Correct!
3. Obtaining prior thoracic imaging studies for comparison to determine if the solitary nodule is stable over time
All of the options listed are appropriate measures used for the assessment of indeterminate solitary nodules. However, the first step in the evaluation of an indeterminate solitary pulmonary nodule should be comparison to prior thoracic imaging studies in the attempt to document long-term stability. As a general rule, documentation of long-term stability (usually 2 years or more) of an indeterminate nodule detected at chest radiography is sufficient to dismiss the nodule as benign without need for further exposure to ionizing radiation or the expense incurred by additional testing. If no such priors are available, or the nodule is new compared to older thoracic imaging studies, then the other methods listed are often employed to assess the nodule and drive the probability of malignancy either high enough to warrant intervention or low enough to safely permit observation.
No prior thoracic imaging studies were available for comparison, so the patient underwent bilateral, frontal, shallow (5°) oblique radiographs to distinguish a true lung nodule from either superimposition artifact or a chest wall abnormality simulating a pulmonary nodule.
Which of the following statements regarding this imaging study is most accurate? (Click on the correct answer to proceed to the next panel)