Improved detection of asbestos-related pleural plaques with digital radiography

Our plain-English summary of Improved detection of asbestos-related pleural plaques with digital radiography, by R. Greene, C.M. Schaefer, L.C. Oliver (Annals of the New York Academy of Sciences, 1991).

The study

• Authors: R. Greene, C.M. Schaefer, L.C. Oliver
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:90-6
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This short paper described two features of storage phosphor digital chest radiography that the authors said could improve surveillance for asbestos-related pleural disease. The first was automatic control of image darkness (optical density). The second was dual-energy imaging, which separates calcium-containing structures such as calcified plaques from soft tissue. For the first feature, the paper cited an earlier study of 40 persons in which film and digital images were taken at the same time. Virtually all digital images fell within the usable density range, while the text says as many as 43% of film images fell outside it; the figure caption gives 28%. For the second, eight radiologists read single posteroanterior (PA) chest images in 61 patients with proven asbestos-related disease, 52 with pleural abnormality and 9 normal. Dual-energy digital images significantly outperformed conventional film in detecting pleural thickening and pleural calcification. They also more closely predicted standard ILO-1980 pleural scores than film or single-energy digital images did. The authors concluded that this technology has the potential to improve detection of asbestos-related chest disease, despite lower spatial resolution than film.

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: Short descriptive paper on an imaging technique, reporting reader comparison (ROC) studies of digital versus film chest radiographs
• Who was studied: For the detection comparison: one side of the chest (hemithorax) in 61 patients with proven asbestos-related disease, 52 with pleural abnormality and 9 normal, read by eight radiologists. For the optical density comparison: 40 persons, from a study the paper cites. Setting and dates are not given.
• Exposure: Not described. The article gives no fiber types, jobs or exposure levels; patients are described only as having proven asbestos-related disease.
• Main results:
  • In 40 persons imaged with film and digital at the same time (a study the paper cites), virtually all digital radiographs had mean optical densities within the usable range. The text says as many as 43% of film radiographs fell outside it; the Figure 1 caption gives 28%.
  • In the 61 patients, single PA dual-energy digital radiographs significantly outperformed conventional PA film in overall detection of pleural thickening and pleural calcification. Each of the eight radiologists performed better with the dual-energy digital images.
  • Dual-energy images were particularly helpful in improving detection of pleural calcification.
  • Single PA dual-energy digital radiographs more closely predicted standard ILO-1980 pleural scores based on multiple-view radiography than single-energy digital or film radiography did (122 observations by two readers).
• The authors' conclusion: The authors concluded that storage phosphor digital radiography has the potential to improve detection of asbestos-related chest disease.
• Limitations the authors state:
  • Digital radiography has lower spatial resolution than film (2.5 versus 5 line pair/mm).

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Plaques.

Related studies

• Screening for asbestos-related pleural disease with digital storage phosphor radiography — C.M. Schaefer, R. Greene, et al. (1990)
• Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease — G. Lee, Y.J. Jeong, et al. (2013)
• Commentary on: Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease — I. Vlahos (2013)
• Comparison of digital with film radiographs for the classification of pneumoconiotic pleural abnormalities — T.C. Larson, D.B. Holiday, et al. (2012)
• Digital tomosynthesis of the chest: current and emerging applications — S.H. Chou, G.A. Kicska, et al. (2014)
• Dual-energy digital subtraction chest radiography: technical considerations — G.J. Whitman, L.T. Niklason, et al. (2002)

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