Ongoing studies continue to support the increased sensitivity and specificity of HRCT over chest radiography for changes related to occupational lung disease [26,43,56-58], although the level of radiologist expertise can affect interpretation [59]. HRCT proves central in the imaging of classic and emerging pneumoconioses [6,34,60-64], as well as differentiating occupational lung disease from other ILDs [65,66]. New HRCT findings are revealing additional imaging characteristics important to the diagnosis of occupational lung disease [67-70]. A negative chest CT also proves useful in excluding disease [71]. The International Classification of High-Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases recently demonstrated correlation with physiologic testing [72]. Finally, CT imaging findings can provide prognostic value [73]. CT with IV contrast serves no purpose in the setting of suspected ILD. MRI Chest There is limited research supporting the use of MRI in occupational lung disease, none of which supports the use of MRI as the initial imaging. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the initial imaging evaluation of suspected occupation-associated ILD. Variant 3: Occupational exposure, suspected interstitial lung disease based on radiography. Next imaging study. CT Chest Chest radiography performed for screening, surveillance, or diagnostic reasons may reveal findings characteristic of occupational lung disease or nonspecific findings in the setting of reported occupational exposure [43,56]. When ILD is suspected on radiographs, chest HRCT again plays the central role in imaging diagnosis, not only further characterizing true lung disease but also increasing specificity by identifying false-positives [57,74].
Occupational Lung Diseases PCAs. Ongoing studies continue to support the increased sensitivity and specificity of HRCT over chest radiography for changes related to occupational lung disease [26,43,56-58], although the level of radiologist expertise can affect interpretation [59]. HRCT proves central in the imaging of classic and emerging pneumoconioses [6,34,60-64], as well as differentiating occupational lung disease from other ILDs [65,66]. New HRCT findings are revealing additional imaging characteristics important to the diagnosis of occupational lung disease [67-70]. A negative chest CT also proves useful in excluding disease [71]. The International Classification of High-Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases recently demonstrated correlation with physiologic testing [72]. Finally, CT imaging findings can provide prognostic value [73]. CT with IV contrast serves no purpose in the setting of suspected ILD. MRI Chest There is limited research supporting the use of MRI in occupational lung disease, none of which supports the use of MRI as the initial imaging. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the initial imaging evaluation of suspected occupation-associated ILD. Variant 3: Occupational exposure, suspected interstitial lung disease based on radiography. Next imaging study. CT Chest Chest radiography performed for screening, surveillance, or diagnostic reasons may reveal findings characteristic of occupational lung disease or nonspecific findings in the setting of reported occupational exposure [43,56]. When ILD is suspected on radiographs, chest HRCT again plays the central role in imaging diagnosis, not only further characterizing true lung disease but also increasing specificity by identifying false-positives [57,74].