As noted above, the use of chest CT to diagnose occupation-related ILD may avoid the need for lung biopsy, differentiate occupational lung disease from other diffuse lung diseases [66,73], and identify emerging occupational lung diseases [34,60-63]. CT findings in occupational lung disease may correlate with physiologic testing [72] and assist in determining prognosis [73]. CT with IV contrast serves no purpose in the setting of suspected ILD. However, IV contrast can be helpful in identifying nonpulmonary manifestations of occupational exposure. MRI Chest Select fast MRI sequences have approached the image quality of CT in characterizing progressive massive fibrosis in the setting of pneumoconiosis [75]. A few recent studies have evaluated MRI for identifying ILD to include the use of 3T MRI with and without IV contrast in the setting of pulmonary fibrosis [51,53] and 1.5T MRI in systemic Occupational Lung Diseases sclerosis [52], suggesting feasibility for differentiating normal lung from ILD. However, MRI has not been specifically studied for imaging of suspected occupation-associated ILD based on radiography. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of population-based screening and surveillance of occupational lung disease. Image-Guided Transthoracic Needle Biopsy There is no relevant literature to support the use of image-guided transthoracic needle biopsy for the evaluation of the diagnosis of ILD based on radiography. Variant 4: Occupational exposure, suspected airway disease. Initial imaging. Radiography Chest Similar to suspected ILD, chest radiography serves a complementary role to chest HRCT in the evaluation of suspected airway disease, although airway findings, if present, are nonspecific on chest radiography [21,24,54,55].
Occupational Lung Diseases PCAs. As noted above, the use of chest CT to diagnose occupation-related ILD may avoid the need for lung biopsy, differentiate occupational lung disease from other diffuse lung diseases [66,73], and identify emerging occupational lung diseases [34,60-63]. CT findings in occupational lung disease may correlate with physiologic testing [72] and assist in determining prognosis [73]. CT with IV contrast serves no purpose in the setting of suspected ILD. However, IV contrast can be helpful in identifying nonpulmonary manifestations of occupational exposure. MRI Chest Select fast MRI sequences have approached the image quality of CT in characterizing progressive massive fibrosis in the setting of pneumoconiosis [75]. A few recent studies have evaluated MRI for identifying ILD to include the use of 3T MRI with and without IV contrast in the setting of pulmonary fibrosis [51,53] and 1.5T MRI in systemic Occupational Lung Diseases sclerosis [52], suggesting feasibility for differentiating normal lung from ILD. However, MRI has not been specifically studied for imaging of suspected occupation-associated ILD based on radiography. FDG-PET/CT Skull Base to Mid-Thigh There is no relevant literature to support the use of FDG-PET/CT in the evaluation of population-based screening and surveillance of occupational lung disease. Image-Guided Transthoracic Needle Biopsy There is no relevant literature to support the use of image-guided transthoracic needle biopsy for the evaluation of the diagnosis of ILD based on radiography. Variant 4: Occupational exposure, suspected airway disease. Initial imaging. Radiography Chest Similar to suspected ILD, chest radiography serves a complementary role to chest HRCT in the evaluation of suspected airway disease, although airway findings, if present, are nonspecific on chest radiography [21,24,54,55].