Diagnostic approach for incidental pulmonary nodules

Lung cancer remains a leading cause of cancer-related mortality worldwide and is often diagnosed at an advanced stage, with poor survival outcomes. Early detection and appropriate management of incidental pulmonary nodules, frequently identified through low-dose computed tomography screening, are critical for improving prognosis and reducing lung cancer mortality. Established guidelines, including those of the Fleischner Society and American College of Radiology, provide structured recommendations for risk assessment, surveillance, and intervention. Recent advancements in diagnostic modalities, such as positron emission tomography, endobronchial ultrasound, electromagnetic navigation bronchoscopy, and robot-assisted bronchoscopy, have enhanced the diagnostic accuracy while minimizing procedural risks. A multidisciplinary approach that incorporates these technologies is essential for optimizing patient care. This review summarizes the current strategies for evaluating and managing solitary pulmonary nodules, including risk stratification models, imaging features, and biopsy techniques, thereby providing a comprehensive overview for clinicians.