Comparison of X-Ray Films and Low-Dose Computed Tomographic Scans: Demonstration of Asbestos-Related Changes in 2760 Nuclear Weapons Workers Screened for Lung Cancer

• Published in: Journal of occupational and environmental medicine 2013-07, Vol.55 (7), p.741-745
• Main Authors: Miller, Albert, Widman, Shannon A., Miller, Jeffrey A., Manowitz, Amy, Markowitz, Steven B.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Asbestosis - complications; Asbestosis - diagnostic imaging; Biological and medical sciences; Biological effects of radiation; Comparative analysis; Early Detection of Cancer - methods; Female; Fundamental and applied biological sciences. Psychology; Humans; Industry; Ionizing radiations; Lung cancer; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - etiology; Male; Medical sciences; Medical screening; Middle Aged; Multidetector Computed Tomography; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Nuclear Weapons; Occupational medicine; Original Article; Pneumology; Public health. Hygiene-occupational medicine; Radiography; Sensitivity and Specificity; Tissues, organs and organisms biophysics; Tomography; Tumors; Tumors of the respiratory system and mediastinum; United States; X-rays
• ISSN: 1076-2752; 1536-5948
• DOI: 10.1097/JOM.0b013e3182954067

OBJECTIVE:Increased availability and technical improvements of computed tomographic (CT) scanning encourages its use for detecting asbestos-related disease. We compared low-dose scans and x-ray films in 2760 workers potentially exposed to asbestos, to assess their ability to detect interstitial lung disease (ILD) and pleural thickening (PT). METHODS:A total of 2760 nuclear workers received radiography and CT scanning (2006 to 2009). X-ray films were read by a B reader for ILD and PT and CT scans by a thoracic radiologist, using a protocol for nodules, ILD, and PT. RESULTS:Of the 2760 workers, 271 showed circumscribed PT on CT scans, and 73 on x-ray films, 54 (74%) of which were confirmed on CT scans; 76 showed ILD on CT scans, and 15 on x-ray film, 10 (67%) of which were confirmed on CT scans. CONCLUSIONS:Radiographic readings of PT and ILD were generally confirmed on CT scans. Computed tomographic scans detected three to five times more cases; the majority were minor.