Development of standard digital images for pneumoconiosis

Our plain-English summary of Development of standard digital images for pneumoconiosis, by W.J. Lee, B.S. Choi, S.J. Kim, et al (Journal of Korean Medical Science, 2011).

The study

• Authors: W.J. Lee, B.S. Choi, S.J. Kim, C.K. Park, J.S. Park, S. Tae, K.G. Hering
• Journal: Journal of Korean Medical Science
• Published: 2011;26(11):1403-8
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We developed the standard digital images (SDIs) to be used in the classification and recognition of pneumoconiosis. From July 3, 2006 through August 31, 2007, 531 retired male workers exposed to inorganic dust were examined by digital (DR) and analog radiography (AR) on the same day, after being approved by our institutional review board and obtaining informed consent from all participants. All images were twice classified according to the International Labour Office (ILO) 2000 guidelines with reference to ILO standard analog radiographs (SARs) by four chest radiologists. After consensus reading on 349 digital images matched with the first selected analog images, 120 digital images were selected as the SDIs that considered the distribution of pneumoconiosis findings. Images with profusion category 0/1, 1, 2, and 3 were 12, 50, 40, and 15, respectively, and a large opacity were in 43 images (A = 20, B = 22, C = 1). Among pleural abnormality, costophrenic angle obliteration, pleural plaque and thickening were in 11 (9.2%), 31 (25.8%), and 9 (7.5%) images, respectively. Twenty-one of 29 symbols were present except cp, ef, ho, id, me, pa, ra, and rp. A set of 120 SDIs had more various pneumoconiosis findings than ILO SARs that were developed from adequate methods. It can be used as digital reference images for the recognition and classification of pneumoconiosis.

In plain English

This Korean study built a reference set of 120 standard digital chest images for doctors who classify pneumoconiosis, a lung disease caused by inhaled dust, under the International Labour Office (ILO) 2000 system. That system had relied on analog film reference images. From July 3, 2006 to August 31, 2007, 531 retired male workers exposed to inorganic dust had digital and film chest X-rays on the same day. The article does not name the type of dust and does not mention asbestos. Four chest radiologists classified all images twice. They agreed on findings for 349 digital images and then chose 120 that covered a range of findings. Of the 120, 15 had no definite pneumoconiosis findings, 43 showed large opacities, 31 showed pleural plaques, 9 showed diffuse pleural thickening, and 11 showed costophrenic angle obliteration. The set contained 21 of the 29 ILO symbols, compared with 15 on the ILO film set. The authors concluded that the set had more varied findings than the ILO film set and could be used as digital reference images.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Development of a set of reference (standard) digital chest X-ray images, chosen from paired digital and film radiographs read by four radiologists
• Who was studied: 531 retired male workers exposed to inorganic dust, examined in Korea from July 3, 2006 to August 31, 2007 (mean age 63.1 years, range 42 to 84)
• Exposure: Inorganic dust, with a mean of 19.5 years of exposure (range 3 to 45 years). No specific dust or fiber type is named.
• Main results:
  • Of the 120 standard digital images, 15 had no definite pneumoconiosis findings. Small-opacity profusion category 1, 2 and 3 appeared in 50, 40 and 15 images respectively.
  • Large opacities appeared in 43 of the 120 images (category A 20, B 22, C 1).
  • Of the 120 images, 31 showed pleural plaque, 9 showed diffuse pleural thickening and 11 showed costophrenic angle obliteration.
  • The 31 images with plaques contained 46 pleural plaques on the chest wall, more often on the right side (32 vs 14).
  • The 120 images contained 21 of the 29 ILO symbols, compared with 15 symbols on the ILO standard film set. The most frequent was coalescence of small opacities (ax), in 64 images (53.3%).
  • Image quality of the 120 images: 85 excellent (70.8%), 11 good (9.2%) and 24 fair (20.0%).
• The authors' conclusion: The authors concluded that the set of 120 standard digital images had more varied pneumoconiosis findings than the ILO standard film radiographs, was developed by adequate methods, and can be used as digital reference images for recognising and classifying pneumoconiosis.
• Limitations the authors state:
  • Because images of fair quality or better were included, some may have defects in the person's positioning or show the shoulder blades over the lung field.

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Informed Consent, ILO Classification, Costophrenic angle, Pleural Plaques.

Related studies

• Comparison of digital with film radiographs for the classification of pneumoconiotic pleural abnormalities — T.C. Larson, D.B. Holiday, et al. (2012)
• Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case — K. Matsuda, T. Yamaryo, et al. (2015)
• The relation between lung dust and lung pathology in pneumoconiosis — G. Nagelschmidt (1960)
• Digital tomosynthesis of the chest: current and emerging applications — S.H. Chou, G.A. Kicska, et al. (2014)
• Comparison of chest digital tomosynthesis and chest radiography for detection of asbestos-related pleuropulmonary disease — G. Lee, Y.J. Jeong, et al. (2013)
• Screening for asbestos-related pleural disease with digital storage phosphor radiography — C.M. Schaefer, R. Greene, et al. (1990)

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