Computed tomography for diagnosis and grading of dust-induced occupational lung disease

Dust-induced occupational lung diseases comprise a vast variety of causative agents. These largely preventable illnesses not only afflict lung parenchyma but also bronchi, bronchioles, as well as mediastinal and pleural structures. Chest radiography undisputedly has value in screening thoracic manifestations of occupational diseases, but also has its limitations. Obviously, modern high-resolution computed tomography improves the visibility of tissue changes, in particular in early disease stages; however, the crucial correlation of radiologic and clinical findings in this heterogeneous group of patients has been seldom addressed in the past.

The most encouraging results of a Medline search for the years 2004-2007 are presented. Beside an international standardized high-resolution computed tomography classification for pneumoconiosis, several other innovative scoring systems are highlighted. Furthermore, the clinical impact of high-resolution computed tomography is stressed in the context of the limited applicability of conventional radiography.

High-resolution computed tomography is a powerful diagnostic and prognostic tool for assessment of dust-induced occupational lung diseases in compliance with promising recent findings. Novel evidence, however, is limited for these occupational diseases.