Possible use of chest ultrasonography in asbestos related lung diseases

Background: Exposure to asbestos fibers can lead to different lung diseases like pleural thickenings and effusions, interstitial disease (asbestosis), mesothelioma and cancer. Aim of the study was to evaluate a possible use of chest ultrasonography (US) in subjects with history of occupational exposure to asbestos (OEA). Methods: Chest US was performed in 59 subjects, blinded to CT-scans reports and images. Different sonographic pathological findings have been considered: pleural thickenings (PT, containing calcifications or not); peripheral lung consolidations (LC); focal sonographic interstitial syndrome (SIS); diffuse pneumogenic SIS (pulmonary asbestosis). Chest US scans were performed using convex (2-5 MHz) and linear (5-7 MHz) probes. Representative US findings were recorded and stored for subsequent comparison with CT-scans. Results: CT scans-PT were reported in 33 cases (26 with calcifications); Focal SIS in 23; Asbestosis in 3, peripheral LC in 13. Sensibility, Specificity, Accuracy, Positive and Negative predicted values (VPP; VPN) were reported for US findings for each pathological condition assessed with CT scans. No US findings were possible in case of central lung nodules (8 cases) and for diaphragmatic PT (14 cases). For minimal pleural effusions (6 subjects) Chest US was considered gold standard technique. Conclusions: Chest US might be considered to follow up patients with OEA, already undergone to CT scans, whether pathology is assessable by US.