Although substantial literature supports research and clinical use of MRI for the study of other large and small airway diseases, such as chronic obstructive airway disease, asthma, lung transplant, and cystic fibrosis. [95-100]. 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 airway lung disease. Occupational Lung Diseases neoplasm but generally in the context of additional complementary imaging [112]. Chest CT has known limitations for diagnosis of malignancy, often requiring alternative imaging assessment or diagnostic testing [109,111]. MRI Chest MRI has been shown in some small studies to be useful in the setting of occupational lung disease and suspected malignancy. For instance, it can be helpful in differentiating progressive massive fibrosis from malignancy [113], characterizing known pleural mesothelioma [114,115], and distinguishing benign from malignant lymphadenopathy [116]. MRI chest with and without contrast is recommended over MRI chest without contrast for increased detection and characterization of pleural malignancy, particularly for mesothelioma diagnosis [117]. FDG-PET/CT Skull Base to Mid-Thigh Recent studies reveal mixed potential benefit of PET/CT for the evaluation of potential malignancy complicating occupational lung disease. PET/CT poorly differentiates benign from malignant changes in progressive massive fibrosis [118,119] but can provide benefit in the diagnosis of pleural and lung malignancies in asbestos exposure [120-122]. The decision between CT surveillance, PET/CT, and lesion biopsy is generally situational and should be determined in the setting of multidisciplinary discussions. Image-Guided Transthoracic Needle Biopsy Transthoracic needle biopsy is a well-established diagnostic test in the workup of suspected thoracic neoplasm, with diagnostic accuracy ranging from 77% to 93% [123-125].
Occupational Lung Diseases PCAs. Although substantial literature supports research and clinical use of MRI for the study of other large and small airway diseases, such as chronic obstructive airway disease, asthma, lung transplant, and cystic fibrosis. [95-100]. 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 airway lung disease. Occupational Lung Diseases neoplasm but generally in the context of additional complementary imaging [112]. Chest CT has known limitations for diagnosis of malignancy, often requiring alternative imaging assessment or diagnostic testing [109,111]. MRI Chest MRI has been shown in some small studies to be useful in the setting of occupational lung disease and suspected malignancy. For instance, it can be helpful in differentiating progressive massive fibrosis from malignancy [113], characterizing known pleural mesothelioma [114,115], and distinguishing benign from malignant lymphadenopathy [116]. MRI chest with and without contrast is recommended over MRI chest without contrast for increased detection and characterization of pleural malignancy, particularly for mesothelioma diagnosis [117]. FDG-PET/CT Skull Base to Mid-Thigh Recent studies reveal mixed potential benefit of PET/CT for the evaluation of potential malignancy complicating occupational lung disease. PET/CT poorly differentiates benign from malignant changes in progressive massive fibrosis [118,119] but can provide benefit in the diagnosis of pleural and lung malignancies in asbestos exposure [120-122]. The decision between CT surveillance, PET/CT, and lesion biopsy is generally situational and should be determined in the setting of multidisciplinary discussions. Image-Guided Transthoracic Needle Biopsy Transthoracic needle biopsy is a well-established diagnostic test in the workup of suspected thoracic neoplasm, with diagnostic accuracy ranging from 77% to 93% [123-125].