Radiographic diagnosis of Pneumoconioses by AIR Pneumo-trained physicians: Comparison with low-dose thin-slice computed tomography

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Objectives: The Asian Intensive Reader of Pneumoconiosis (AIR Pneumo) is a training program designed to improve diagnostic skills for chest radiographies (CXRs) in accordance with the ILO/ICRP 2000. The purpose was to determine the prevalence of occupational environmental pulmonary disease findings in construction workers on thin-slice computed tomography (thin-slice CT), and to compare the diagnostic performance with CXR evaluated by AIR Pneumo-trained physicians.

Methods: Ninety-seven male construction workers underwent low-dose thin-slice CT and CXR on the same day. NIOSH B reader and a board-certified radiologist each interpreted the thin-slice CTs independently. The concordant findings on thin-slice CT were established as the reference standard and were statistically compared with CXRs. Four physicians interpreted CXRs independently according to the ILO/ICRP 2000.

Results: Of the 97 cases, nine showed irregular or linear opacities, and 44 had pleural plaques on thin-slice CT. Five, four, three, and two of nine cases with irregular opacity were detected by the four readers on CXRs, respectively. Sixteen, 14, 9, and 5 of the 44 cases with pleural plaques were detected by the four readers, respectively. Specificities for irregular opacities ranged from 94% to 100%, and those for pleural plaques were from 86% to 96%.

Conclusions: Thin-slice CT-detected irregular opacity was found in 9.3%, whereas pleural plaque was found in 45.4% among the construction workers. Chest radiography showed acceptable performance in classifying pneumoconiotic opacities according to ILO/ICRP 2000 by the AIR Pneumo and/or NIOSH-certified physicians.