Radiologic Diagnosis of Asbestosis in Korea

Our plain-English summary of Radiologic Diagnosis of Asbestosis in Korea, by Y.K. Cha, J.S. Kim, Y. Kim, et al (Korean Journal of Radiology, 2016).

The study

• Authors: Y.K. Cha, J.S. Kim, Y. Kim, Y.K. Kim
• Journal: Korean Journal of Radiology
• Published: 2016;17(5):674-83
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Asbestosis is the most important change noted in the lung parenchyma after environmental and occupational exposure to asbestos fibers. It is characterized by diffuse interstitial pulmonary fibrosis. In Korea, the incidence of asbestosis will continue to increase for many years to come and the government enacted the Asbestos Damage Relief Law in 2011 to provide compensation to those suffering from asbestos-related diseases. Radiologic evaluation is necessary for diagnosis of asbestosis, and radiologists play a key role in this process. Therefore, it is important for radiologists to be aware of the various imaging features of asbestosis.

In plain English

This is a review article by Korean radiologists. It describes how asbestosis, which is scarring (fibrosis) of the lung tissue after asbestos exposure, appears on chest X-rays and computed tomography (CT) scans, with a focus on CT. It summarizes diagnostic criteria and earlier studies. It also reports the authors' own retrospective review of chest CTs from 200 asbestosis patients compensated under Korea's Asbestos Damage Relief Law between January 2011 and May 2013. These were compared with 11 cases of idiopathic pulmonary fibrosis (IPF). Among the 200 asbestosis patients, subpleural dot-like or branching opacities were seen in 195 (97.5%) and pleural plaques in 197 (98.5%). Neither was seen in any of the 11 IPF cases. Parenchymal bands appeared in 101 asbestosis patients (50.5%) and in no IPF cases. Honeycomb cysts, ground-glass opacity and traction bronchiectasis were more frequent in IPF. The authors concluded that CT plays a key role in diagnosing asbestosis in Korea. They added that some cases are very difficult to diagnose by CT alone, so exposure history must be combined with CT findings.

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: Review article on imaging of asbestosis, including the authors' own retrospective review of chest CT scans comparing asbestosis with idiopathic pulmonary fibrosis
• Who was studied: For the authors' own data: chest CTs of 200 asbestosis patients compensated under Korea's Asbestos Damage Relief Law from January 2011 to May 2013, compared with 11 cases of idiopathic pulmonary fibrosis (IPF)
• Exposure: Environmental and occupational asbestos exposure in general. The article does not describe exposure sources, fiber types or doses for the 200 patients in its own CT review. The illustrated cases include residents near asbestos mines, a resident under an asbestos roof, and construction and mine workers.
• Main results:
  • Subpleural dot-like or branching opacities were found in 195 of 200 asbestosis patients (97.5%) and in 0 of 11 IPF cases (p less than 0.001).
  • Pleural plaques were found in 197 of 200 asbestosis patients (98.5%) and in 0 of 11 IPF cases (p less than 0.001).
  • Parenchymal bands were found in 101 of 200 asbestosis patients (50.5%) and in 0 of 11 IPF cases (p = 0.012).
  • Parenchymal changes adjacent to pleural plaques were found in 79 of 200 asbestosis patients (39.5%) and in 0 of 11 IPF cases (p less than 0.05).
  • Subpleural curvilinear lines were found in 34 of 200 asbestosis patients (17.0%) and in 0 of 11 IPF cases. No p-value is given for this finding.
  • Honeycomb cysts were found in 9 of 11 IPF cases (81.8%) and in 35 of 200 asbestosis patients (17.5%) (p = 0.009).
  • Ground-glass opacity was found in 11 of 11 IPF cases (100%) and in 31 of 200 asbestosis patients (15.5%) (p less than 0.001).
  • Traction bronchiectasis was found in 11 of 11 IPF cases (100%) and in 87 of 200 asbestosis patients (43.5%) (p = 0.004).
  • Intralobular interstitial thickening (190 of 200 asbestosis, 95.0%; 11 of 11 IPF) and interlobular septal thickening (185 of 200 asbestosis, 92.5%; 11 of 11 IPF) were common in both groups. The authors said these findings did not help tell the two diseases apart.
• The authors' conclusion: The authors concluded that the characteristic CT findings of asbestosis are subpleural dot-like or branching opacities, parenchymal bands, parenchymal changes adjacent to pleural plaques, subpleural curvilinear lines and plaques. They also concluded that CT plays a key role in the diagnosis of asbestosis in Korea.
• Limitations the authors state:
  • The authors state that some cases are very difficult to diagnose using CT findings alone.
  • The authors state that findings of advanced asbestosis resemble pulmonary fibrosis from other causes and are difficult to distinguish.

Topics

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

Medical terms in this study, explained in our Lexicon: Parenchyma, Occupational Exposure, Interstitial, Pulmonary Fibrosis.

Related studies

• Clinical and radiological criteria for the differential diagnosis between asbestosis and idiopathic pulmonary fibrosis: Application in two cases — A. Stufano, A. Scardapane, et al. (2021)
• Asbestos disease in sheet metal workers: II. Radiologic signs of asbestosis among active workers — D. Michaels, S. Zoloth, et al. (1987)
• Pulmonary asbestosis: radiologic-pathologic brief report — C.S. Ahn, S.J. Kim, et al. (1997)
• The comparison of high-resolution computed tomography findings in asbestosis and idiopathic pulmonary fibrosis — M. Akira, K. Morinaga (2016)
• Occupational Burden of Asbestos-Related Diseases in Korea, 1998-2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer — D.M. Kang, J.E. Kim, et al. (2018)
• Multidetector CT Findings and Differential Diagnoses of Malignant Pleural Mesothelioma and Metastatic Pleural Diseases in Korea — Y.K. Kim, J.S. Kim, et al. (2016)

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