Ultra low dose CT screen-detected non-malignant incidental findings in the Western Australian Asbestos Review Programme

作者：Murray, Conor P.; Wong, Patrick M.; Teh, Joelin; de Klerk, Nick; Rosenow, Tim; Alfonso, Helman; Reid, Alison; Franklin, Peter; Musk, A. W.; Brims, Fraser J. H.^*

来源：Respirology, 2016, 21(8): 1419-1424.

DOI：10.1111/resp.12826

• asbestos
• multidetector computed tomography
• pleural diseases
• pulmonary nodule

Background and objectiveComputed tomography (CT)-based studies of asbestos-exposed individuals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of asbestos-exposed subjects in Western Australia. @@@ MethodsA total of 906 subjects from the Western Australian Asbestos Review Programme underwent LDCT of the chest as part of regular annual review. An indeterminate (solid) nodule was defined as >50mm(3) and part-solid/non-solid nodules >5mm. The presence of asbestos-related diseases was recorded with a standardized report. @@@ ResultsSubjects were mostly (81%) men with a median age of 70years. Fifty-eight (6.5%) participants were current smokers, 511 (56.4%) ex-smokers and 325 (36.4%) never-smokers. One hundred and four indeterminate nodules were detected in 77 subjects (8.5%); of these, eight cases had confirmed lung cancer (0.88%). Eighty-seven subjects (9.6%) had incidental findings that required further investigation, 42 (4.6%) from lower airways inflammation. The majority of nodules were solid, 4-6mm and more common with age. Five hundred and eighty (64%) subjects had pleural plaques, and 364 (40.2%) had evidence of interstitial lung disease. @@@ ConclusionThe prevalence of LDCT-detected indeterminate lung nodules in 906 individuals with significant asbestos exposure was 8.5%, lower than many other CT studies. Clinically important incidental findings were found in 9.4%, predominantly related to lower respiratory tract inflammation. LDCT appears to effectively describe asbestos-related diseases and is likely to be an acceptable modality to monitor asbestos-exposed individuals. @@@ The utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. This study describes the incidental radiological findings from LDCT screening an asbestos-exposed cohort. The prevalence of indeterminate nodules compared with other high-risk populations appears low. LDCT appears effective in demonstrating other asbestos-related diseases.

• 出版日期2016-11