Reliability of the Proposed International Classification of High‐Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases

Abstract

Reliability of the Proposed International Classification of High-Resolution Computed Tomography for Occupational and EnvironmentalRespiratory Diseases: Narufumi SUGANUMA, et al. Department of Environmental Medicine, Kochi Medical School-Purpose: We have developed a classification of high-resolution computed tomography (HRCT) images for screening, surveillance and epidemiological studies of respiratory diseases caused by occupational and environmental factors. The proposed classification consists of three parts: a guideline explaining the elements of the classification scheme, a reading sheet, and reference films to aid in assessing thin-section CT films. We assessed the reliability of the proposed classification system by blinded, independent trial reading. Materials and Methods: Seven independent radiologists and pulmonologists performed a trial reading to measure the reliability of the classification system using HRCT films from 27 pneumoconiosis patients and 7 normal controls. Results: The agreement was moderate to good for rounded opacities (weighted κ=0.68 and 0.64), irregular opacities (0.59, 0.48), honeycombing (0.65, 0.47), emphysema (0.76, 0.62) and large opacities (0.48, 0.52). Ground glass opacities (0.16, 0.20) showed poor to fair agreement. Intra-reader agreement of each of the seven readers was moderate to good (mean: weighted κ=0.52-0.80) for parenchymal findings, but the agreement was relatively low (mean weighted κ=0.52) for ground glass opacities. Conclusion: The proposed classification is able to describe early dust-related fibrotic changes and provide a semi-quantitative description of the HRCT features of major fibrotic changes in the parenchyma and pleura. Reliability, as measured by inter-reader agreement, was satisfactory. (J Occup Health 2009; 51: 210-222)

Oxidative Stress Markers in Exhaled Breath Condensate in Lung Fibroses Are Not Significantly Affected by Systemic Diseases

“…Pleural hyalinosis was found in all patients; among them, 20 subjects (44.4%) had diffuse pleural thickening. As for parenchymal changes, 28 subjects (62.2%) had radiological finding of irregular opacities grade 0/1 s/s, 1/0 s/s or 1/1 s/s; and 17 patients (37.8%) had a higher grade of opacities, corresponding to asbestosis, in the range of 1/2 s/s to 3/2 t/u 13,14) .…”

Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations

“…Such a common classification system is described in a monograph (14) and has been adopted by many countries. This classification has now been further developed to cover all types of occupational and environmental diseases (ICOERD) (15). Some countries such as France, have developed a nationally based classification system.…”

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

“…There are some cases where CT may be useful in diagnosis of asbestos-related diseases: borderline chest X-ray (ILO 0/1 or 1/0), discrepancy between chest X-ray and pulmonary function tests and extensive pleuropathy that hides lungs. The Helsinki protocol recommends the use of an international classification [ICOERD criteria (28)] for pulmonary and pleural abnormalities detected on CT to identify both malignant and non-malignant asbestos diseases. The ICOERD system, comparable to the 1980 ILO international classification of radiographs for pneumoconiosis, defines the criteria for diagnosis of asbestosis using standard reference images.…”