The diagnosis of early pneumoconiosis in dust-exposed workers: comparison of chest radiography and computed tomography

Abstract

Background Chest radiography (CR) is employed as the evaluation of pneumoconiosis; however, we sometimes encounter cases in which computed tomography (CT) is more effective in detecting subtle pathological changes or cases in which CR yields false-positive results. Purpose To compare CR to CT in the diagnosis of early-stage pneumoconiosis. Material and Methods CR and CT were performed for 132 workers with an occupational history of mining. We excluded 23 cases of arc-welder’s lung. Five readers who were experienced chest radiologists or pulmonologists independently graded the pulmonary small opacities on CR of the remaining 109 cases. We then excluded 37 cases in which the CT data were not sufficient for grading. CT images of the remaining 72 cases were graded by the five readers. We also assessed the degree of pulmonary emphysema in those cases. Results The grade of profusion on CR (CR score) of all five readers was identical in only 5 of 109 cases (4.6%). The CR score coincided with that on CT in 40 of 72 cases (56%). The CT score was higher than that on CR in 13 cases (18%). On the other hand, the CT score was lower than that on CR in 19 cases (26%). The incidence of pulmonary emphysema was significantly higher in patients whose CR score was higher than their CT score. Conclusion CT is more sensitive than CR in the evaluation of early-stage pneumoconiosis. In cases with emphysema, the CR score tends to be higher in comparison to that on CT.

Micro-nodule analysis by severity of pneumoconiosis using 3D CT images

“…In terms of pneumoconiosis, the thoracic CT images have the potential to provide an essential feature for distinguishing subtle morphological patterns of micro-nodule distributions. 7,8 Recent progress of quantitative computed tomography (QCT)-based analysis has spawned research on object assessment of alterations secondary to pneumoconiosis. [9][10][11][12][13][14] The QCT-based image analysis allows for accurate evaluation and monitoring of pneumoconiosis.…”

Computed tomography-based imaging biomarker identifies coal workers’ pneumoconiosis

“…However, majority of the conventional methods are based on the subjective assessment of radiologists, that is, failure of accurately identifying small opacities or oversight on assessing the degree of disease progression (J-P et al, 2023). Recently, several studies have demonstrated that CT provides better sensitive results, compared with chest X-rays, implying that CT is considered as an effective method for diagnosing pneumoconiosis (Takahashi et al, 2018;Hayashi et al, 2022). In addition, quantitative computed tomography (QCT)-based analysis is gaining widespread attention as an effective tool that can more accurately and objectively assess alterations secondary to pneumoconiosis (Liu et al, 2002;Xia et al, 2012).…”