Asbestosis and Idiopathic Pulmonary Fibrosis: Comparison of Thin-Section CT Features

Susan J. Copley, Athol U. Wells, Pathanamathan Sivakumaran, Michael B. Rubens, Y. C.Gary Lee, Sujal R. Desai, Sharyn L.S. MacDonald, Richard I. Thompson, Thomas V. Colby, Andrew G. Nicholson, Roland M. Du Bois, A. William Musk, David M. Hansell

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93 Scopus citations

Abstract

PURPOSE: To identify differences, if any, in thin-section computed tomographic (CT) features between asbestosis and idiopathic pulmonary fibrosis (IPF) and to test the findings in a subset of histopathologically proved cases of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). MATERIALS AND METHODS: Consecutive patients with a diagnosis of IPF (n = 212) or asbestosis (n = 74) were included. The relationships derived from the initial comparison were tested in a separate group of biopsy-proved UIP (n = 30) and NSIP (n = 23) cases. Two observers independently scored thin-section CT images for extent, distribution, and coarseness of fibrosis; proportion of ground-glass opacification; severity of traction bronchiectasis; and extent of emphysema. RESULTS: After controlling for extent of fibrosis, patients with asbestosis had coarser fibrosis than those with IPF (odds ratio, 1.52; 95% CI: 1.25, 1.84; P < .001). Compared with the biopsy-proved cases, the asbestosis cases involved coarser fibrosis (after controlling for disease extent) than the NSIP cases (odds ratio, 2.48; 95% CI: 1.49, 4.11; P < .001) but fibrosis similar to that in the UIP cases. A basal and subpleural distribution of disease was usual in all subgroups but significantly more prevalent (P, <.01 to .001) with asbestosis than with UIP or NSIP. CONCLUSION: The thin-section CT pattern of asbestosis closely resembles that of biopsy-proved UIP and differs markedly from that of biopsy-proved NSIP.

Original languageEnglish (US)
Pages (from-to)731-736
Number of pages6
JournalRadiology
Volume229
Issue number3
DOIs
StatePublished - Dec 2003

Keywords

  • Lung, CT
  • Lung, diseases
  • Lung, fibrosis
  • Pneumonia, interstitial with fibrosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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