Objective. To review the
radiological management of a solitary
pulmonary nodule.Data sources. MEDLINE literature search (1958-2002).Study
selection. All review articles and original articles. Key words for the lit-erature search were ‘solitary
pulmonary nodule’ and ‘imaging’.Data extraction. All relevant information and data.Data synthesis. The solitary pulmonary nodule remains a perennial problem inradiological practice, particularly with current trends using low-dose computedtomography to screen for lung cancer. Determining the likelihood of malignancyforms the basis of the
radiological approach of a solitary pulmonary nodule.Several factors that influence risk analysis include morphological and enhance-ment characteristics of the solitary pulmonary nodule on imaging, stability ofthe nodule, age of patient, smoking history, and history of malignant disease.Other ancillary procedures and imaging techniques that assist in the evaluationof a solitary pulmonary nodule include fluorodeoxyglucose positron-emissiontomography, technetium Tc 99m depreotide imaging, bronchoscopy withbronchioloalveolar lavage and biopsy, image-guided transthoracic needle aspi-ration biopsy, video-assisted thorascopic surgery, and thoracotomy.Conclusions. The success of any radiological management of a solitary pulmo-nary nodule rests on careful clinical evaluation and risk stratification for malig-nancy before the implementation of appropriate imaging techniques.