodule that had grown more than 2 cm since the initial abdominal scan. In all, 46 nodules were malignant. But the researchers also found that malignancy could be predicted to a significant extent based on patient age, indication for the original scan, and nodule size.
Wu and her colleagues recommend aggressive workup for larger nodules and older patients. "On the other hand, in younger patients with no history of malignancy and small nodules, follow-up CT chest can perhaps be performed at longer time intervals," she said.
