title: Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis.
abstract: BACKGROUND
  High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP).
  
  
  METHODS
  71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis.
  
  
  RESULTS
  Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT.
  
  
  CONCLUSIONS
  Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.
authors.affiliation: Department of Radiology, Faculty of Medicine, Zonguldak Karaelmas University, 67600 Kozlu, Zonguldak, Turkey. savranlar@yahoo.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Savranlar
authors.forename: Remzi
authors.initials: R
authors.lastname: Altin
authors.forename: Kamran
authors.initials: K
authors.lastname: Mahmutyazicioğlu
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Ozdemir
authors.forename: Levent
authors.initials: L
authors.lastname: Kart
authors.forename: Tülay
authors.initials: T
authors.lastname: Ozer
authors.forename: Sadi
authors.initials: S
authors.lastname: Gündoğdu
mesh_terms: D000328:Adult; D003031:Coal; D003032:Coal Mining; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015588:Observer Variation; D010995:Pleural Diseases / Q000000981:diagnostic imaging; D011009:Pneumoconiosis / Q000145:classification / Q000000981:diagnostic imaging*; D013902:Radiography, Thoracic; D012907:Smoking; D036542:Tomography, Spiral Computed
chemical_list: D003031:Coal