Background: With the increasing use of advanced imaging techniques in pediatric populations, incidental findings—particularly pulmonary nodules—are being detected with greater frequency. While many of these nodules are benign, their discovery often leads to clinical uncertainty, additional imaging, and potential anxiety for patients and families. Unlike in adult patients, for whom the Fleischner Society guidelines for incidental pulmonary nodules are well-established, pediatric-specific recommendations remain limited. Objective: This educational poster aims to provide a comprehensive overview of incidental pulmonary nodules identified on pediatric chest imaging. It seeks to guide radiologists in evidence-based decision-making regarding the evaluation, follow-up, and management of these findings. Content Organization: The poster is structured into the following key sections: Epidemiology and Etiology: Overview of the prevalence and common causes of incidental pulmonary nodules in children, including infectious, inflammatory, and neoplastic etiologies. Imaging Characteristics: Description of typical imaging features on chest radiographs and CT scans that help differentiate benign from potentially malignant nodules. Current Guidelines and Limitations: Review of existing guidelines and literature. Discussion of recent efforts to develop pediatric-specific protocols. Risk Stratification and Management Algorithms: Presentation of proposed algorithms for managing incidental nodules based on size, morphology, patient age, clinical history, and risk factors. Radiologist’s Role and Communication Strategies: Emphasis on the importance of clear reporting, interdisciplinary collaboration, and effective communication to reduce unnecessary interventions and anxiety. Future: Review the potential use of new techniques (Photon-counting CT, MR) in this context. Conclusion: The detection of incidental pulmonary nodules in pediatric imaging presents a diagnostic challenge. Through a structured, evidence-informed approach, radiologists can play a pivotal role in guiding appropriate management, minimizing harm, and ensuring optimal patient care. This poster aims to empower radiologists with practical tools and knowledge to navigate these increasingly common findings. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Riera Luis, Riaza Lucía, Gonzalo Marta, Coma Ana, Vázquez Elida, Perdomo-luna Camilo, Kvist Ola, Liszewski Mark

Keywords: CT, Nodules, Pulmonary