Keywords:
Lung, CT, Screening, Occupational / Environmental hazards
Authors:
J. Teh, P. Wong, C. P. Murray, Y.-J. Kuok, N. de Klerk, H. Alfonso, A. Reid, A. W. Musk, F. J. Brims; Perth/AU
DOI:
10.1594/ranzcr2015/R-0062
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 doses,
significant costs and scan time make HRCT impractical for examining large populations [4].
The introduction of ultra-low-radiation dose CT (LDCT) facilitates screening of asbestos-exposed populations.
However,
the utility of ultra-LDCT to reliably demonstrate ILD is not well established.
The mining of blue asbestos in Western Australia (particularly around the town of Wittenoom) and its widespread use in the 20th century has resulted in significant asbestos exposure to the Australian population.
Since 1990,
West Australians with significant asbestos exposure have had the opportunity to participate in an annual surveillance program,
the Asbestos Review Program (ARP).
Our study aims to evaluate the correlation between the appearances of ILD changes on ultra-LDCT and pulmonary function tests (PFT) in a subgroup of an asbestos-exposed cohort who were screened for the early detection of lung cancer and mesothelioma.