Imaging of thoracic occupational and environmental malignancies

Our plain-English summary of Imaging of thoracic occupational and environmental malignancies, by K. Garg, D.A. Lynch (Journal of Thoracic Imaging, 2002).

The study

• Authors: K. Garg, D.A. Lynch
• Journal: Journal of Thoracic Imaging
• Published: 2002;17(3):198-210
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The imaging features of occupational lung cancer are similar to those of nonoccupational cancer. Occupational lung cancer in patients with asbestos exposure must be differentiated from mimics such as round atelectasis and fissural pleural plaques. Mesothelioma remains a largely incurable tumor, though treatment options are expanding. CT, MRI, and PET scanning may all have complementary roles in staging mesothelioma.

In plain English

This article was a narrative review, not an original study. It reported no new patient data and illustrated its points with images from individual patients. It reviewed published work on imaging of occupational lung cancer and malignant pleural mesothelioma, mainly in people exposed to asbestos, and also lung cancer in people with pneumoconiosis from silica or coal dust. Results it quoted from other studies included a table of lung cancer death rates per 100,000 per year: 11.3 with neither asbestos exposure nor smoking, 58.4 with asbestos exposure alone, 122.6 with smoking alone and 601.6 with both. It also cited a CT screening study of 602 asbestos workers that found nodules over 5 mm in 111 (18%) and lung cancer in five (1%). The authors described benign look-alikes such as round atelectasis and fissural pleural plaques. They reviewed CT, MRI and PET for staging mesothelioma, noting that CT and MR were relatively nonspecific for detecting invasion and that there were no large PET studies. The authors concluded that CT, MRI and PET may all have complementary roles in staging mesothelioma.

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: Narrative review of imaging of occupational lung cancer and mesothelioma, with no new patient data of its own
• Who was studied: No study population of its own. The review drew on published studies and used images from individual patients as illustrations.
• Exposure: Mainly occupational asbestos exposure (fiber types not specified). Silica and coal dust were also discussed in relation to lung cancer.
• Main results:
  • A table adapted from an earlier study (reference 9) gave lung cancer death rates per 100,000 per year: 11.3 with no asbestos exposure and no smoking, 58.4 with asbestos exposure only, 122.6 with smoking only, and 601.6 with both.
  • The review cited estimates that bronchogenic carcinoma develops in 20% to 25% of heavily exposed asbestos workers.
  • The review stated that in asbestos-exposed workers lung cancer appears to occur equally in the upper and lower lobes, whereas in the general population it is two to three times more common in the upper lobes.
  • In a cited study by Tiitola et al., spiral CT screening of 602 asbestos workers found nodules over 5 mm in 111 (18%) and lung cancer in five (1%).
  • In a cited study of 563 patients with nonasbestos pneumoconiosis, 107 (19%) had lung cancer.
  • In a cited study, round atelectasis coexisted with malignant pleural mesothelioma in 5 of 391 patients with mesothelioma over a 10-year period.
  • A cited CT study of patients with malignant pleural mesothelioma reported pleural thickening in 92% and thickening of the interlobar fissures in 86%.
  • In a cited study of 41 consecutive patients with mesothelioma, CT and MR provided similar information on whether the tumor could be removed surgically.
  • The authors stated that CT and MR are relatively nonspecific for detecting invasion of the chest wall, diaphragm and mediastinum.
  • In a cited PET study of 18 patients with mesothelioma, nodal metastases were found in four patients, only two of which had been identified by CT.
• The authors' conclusion: The authors concluded that asbestos-related lung cancer must be told apart from mimics such as round atelectasis and fissural pleural plaques, that mesothelioma remains largely incurable though treatment options are expanding, and that CT, MRI and PET may all have complementary roles in staging mesothelioma.
• Limitations the authors state:
  • The authors noted a gap in the evidence: there were no large studies of PET scanning for malignant pleural mesothelioma.
  • The authors noted a gap in the evidence: little information was available on CT or MR diagnosis of lymph node involvement in mesothelioma.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Asbestos Exposure, Atelectasis, Pleural Plaques, Mesothelioma, Staging.

Related studies

• Occupational and environmental thoracic malignancies — E.B. Gottschall (2002)
• Occupational and environmental causes of bronchogenic carcinoma — B.M. Haus, H. Razavi, et al. (2001)
• [18F]Fluorodeoxyglucose PET in Thoracic Malignancies — M.H. Vilstrup, D.A. Torigian (2014)
• A current global view of environmental and occupational cancers — M. Yang (2011)
• Epidemiological Research on Occupational and Environmental Carcinogens — C. Ledda (2021)
• New applications of magnetic resonance imaging for thoracic oncology — Y. Ohno (2014)

Browse more research in Journal of Thoracic Imaging, or return to medical research.