A diagnostic approach to asbestosis, utilizing clinical criteria, high resolution computed tomography, and gallium scanning.
Seventy-five individuals known to have significant exposure to asbestos were evaluated by physical exam, pulmonary function tests (PFT), chest radiographs, high resolution computed tomography (HRCT), gallium-67 scanning, and various laboratory exams. Sixteen subjects met three of the following four criteria and were considered to have clinical asbestosis: 1) bibasilar rales, 2) FVC < 80% of predicted, 3) DLCO < 80% of predicted, and 4) an abnormal chest radiograph. Evaluations which included HRCT and Ga scanning detected pulmonary disease in these asbestos-exposed individuals in many cases where other modalities were unable to demonstrate significant abnormalities. While only 21% of the subjects satisfied commonly accepted criteria for the diagnosis of asbestosis, 75% had evidence of disease by both HRCT and gallium scanning. These data suggest that it may be time to include HRCT and Ga scanning when evaluating asbestos-exposed individuals, especially in cases where evaluations by physical exam, PFTs, and chest radiographs are non-diagnostic.
Klaas
V E
VE
Department of Radiology, Stanford University Hospital, CA 94305.
D000328:Adult; D000368:Aged; D001195:Asbestosis / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D016009:Chi-Square Distribution; D005710:Gallium Radioisotopes; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012767:Ships; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D014480:United Nations
D005710:Gallium Radioisotopes