Pleural abnormalities in the Framingham Heart Study: prevalence and CT image features

Area of Science:

• Pulmonary Medicine
• Radiology
• Epidemiology

Background:

• Pleural abnormalities serve as crucial indicators of asbestos exposure.
• Previous epidemiological data on pleural abnormalities are outdated, relying on 1980s radiography.
• Current asbestos exposure levels require updated investigation.

Purpose of the Study:

• To determine the prevalence and characteristics of pleural abnormalities in a contemporary cohort.
• To assess changes in pleural abnormality prevalence compared to historical data.
• To identify demographic and clinical associations with pleural abnormalities.

Main Methods:

• Analysis of 2633 chest CT scans from the Framingham Heart Study (FHS).
• Evaluation for presence and imaging features of pleural plaques and diffuse pleural thickening.
• Stratification of demographics and pulmonary function based on pleural abnormality status.

Main Results:

• Pleural abnormalities were detected in 1.5% of the FHS cohort.
• Lesions were predominantly bilateral, multiple, calcified, and involved posterior, anterior, and diaphragmatic pleural areas.
• Individuals with pleural abnormalities were older, more likely male, and had higher smoking pack-years.

Conclusions:

• The prevalence of pleural abnormalities on CT is 1.5% in the FHS cohort.
• This lower prevalence suggests reduced asbestos exposure in recent decades compared to the 1980s.
• The posterior pleura is most commonly affected, but anterior involvement is also frequent.