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

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.