Functional consequences of pleural disease evaluated with chest radiography and CT.
OBJECTIVE
To identify a system for the quantification of pleural thickening with an acceptable level of interobserver variation and good functional correlation in individuals with pleural disease.


METHODS
The extent of pleural thickening and plaques was assessed in 50 patients by using the following: (a) a radiographic score based on the International Labour Office system, (b) a subjective simple computed tomographic (CT) score, (c) a subjective comprehensive CT score, (d) an objective nonautomated method, and (e) an objective computer-aided semiautomated method.


RESULTS
Similar correlations between the extent of diffuse pleural thickening and forced vital capacity were seen for each system (objective CT, r = -0.72, P <.001; simple CT, r = -0.69, P <.001; radiographic, r = -0.67, P <.001; comprehensive CT, r = -0.66, P <.001). Comparable correlations were observed for total lung capacity. After controlling for extent of diffuse pleural thickening, pleural plaque scores were functionally irrelevant.


CONCLUSIONS
Comparable functional-morphologic correlations were achieved by using different CT and radiographic scoring systems for pleural disease. A subjective simple CT system had the advantages of ease of application and potential to aid in the accurate assessment of the lung parenchyma, which may be important in individuals exposed to asbestos.
Copley
S J
SJ
Department of Radiology, Royal Brompton Hospital, Sydney St, London SW3 6NP, England.
Wells
A U
AU
Rubens
M B
MB
Chabat
F
F
Sheehan
R E
RE
Musk
A W
AW
Hansell
D M
DM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010994:Pleura / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010995:Pleural Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011336:Probability; D013902:Radiography, Thoracic / Q000379:methods*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*