ACR Appropriateness Criteria® Incidentally Detected Indeterminate Pulmonary Nodule

Expert Panel on Thoracic Imaging

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Incidental pulmonary nodules are common. Although the majority are benign, most are indeterminate for malignancy when first encountered making their management challenging. CT remains the primary imaging modality to first characterize and follow-up incidental lung nodules. This document reviews available literature on various imaging modalities and summarizes management of indeterminate pulmonary nodules detected incidentally. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.

Original languageEnglish (US)
Pages (from-to)S455-S470
JournalJournal of the American College of Radiology
Issue number11S
StatePublished - Nov 2023


  • appropriate use criteria
  • Appropriateness Criteria
  • AUC
  • CT
  • incidental lung nodule
  • incidental pulmonary nodule
  • lung nodule
  • pulmonary nodule
  • solitary pulmonary nodule
  • Multiple Pulmonary Nodules/diagnostic imaging
  • United States
  • Humans
  • Lung
  • Evidence-Based Medicine
  • Societies, Medical
  • Diagnostic Imaging/methods

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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