Comparison of x-ray films and low-dose computed tomographic scans: demonstration of asbestos-related changes in 2760 nuclear weapons workers screened for lung cancer

J Occup Environ Med. 2013 Jul;55(7):741-5. doi: 10.1097/JOM.0b013e3182954067.

Abstract

Objective: Increased availability and technical improvements of computed tomographic (CT) scanning encourages its use for detecting asbestos-related disease. We compared low-dose scans and x-ray films in 2760 workers potentially exposed to asbestos, to assess their ability to detect interstitial lung disease (ILD) and pleural thickening (PT).

Methods: A total of 2760 nuclear workers received radiography and CT scanning (2006 to 2009). X-ray films were read by a B reader for ILD and PT and CT scans by a thoracic radiologist, using a protocol for nodules, ILD, and PT.

Results: Of the 2760 workers, 271 showed circumscribed PT on CT scans, and 73 on x-ray films, 54 (74%) of which were confirmed on CT scans; 76 showed ILD on CT scans, and 15 on x-ray film, 10 (67%) of which were confirmed on CT scans.

Conclusions: Radiographic readings of PT and ILD were generally confirmed on CT scans. Computed tomographic scans detected three to five times more cases; the majority were minor.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asbestosis / complications
  • Asbestosis / diagnostic imaging*
  • Early Detection of Cancer / methods*
  • Female
  • Humans
  • Industry*
  • Lung Neoplasms / diagnostic imaging*
  • Lung Neoplasms / etiology
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Nuclear Weapons*
  • Sensitivity and Specificity
  • United States