David Manners1, Patrick Wong2, Conor Murray2, Joelin Teh2, Yi Jin Kwok3, Nick de Klerk4, Helman Alfonso5, Peter Franklin4, Alison Reid5, A W Bill Musk1,4,6, Fraser J H Brims7,8,9. 1. Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Ground Floor B-block, Hospital Avenue, Nedlands, WA, Australia. 2. Department of Diagnostic Imaging, Royal Perth Hospital, Perth, Australia. 3. Department of Diagnostic Imaging, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. 4. School of Population Health, University of Western Australia, Perth, WA, Australia. 5. School of Public Health, Curtin University, Perth, WA, Australia. 6. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia. 7. Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Ground Floor B-block, Hospital Avenue, Nedlands, WA, Australia. fraser.brims@curtin.edu.au. 8. School of Population Health, University of Western Australia, Perth, WA, Australia. fraser.brims@curtin.edu.au. 9. Curtin Medical School, Curtin University, Perth, Australia. fraser.brims@curtin.edu.au.
Abstract
OBJECTIVES: The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. METHODS: Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). RESULTS: Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). CONCLUSION: Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. KEY POINTS: • Interobserver agreement for the ILD score using prone ULDCT is good. • Prone ULDCT appearances of ILD correlate with changes in spirometric observations. • Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer. • Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.
OBJECTIVES: The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. METHODS: Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). RESULTS:Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). CONCLUSION: Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. KEY POINTS: • Interobserver agreement for the ILD score using prone ULDCT is good. • Prone ULDCT appearances of ILD correlate with changes in spirometric observations. • Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer. • Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.
Entities:
Keywords:
Asbestos; Asbestosis; Multidetector computed tomography; Respiratory function tests; Screening
Authors: David A Lynch; J David Godwin; Sharon Safrin; Karen M Starko; Phil Hormel; Kevin K Brown; Ganesh Raghu; Talmadge E King; Williamson Z Bradford; David A Schwartz; W Richard Webb Journal: Am J Respir Crit Care Med Date: 2005-05-13 Impact factor: 21.405
Authors: Fraser J H Brims; Conor P Murray; Nick de Klerk; Helman Alfonso; Alison Reid; David Manners; Patrick M Wong; Joelin Teh; Nola Olsen; Robin Mina; A W Musk Journal: Am J Respir Crit Care Med Date: 2015-01-01 Impact factor: 21.405
Authors: Giuseppe Mastrangelo; Maria N Ballarin; Ernesto Bellini; Fabio Bicciato; Federica Zannol; Francesco Gioffrè; Antonio Zedde; Gianna Tessadri; Ugo Fedeli; Flavio Valentini; Luca Scoizzato; Gianluca Marangi; John H Lange Journal: Am J Ind Med Date: 2009-08 Impact factor: 2.214
Authors: Conor P Murray; Patrick M Wong; Joelin Teh; Nick de Klerk; Tim Rosenow; Helman Alfonso; Alison Reid; Peter Franklin; A W Bill Musk; Fraser J H Brims Journal: Respirology Date: 2016-06-16 Impact factor: 6.424
Authors: Victor L Roggli; Allen R Gibbs; Richard Attanoos; Andrew Churg; Helmut Popper; Philip Cagle; Bryan Corrin; Teri J Franks; Francoise Galateau-Salle; Jeff Galvin; Philip S Hasleton; Douglas W Henderson; Koichi Honma Journal: Arch Pathol Lab Med Date: 2010-03 Impact factor: 5.534