Low-dose chest computed tomography as a screening tool: findings in 536 aircrews

Plain chest radiographs and pulmonary function tests have been used for pulmonary screening for flight duties of aircrews of the Republic of Korea Air Force. However, the screening accuracy of plain chest radiographs is controversial. Chest CT imaging with low-dose protocol (LDCT) improves detection of intra-thoracic abnormalities compared to plain chest radiographs. The aim of this study was to assess the influence of LDCT on flight duties of aircrews and to investigate their radiologic findings.

From June 2009 to May 2011, the Aerospace Medical Center screened asymptomatic subjects 40 yr of age or older to evaluate intra-thoracic abnormalities using LDCT. The abnormal findings, including types and frequency, were recorded and the aircrew's flight duties were also recorded.

This study included 536 subjects. No abnormal findings were found in 387 (72.2%) subjects. Abnormal findings related to pulmonary nodules were detected in 123 (23.00%) subjects. Air-trapping lesions were found in 33 (6.1%) subjects. One subject had a mediastinal tumor. Changes of flight duty were made in 26 (4.9%) subjects on the basis of LDCT findings. No subject was permanently disqualified for flight duty.

Pulmonary screening with LDCT could detect many intra-thoracic abnormalities. LDCT was especially useful in the detection of bullae and bleb, and the flight duties of all subjects with bullae and bleb were changed.