Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features.
OBJECTIVE
To identify differences, if any, in thin-section computed tomographic (CT) features between asbestosis and idiopathic pulmonary fibrosis (IPF) and to test the findings in a subset of histopathologically proved cases of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP).


METHODS
Consecutive patients with a diagnosis of IPF (n = 212) or asbestosis (n = 74) were included. The relationships derived from the initial comparison were tested in a separate group of biopsy-proved UIP (n = 30) and NSIP (n = 23) cases. Two observers independently scored thin-section CT images for extent, distribution, and coarseness of fibrosis; proportion of ground-glass opacification; severity of traction bronchiectasis; and extent of emphysema.


RESULTS
After controlling for extent of fibrosis, patients with asbestosis had coarser fibrosis than those with IPF (odds ratio, 1.52; 95% CI: 1.25, 1.84; P <.001). Compared with the biopsy-proved cases, the asbestosis cases involved coarser fibrosis (after controlling for disease extent) than the NSIP cases (odds ratio, 2.48; 95% CI: 1.49, 4.11; P <.001) but fibrosis similar to that in the UIP cases. A basal and subpleural distribution of disease was usual in all subgroups but significantly more prevalent (P, <.01 to.001) with asbestosis than with UIP or NSIP.


CONCLUSIONS
The thin-section CT pattern of asbestosis closely resembles that of biopsy-proved UIP and differs markedly from that of biopsy-proved NSIP.
Department of Radiology, Hammersmith Hospital, London, England.
Susan J
SJ
Copley
Athol U
AU
Wells
Pathanamathan
P
Sivakumaran
Michael B
MB
Rubens
Y C Gary
YC
Lee
Sujal R
SR
Desai
Sharyn L S
SL
MacDonald
Richard I
RI
Thompson
Thomas V
TV
Colby
Andrew G
AG
Nicholson
Roland M
RM
du Bois
A William
AW
Musk
David M
DM
Hansell
D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000473:pathology; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed