Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT

Our plain-English summary of Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT, by T.C. McLoud (Investigative Radiology, 1989).

The study

• Author: T.C. McLoud
• Journal: Investigative Radiology
• Published: 1989;24(8):636-7
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000126).

In plain English

This article was not an original study. It was a critical review written by the author, Theresa C. McLoud, of a 1988 study by Aberle, Gamsu, Ray and Feuerstein, followed by a reply from two of that study's authors, Aberle and Gamsu. The reviewed study compared high-resolution CT (HRCT) with standard CT in 29 people with occupational asbestos exposure. All of them already had abnormalities consistent with asbestosis on ordinary chest X-rays, and the study included an age-matched control group of 34. As summarized here, that study found HRCT more sensitive than standard CT for detecting pleural plaques and parenchymal fibrosis. The reviewer questioned whether the HRCT findings were specific to asbestosis and pointed to the lack of pathologic (tissue) correlation. The reviewer concluded that HRCT may help, particularly in equivocal cases, but should be interpreted with caution. In reply, the original authors agreed that the abnormalities they described were not histospecific. They also reported that in a larger cohort of 100 asbestos-exposed workers, smoking history had no statistical correlation with HRCT asbestosis scores.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Critical review (commentary) by Theresa C. McLoud of a published study by Aberle, Gamsu, Ray and Feuerstein, with a response from Aberle and Gamsu; not original research
• Who was studied: The reviewed study (Aberle et al., Radiology 1988): 29 subjects with occupational asbestos exposure, plus an age-matched control group of 34 individuals
• Exposure: Occupational asbestos exposure (no fiber type named). All subjects in the reviewed study had mild to severe abnormalities consistent with asbestosis on standard chest X-rays.
• Main results:
  • As summarized by the reviewer, the reviewed study found HRCT more sensitive than standard CT for detecting both pleural plaques and parenchymal fibrosis in the 29 exposed subjects
  • HRCT findings in the reviewed study included curvilinear subpleural lines, thickened interlobular septa, subpleural dependent density and multiple parenchymal bands
  • The reviewer raised the question of whether some HRCT findings in asbestos-exposed people may reflect the 'dirty lungs' phenomenon seen in people without known disorders, and so may not be specific for asbestosis
  • In their response, the original authors reported that controls (who had a variety of other intrathoracic diseases) showed nondependent parenchymal bands and subpleural short lines much less often, and none had honeycombing. They acknowledged the abnormalities are not histospecific.
  • The original authors cited their recent evaluation of a larger cohort of 100 asbestos-exposed workers, in which neither smoking history nor measures of obstruction on lung function testing had statistical correlation with HRCT scores of asbestosis
• The authors' conclusion: The reviewer concluded that HRCT may be helpful, particularly in equivocal cases, but radiologists should interpret its findings with some caution because the data remained somewhat equivocal
• Limitations the authors state:
  • The reviewer stated that a major problem with the reviewed study was the lack of pathologic correlation, which raises questions about the specificity of the findings
  • The original authors stated that the relationship of HRCT findings to smoking history was not specifically addressed in the reviewed study

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Parenchymal Fibrosis, High-Resolution CT (HRCT).

Related studies

• Asbestos-related pleural and parenchymal fibrosis: detection with high-resolution CT — D.R. Aberle, G. Gamsu, et al. (1988)
• Asbestos-related disease: progression of parenchymal abnormalities on high-resolution CT — C.I. Silva, N.L. Müller, et al. (2008)
• Agreement between chest radiography and high-resolution computed tomography in diagnosing dust-related interstitial lung fibrosis — R.R. Tiwari (2015)
• Relationships (I) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with the ILO International Classification of Radiographs of Pneumoconioses for parenchymal abnormalities — T. Tamura, N. Suganuma, et al. (2015)
• Pulmonary function, smoking habits, and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos — S. Neri, P. Boraschi, et al. (1996)
• The comparison of high-resolution computed tomography findings in asbestosis and idiopathic pulmonary fibrosis — M. Akira, K. Morinaga (2016)

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