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Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis

  • Computed Tomography
  • Published:
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Abstract

Objectives

The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population.

Methods

Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO).

Results

Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001).

Conclusion

Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis.

Key Points

• Interobserver agreement for the ILD score using prone ULDCT is good.

• Prone ULDCT appearances of ILD correlate with changes in spirometric observations.

• Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer.

• Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.

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Abbreviations

ARP:

Asbestos Review Program

ATS:

American Thoracic Society

CXR:

Chest x-ray

DLCO:

Diffusion capacity of carbon monoxide

ERS:

European Respiratory Society

FEV1:

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

HRCT:

High-resolution computed tomography

ILD:

Interstitial lung disease

IQR:

Interquartile range

IPF:

Idiopathic pulmonary fibrosis

LDCT:

Low-dose computed tomography

SD:

Standard deviation

UIP:

Usual interstitial pneumonitis

ULDCT:

Ultra-low dose computed tomography

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Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Ground Floor B-block, Hospital Avenue, Nedlands, WA, Australia

    David Manners, A. W. Bill Musk & Fraser J. H. Brims

  2. Department of Diagnostic Imaging, Royal Perth Hospital, Perth, Australia

    Patrick Wong, Conor Murray & Joelin Teh

  3. Department of Diagnostic Imaging, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

    Yi Jin Kwok

  4. School of Population Health, University of Western Australia, Perth, WA, Australia

    Nick de Klerk, Peter Franklin, A. W. Bill Musk & Fraser J. H. Brims

  5. School of Public Health, Curtin University, Perth, WA, Australia

    Helman Alfonso & Alison Reid

  6. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia

    A. W. Bill Musk

  7. Curtin Medical School, Curtin University, Perth, Australia

    Fraser J. H. Brims

Authors
  1. David Manners
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  2. Patrick Wong
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  3. Conor Murray
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  4. Joelin Teh
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  5. Yi Jin Kwok
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  6. Nick de Klerk
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  7. Helman Alfonso
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  8. Peter Franklin
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  9. Alison Reid
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  10. A. W. Bill Musk
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  11. Fraser J. H. Brims
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Corresponding author

Correspondence to Fraser J. H. Brims.

Ethics declarations

Guarantor

The scientific guarantor of this publication is A/Prof Fraser Brims.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by the Western Australian Department of Health.

Statistics and biometry

One of the authors (Prof Nick de Klerk) has significant statistical expertise.

Ethical approval

Approval for the Asbestos Review Program was granted by the Western Australian Department of Health Human Research Ethics Committee, reference RA/4/1/2119.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Study subjects or cohorts overlap

Some study subjects or cohorts have been previously reported in: Murray CP, Wong PM, Teh J et al (2016) Ultra low dose CT screen-detected non-malignant incidental findings in the Western Australian Asbestos Review Programme. Respirology 21:1419-1424.

Methodology

Prospective, observational cohort study, performed at one institution.

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Manners, D., Wong, P., Murray, C. et al. Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis. Eur Radiol 27, 3485–3490 (2017). https://doi.org/10.1007/s00330-016-4722-7

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  • DOI: https://doi.org/10.1007/s00330-016-4722-7

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