[Management strategy of pulmonary nodules]

Today pulmonary nodules are commonly detected by spiral CT but their evaluation and management remain a difficult task. The traditional approach, based on the principles of decision analysis, relies on estimating the probability of malignancy from risks factors assessed by history and morphological characteristics on chest radiographs and CT examinations. Use of non-invasive techniques such as PET and contrast-enhanced CT may decrease the number of invasive procedures performed to obtain an histological diagnosis. A precise evaluation of nodule growth can be obtained from recent improvements in CT technology and may shorten the follow-up. The goal of this review, based on the consensus obtained in a multidisciplinary group, is to emphasize the recent advances on the topic and to propose guidelines.