Background This study was conducted to systematically evaluate the diagnostic value of computed tomography (CT) in differentiating benign and malignant pulmonary nodules through a meta-analysis, thereby providing a solid evidence-based foundation for clinical diagnosis and treatment decisions. Methods We searched the PubMed, Web of Science, Embase, Medline, China National Knowledge Infrastructure (CNKI), and Cochrane Library databases for relevant studies published up to December 2025 and performed a meta-analysis using Review Manager v.5.4. Results A total of 28 retrospective analyses and 19 prospective studies were included, comprising 4,705 patients with pulmonary nodules. The pooled sensitivity of CT was 0.90 (95% confidence interval CI: 0.89–0.91; p 0.001), while the pooled specificity was 0.74 (95% CI: 0.72–0.76; p 0.001). The positive likelihood ratio was 3.28 (95% CI: 2.81–3.83; p 0.001), the negative likelihood ratio was 0.13 (95% CI: 0.10–0.17; p 0.001), and the diagnostic odds ratio (DOR) was 33.20 (95% CI: 23.52–46.87; p 0.001). The area under the summary receiver operating characteristic (SROC) curve was 0.9177. Conclusion These findings indicate that CT has a high diagnostic value in differentiating benign from malignant pulmonary nodules and is an important method for evaluating pulmonary nodules in clinical practice. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261277036 , Identifier: CRD420261277036.
Chen et al. (Thu,) studied this question.