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Silicosis in stone carvers: correlation between HRCT and standard radiographs.

Antao VC; Pinheiro GA; Kavakama J; Terra-Filho M
Am J Respir Crit Care Med 2004 Apr; 169(7)(Abstracts):A46
Rationale: A high prevalence of silicosis has been described among stone carvers in Brazil. This study was aimed to determine the correlation between two methods of radiological evaluation of silicosis in this population. Methods: Forty-one workers and 9 healthy controls were studied with chest radiographs (CR) and high resolution computed tomography (HRCT). The radiographs were independently interpreted by 3 "A" readers (according to ILO/1980 rules), and 3 radiologists experienced in the evaluation of pneumoconiosis read the HRCTs. All readers were blinded with respect to exposure. The results of each CR and HRCT examination was summarized as the median of 3 readings. A small opacity profusion of 1/0 or greater was considered as silicosis. A systematic protocol was used for grading silicosis on HRCT. Results: All CR and HRCT from the control group were considered normal. Silicosis was identified in 22/41 workers (53.7%) by CR, and in 23/41 workers (56.1%) by HRCT. The inter-reader agreement (generalized kappa) for major profusion categories (0, 1, 2, 3) was k=0.44 by CR and k=0.62 by HRCT (p<O.OOI). When only the diagnosis of silicosis was considered, k=0.54 for CR and k=0.84 for HRCT. The Spearman correlation coefficient for the two exams, considering 4 categories of profusion, was 0.84. HRCT demonstrated higher profusions than CR, mostly in categories 1 and 2. Coalescence of small opacities was noted on 7 exams by HRCT that were not noted on CRs for the same patients. Large opacities "A" were noted on 6 exams by HRCT (3 of which were coded with symbol "AX" by CR) and on no exams by CR. Conclusions: Despite. the high correlation of CR and HRCT, this study found higher small opacity profusion and apparent greater sensitivity to coalescence and large opacities for HRCT compared to CR. In addition, the inter-reader agreement was higher for HRCT than for standard CR.
Pulmonary-function; Humans; Lung-function; Pulmonary-system-disorders; Pulmonary-disorders; Respiratory-system-disorders; X-ray-analysis; X-ray-diagnosis; Radiographic-analysis; Radiography
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American Journal of Respiratory and Critical Care Medicine
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division