Original InvestigationImpact of Body Mass Index on the Detection of Radiographic Localized Pleural Thickening
Section snippets
Subjects and Radiologic Image Reading
Informed consent was obtained under an institutional review board–approved protocol. Subjects (n = 200) were participants of a study assessing film and digital radiographs to determine their comparability for the classification of pneumoconiotic pleural plaque (8). All were patients being treated or screened for asbestos-related health outcomes in Libby, Montana. Subjects were consecutive patients selected on the basis of having a retrospectively collected HRCT scan collected within 24 months
Results
Table 1 shows characteristics of subjects by BMI category. More than half of all subjects were obese (48%) or morbidly obese (9%) and none had a BMI <19 kg/m2. One hundred forty-three (72%) were male and the majority (n = 103; 52%) reported residential exposure only (i.e., no occupational or household contact exposure). Median age was about 10 years lower among subjects with a normal BMI compared with other BMI categories.
Table 2 shows the unadjusted performance of film and digital radiographs
Discussion
These results suggest that BMI can be a substantial factor influencing radiographic findings of LPT. Using HRCT as a gold standard and a modeling approach, we found a distinct trend of increasing probability of a false-positive result with increasing BMI. This result suggests that subpleural fat is more likely to have the appearance of LPT as a patient's BMI increases and may have medicolegal implications. Further, we observed an inverse relationship between the probability of a false-positive
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ACR Appropriateness Criteria® Occupational Lung Diseases
2020, Journal of the American College of RadiologyCitation Excerpt :Chest radiography performed for screening, surveillance, or diagnostic reasons may reveal findings characteristic of occupational lung disease or nonspecific findings in the setting of reported occupational exposure [43,56]. When ILD is suspected on radiographs, chest HRCT again plays the central role in imaging diagnosis, not only further characterizing true lung disease but also increasing specificity by identifying false-positives [57,74]. As noted above, the use of chest CT to diagnose occupation-related ILD may avoid the need for lung biopsy, differentiate occupational lung disease from other diffuse lung diseases [66,73], and identify emerging occupational lung diseases [34,60-63].
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