The use of CT in the examination of asbestos-exposed persons

Our plain-English summary of The use of CT in the examination of asbestos-exposed persons, by T.C. McLoud (Radiology, 1988).

The study

• Author: T.C. McLoud
• Journal: Radiology
• Published: 1988;169(3):862-3
• Type of article: Editorial
• Cited by: 18 articles, 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. 000922).

In plain English

This was an editorial, not an original study, and it reported no new data. The author discussed the use of CT and high-resolution CT (HRCT) in examining asbestos-exposed persons. The author wrote that CT may be useful in difficult and problematic cases. The author saw no compelling reason to use it routinely to detect pleural plaques, which the author described as markers of asbestos exposure. The author reported that the author's department had found CT extremely useful in determining the extent of diffuse pleural thickening. On asbestosis, the author wrote that the specificity of HRCT findings remained in question. The author cited a lack of pathologic correlation in earlier HRCT studies by other researchers. Commenting on a study by Lynch et al in the same issue, the author described that study as identifying 43 unsuspected pulmonary masses not seen on standard radiographs, only three of which were thought to represent bronchogenic carcinoma. The author concluded that CT, particularly HRCT, was promising but urged caution about its indiscriminate use and about reading lung abnormalities as specific for asbestosis.

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: editorial (commentary; no original data)
• Who was studied: No study population; the editorial commented on CT examination of asbestos-exposed persons and on a study by Lynch et al in the same issue of Radiology
• Exposure: Asbestos exposure in general; the editorial does not specify fiber types, products, jobs or doses
• Main results:
  • The author's view: CT may be useful in difficult and problematic cases of asbestos-exposed persons
  • The author's view: there is no compelling reason to use CT routinely to detect pleural plaques, which the author described as markers of asbestos exposure
  • The author reported that, in the author's department, CT had been found extremely useful in determining the extent of diffuse pleural thickening
  • The author's view: the specificity of HRCT findings described for asbestosis remains in question
  • The author identified the lack of pathologic correlation as a major difficulty with the HRCT studies by Aberle et al and Yoshimura et al (other researchers' studies)
  • The author described the separate study by Lynch et al as identifying 43 unsuspected pulmonary masses not recognized on standard radiographs, of which only three were thought to represent bronchogenic carcinoma (these are Lynch et al's findings, not this editorial's)
• The authors' conclusion: The author concluded that CT, particularly HRCT, is a promising advance. The author also said caution is necessary about the indiscriminate use of HRCT in asbestos-exposed individuals and about interpreting lung (parenchymal) abnormalities as specific for asbestosis.

Related studies

• Final results from a 90-day quantitative inhalation toxicology study evaluating the dose-response and fate in the lung and pleura of chrysotile-containing brake dust compared to TiO2, chrysotile, crocidolite or amosite asbestos: Histopathological examination, confocal microscopy and collagen quantification of the lung and pleural cavity — D.M. Bernstein, B. Toth, et al. (2021)
• Asbestos-related focal lung masses: manifestations on conventional and high-resolution CT scans — D.A. Lynch, G. Gamsu, et al. (1988)
• Imaging of occupational lung disease — K.I. Kim, C.W. Kim, et al. (2001)
• Chest CT scan findings in World Trade Center workers — R.E. de la Hoz, J. Weber, et al. (2019)
• Specificity of high-resolution CT findings in pulmonary asbestosis: do patients scanned for other indications have similar findings? — C.J. Bergin, R.A. Castellino, et al. (1994)
• The effects of secondhand smoke exposure on HRCT findings among asbestos-exposed workers — T. Vierikko, R. Järvenpää, et al. (2008)

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