Purpose
Inhalation of asbestos fibres has numerous benign and malignant pathologic consequences,
including interstitial lung disease (ILD) [1].
Ongoing surveillance for the early detection of asbestos-related pleural and parenchymal changes is necessary due to the latent nature of the body’s response to inhaled asbestos fibres [2].
In ILD,
physiologic testing with pulmonary function tests (PFT) shows a restrictive defect and reduced diffusing capacity of the lung for carbon monoxide (DLCO).
The main radiologic tool to diagnose ILD is with high-resolution computed tomography (HRCT) [3].
High radiation...
Methods and materials
Study population:
This retrospective study examined 143 randomly selected subjects participating in the ARP between September 2012 and September 2013.
All subjects had a baseline chest ultra-LDCT and PFTs as part of their routine annual assessment.
Participants were previous Wittenoom workers,
former residents of the Wittenoom township and other workers with at least three months occupational asbestos exposure and/or those with radiographically confirmed pleural plaques.
CT scanning:
The ultra-LDCT was performed at a single site using a 128-slice CT scanner with iterative reconstruction software.
All...
Results
A total of 143 cases with paired ultra-LDCT and DLCO results were included in the study.
The demographic data of participants is presented in Table 1.
The cases consisted of 130 males and 13 females,
with a mean age of 72 years ± 9.7 (range 49 to 92 years).
Inter-observer agreement regarding the presence of ILD was excellent (k = 0.95).
No evidence of ILD was shown in 80 (56%) participants; 25 (17%) were equivocal for ILD; and 38 (27%) had ILD.
The correlation between...
Conclusion
Our study demonstrates that the presence of radiographic abnormalities associated with ILD on ultra-LDCT correlates with reduced lung diffusion capacity in a screening population.
A limitation of this study was that the ultra-LDCT imaging protocol used targeted the detection of parenchymal or pleural abnormalities for the early diagnosis of lung cancer and mesothelioma and not the presence of interstitial lung disease.
HRCT is the current gold standard imaging modality for the radiologic diagnosis of ILD,
with greater sensitivity than chest radiography for the detection of...
Personal information
Joelin Teh,
MBBS,
RANZCR
Department of Radiology,
Royal Perth Hospital,
Western Australia,
Australia.
References
1.
American Thoracic Society.
Diagnosis and initial management of nonmalignant diseases related to asbestos.
Am J Respir Crit Care Med 2004;170:691-715.
2.
Norbet C,
Joseph A,
Rossi SS,
Bhalla S,
Gutierrez FR.
Asbestos-related lung disease: A pictorial review.
Curr Probl Diagn Radiol 2014; Epub ahead of print.
3.
Huuskonen O,
Kivisaari L,
Zitting A,
Taskinen K,
Tossavainen A,
Vehmas T.
Highresolution computed tomography classification of lung fibrosis for patients with asbestos-related disease.
Scand J Work Environ Health 2001;27(2)106-12.
4.
McLoud TC.
The use of CT...