Asbestosis and other pulmonary fibrosis in asbestos-exposed workers: high-resolution CT features with pathological correlations.
OBJECTIVE
The purpose was to identify distinguishing CT features of pathologically diagnosed asbestosis, and correlate diagnostic confidence with asbestos body burden.


METHODS
Thirty-three workers (mean age at CT: 73 years) with clinical diagnoses of asbestosis, who were autopsied (n = 30) or underwent lobectomy (n = 3), were collected. Two radiologists independently scored high-resolution CT images for various CT findings and the likelihood of asbestosis was scored. Two pathologists reviewed the pathology specimens and scored the confidence of their diagnoses. Asbestos body count was correlated with CT and pathology scores.


RESULTS
Pathologically, 15 cases were diagnosed as asbestosis and 18 cases with various lung fibroses other than asbestosis. On CT, only the score of the subpleural curvilinear lines was significantly higher in asbestosis (p = 0.03). Accuracy of CT diagnosis of asbestosis with a high confidence ranged from 0.73 to 0.79. Asbestos body count positively correlated with CT likelihood of asbestosis (r = 0.503, p = 0.003), and with the confidence level of pathological diagnosis (r = 0.637, p < 0.001).


CONCLUSIONS
Subpleural curvilinear lines were the only clue for the diagnosis of asbestosis. However, this was complicated by other lung fibrosis, especially at low asbestos body burden.


CONCLUSIONS
• Various patterns of pulmonary fibrosis occurred in asbestos-exposed workers. • The fibre burden in lungs paralleled confident CT diagnosis of asbestosis. • The fibre burden in lungs paralleled confident pathological diagnosis of asbestosis. • Subpleural curvilinear lines were an important CT finding favouring asbestosis.
Department of Radiology, Dokkyo Medical University, 880, Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan. arakawa@dokkyomed.ac.jp.
Hiroaki
H
Arakawa
Asbestos Research Center, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi Ninamiku, Okayama, 702-8055, Japan.
Takumi
T
Kishimoto
Department of Clinical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
Kazuto
K
Ashizawa
Department of Diagnostic Radiology 2, Kawasaki Medical School, 2-1-80, Nakasange, Kita-ku, Okayama, 701-0114, Japan.
Katsuya
K
Kato
Department of Pathology, Hokkaido Chuo Hospital, 4 Joh Higashi 16, Iwamizawa, Hokkaido, 068-0004, Japan.
Kenzo
K
Okamoto
Department of Pathology, Dokkyo Medical University, 880, Kita-Kobayashi, Mibu, Tochigi, 321-0293, Japan.
Koichi
K
Honma
National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai-city, Osaka, 591-8555, Japan.
Seiji
S
Hayashi
Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan.
Masanori
M
Akira
D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D001195:Asbestosis / Q000000981:diagnostic imaging / Q000473:pathology*; D001344:Autopsy; D001822:Body Burden; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D001194:Asbestos
Asbestos; Asbestosis; Chronic interstitial pneumonia; Computed tomography, radiography; Pulmonary fibrosis