Non-calcified pulmonary nodules are a not uncommon incidental finding in CT heart scans and their evaluation is a matter of serious debate. Some physicians have complained to us that dealing with these findings is bothersome. We hope that the following information is helpful.
The ultimate clinical value of CT screening for cancer in general remains unproven. The value of detecting an early cancer must be weighed against the costs of false positive findings, sequential follow-up tests with the attendant radiation burden, and unnecessary biopsies and surgical procedures.
In this context, some have suggested that CT heart scans should not have the available lung fields reconstructed or read simply to avoid this problem, a stance which has not been supported by specialty bodies or insurers. For now, the standard of practice is to read the lung fields for incidental lesions or findings.
The following references summarize these viewpoints. The paper from the Massachusetts General Hospital succinctly discusses the evaluation of pulmonary nodules.
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