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Scoring CT/HRCT findings among asbestos-exposed workers: effects of patient’s age, body mass index and common laboratory test results

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Abstract

We studied the effects of age, body mass index (BMI) and some common laboratory test results on several pulmonary CT/HRCT signs. Five hundred twenty-eight construction workers (age 38–80, mean 63 years) were imaged with spiral and high resolution CT. Images were scored by three radiologists for solitary pulmonary nodules, signs indicative of fibrosis and emphysema, ground glass opacities, bronchial wall thickness and bronchiectasis. Multivariate statistical analyses were adjusted for smoking and asbestos exposure. Increasing age, blood haemoglobin value and erythrocyte sedimentation rate correlated positively with several HRCT signs. Increasing BMI was associated with a decrease in several signs, especially parenchymal bands, honeycombing, all kinds of emphysema and bronchiectasis. The latter finding might be due to the suboptimal image quality in obese individuals, which may cause suspicious findings to be overlooked. Background data, including patient’s age and body constitution, should be considered when CT/HRCT images are interpreted.

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Acknowledgements

We would like to thank Dr. Hannu Lehtola for the patient interviews and Dr. Anders Zitting for the image analysis. The Finnish Work Environment Fund and the Federation of Accident Insurance Institutions supported the original data collection.

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Authors and Affiliations

  1. Department of Radiology, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250, Helsinki, Finland

    T. Vehmas, M. S. Huuskonen & M. S. Jaakkola

  2. Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland

    L. Kivisaari

  3. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK

    M. S. Jaakkola

Authors
  1. T. Vehmas
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  2. L. Kivisaari
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  3. M. S. Huuskonen
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  4. M. S. Jaakkola
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Corresponding author

Correspondence to T. Vehmas.

Appendix: Criteria for assessing the radiological signs

Appendix: Criteria for assessing the radiological signs

Solitary nodules (scale 0–1): recorded 0 if no nodules were found and 1 if one or more nodules were found.

Radiological signs (scale 0–5: fibrosis score, subpleural septal lines, parenchymal bands 2–5 cm in length, honeycombing, ground glass opacities, centrilobular, paraseptal and panlobular emphysema, bullae):

  • 0= normal

  • 1= faint or few abnormalities, usually in a single slice

  • 2= more distinct abnormalities

  • 3= clear abnormalities in several slices

  • 4= score between 3 and 5

  • 5= severe abnormalities widely distributed in the whole lung, in all or most slices

Radiological signs in scale 0–3:

  • 0= normal

  • 1= a single faint dependent opacity, a faintly thickened bronchial wall in one to two bronchi or mildly dilated bronchi

  • 2= a clear dependent opacity in 1–3 slices, several bronchi with thickened walls, or 1–3 saccular bronchiectasis

  • 3= dependent opacities in most slices, several bronchi with distinctly thickened walls, or bronchiectasis widely distributed in the lungs

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Vehmas, T., Kivisaari, L., Huuskonen, M.S. et al. Scoring CT/HRCT findings among asbestos-exposed workers: effects of patient’s age, body mass index and common laboratory test results. Eur Radiol 15, 213–219 (2005). https://doi.org/10.1007/s00330-004-2552-5

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  • DOI: https://doi.org/10.1007/s00330-004-2552-5

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