ARE WE OVERDOING CT SCANS?

Our radiologists are requesting that CT scans be ordered when chest x-rays done for unrelated symptoms show small benign-appearing nodules (≤5 mm). The recommendation is to repeat the CT in three months “to assure stability.” What are the guidelines for following incidentally found pulmonary nodules ≤5 mm in size?
—James P. Cohen, MD, Westford, Mass.

The appropriate time interval for follow-up of smaller nodules has not yet been established. The National Lung Screening Trial will hopefully provide information regarding the appropriate follow-up of patients with incidental lung nodules discovered on CT scan. Expert opinion suggests that stability over two years usually—though not always—indicates a benign lesion.
—Susan Kashaf, MD, MPH (113-3)

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