What are the tools for post-occupational follow-up, how should they be performed and what are their performance, limits and benefit/risk ratio? Chest X-Ray and CT scan

被引:0
作者
Ferretti, G. [1 ,2 ,3 ]
机构
[1] Univ Grenoble 1, F-38041 Grenoble 9, France
[2] Inst Albert Bonnot, CRI, INSERM, UJF,U823, F-38706 La Tronche, France
[3] CHU Grenoble, Clin Univ Radiol & Imagerie Med, F-38043 Grenoble, France
关键词
Asbestos; Chest radiography; Computed tomography; Pleural plaque; Pleural fibrosis; Mesothelioma; Bronchogenic carcinoma; RESOLUTION COMPUTED-TOMOGRAPHY; ASBESTOS-EXPOSED WORKERS; EARLY LUNG-CANCER; BODY-MASS INDEX; PLEURAL PLAQUES; PULMONARY-FIBROSIS; SPIRAL CT; ABNORMALITIES; DISEASES; RADIOGRAPHY;
D O I
10.1016/j.rmr.2011.02.012
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Chest radiography and computed tomography (CT) are the two radiological techniques used for the follow-up of people exposed to asbestos. Since the last conference of consensus (1999), the scientific literature has primarily covered high-resolution CT and high-resolution volume CT (HR-VCT). We consider in turn the contribution of digital thoracic radiography, recommendations for the performance of HR-VCT to ensure the quality of examination while controlling the delivered radiation dose, and the need to refer to the "CT atlas of benign diseases related to asbestos exposure", published by a group of French experts in 2007, for interpretation. The results of the published studies concerning radiography or CT are then reviewed. We note the great interobserver variability in the recognition of pleural plaques and asbestosis, indicating the need for adequate training of radiologists, and the importance of defining standardized, quantified criteria for CT abnormalities. The very low agreement between thoracic and general radiologists must be taken into account. The reading of CT scans in cases of occupational exposure to asbestos should be entrusted to thoracic radiologists or to general radiologists having validated specific training. A double interpretation of CT could be considered in medicosocial requests. CT is more sensitive than chest radiography in the detection of bronchial carcinoma but generates a great number of false positive results (96 to 99%). No scientific data are available to assess the role of imaging by either CT or chest radiography in the early detection of mesothelioma. (C) 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:761 / 772
页数:12
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