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ACR Appropriateness Criteria Review ACR Appropriateness Criteria® Occupational Lung Diseases
, Leon Bacchus1, Rakesh D Shah
1*Department of Radiology, North Shore University Hospital, Manhasset, NY †National Jewish Health, Denver, CO ‡Department of Radiology, Washington University School of Medicine, Saint Louis, MO, Society of Thoracic Surgeons §Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN ∥Cardiovascular Sciences, University of Iowa, Iowa City, IA, Society of Thoracic Surgeons ¶Mayo Clinic, Rochester, MN #Mayo Clinic, Phoenix, AZ **Mayo Clinic, Jacksonville, FL ††New York Methodist Hospital, Brooklyn, NY, The American College of Chest Physicians ‡‡Department of Radiology, Temple University, Philadelphia, PA §§Department of Radiology, University of Florida College of Medicine, Gainesville, FL ∥∥Department of Radiology, Medical University of South Carolina, Charleston, SC.
Abstract:
Occupational lung disease is a category of disease entities characterized by a reaction of the lung parenchyma to inhaled aerosolized particles found in the environment. This document summarizes the imaging appropriateness data for silicosis, coal worker pneumoconiosis, and asbestosis. The main points of the document are that computed tomography is more sensitive than radiography, computed tomography without contrast generally suffices for evaluation, and fluorodeoxyglucose-positron emission tomography may have utility in patients with mesothelioma. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review includes an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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