Pediatric pulmonary nodules: current state of knowledge, AI applications, and future directions

Pulmonary nodules are commonly encountered in pediatric patients. While metastases make up the majority of malignant pulmonary nodules found in children, nodules are also frequently identified in healthy children. Currently, there are no definitive nodule features to differentiate benign from malignant nodules, and there are no guidelines for incidental nodule follow-up in children similar in scope to the 2017 Fleischner Society Guidelines for adults. In this review, we discuss the epidemiology, histology, and imaging findings of pulmonary nodules found in healthy children, pulmonary metastases, primary pediatric lung cancer, and other causes of pulmonary nodules in children. We also explore current applications of artificial intelligence for the evaluation of pediatric pulmonary nodules.