Early diagnosis of asbestos-related carcinomas by means of x-ray computer tomography

Status:

completed 02/1998

Aims:

By the year 2020 an increase in cancers caused by asbestos, characterised by long latency periods and rapid development, is expected. People exposed to asbestos dust are subject to occupational medical monitoring but the instrumentarium does not enable early diagnosis. Goal: Testing the suitability of x-ray computer tomography for the early diagnosis of malignant tumours caused by asbestos in the framework of preventative occupational medicine.

Activities/Methods:

A pilot study with 636 persons in the high risk category previously exposed to asbestos dust; annual examination in accordance with occupational medical principal G. 1.2 with additional use of pictures provided by conventional x-rays and computer tomography over a period of 4 years; additional molecular biological examination, epidemiological analysis.

Results:

HRCT sensitivity is 44 % (lungs) or 30 % (pleura) greater relative to conventional x-ray technology; the specificity is 14 % or 33 % greater. 31 % of the group show indications of the beginning of asbestosis, 49 % changes in the pleura associated with asbestos; for 52 % occupational illness reports were made (8 bronchial carcinomas, 7 pleura mesotheliomae, 1 laryngeal carcinoma recognised). In comparison with the cases not examined with HRCT the suspected rate of occupational illness was 4.3 to 7.7 times higher. The general use of HRCT for preventative occupational medicine cannot be recommended for different reasons; its use is indicated for defined high risk groups.

Publications:

Kraus, Th.; Raithel, H.J.: Frühdiagnostik asbeststaub-verursachter Erkrankungen. Schriftenreihe des HVBG, Sankt Augustin, Oktober 1998

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