Radiation research methods in the diagnosis of pneumoconiosis

Introduction. Pneumoconiosis is a chronic lung disease that develops with prolonged exposure to dust factors in production. The absence of pronounced symptoms in the early stages often leads to delayed diagnosis, when serious consequences, including disability, are already developing. Due to the lack of specific clinical and laboratory signs, chest X-ray, previously considered the standard of diagnosis, remained the main method of detecting pathology for a long time. The study аims to analyze the effectiveness of methods of radiation diagnosis of pneumoconiosis in workers of the mining and metallurgical industries, as well as to identify typical tomographic signs characterizing this disease. Materials and methods. The study was conducted at the Izmerov Research Institute of Occupational Health (Moscow) and the Orenburg Regional Clinical Hospital No. 2. A total of 105 patients with suspected pneumoconiosis, based on chest radiographic findings, were included. All participants underwent a comprehensive diagnostic protocol including laboratory tests, pulmonary function assessment, bronchoscopy, and high-resolution computed tomography (CT) of the chest organs. Results. Computed tomography has demonstrated higher diagnostic accuracy compared to X-ray. The sensitivity of the X-ray method was 85.1% (95% CI: 76.28–91.61%), while its specificity was limited to 9.1% (95% CI: 0.23–41.28%). In the case of CT, sensitivity reached 98.9% and specificity 81.8% (95% CI: 94.21–99.97% and 48.22–97.72%, respectively). According to the CT results, the patients were classified according to the shape of the lesion into three groups: nodular (n=41), interstitial (n=15) and combined (n=38). The majority (56.2%) had respiratory failure, while five had pulmonary tuberculosis. Typical CT signs were multiple foci, mainly of perilymphatic distribution, as well as thickening of the interlobular structures of the lungs. Limitations. The sample size was limited by the number of patients with confirmed pneumoconiosis. Conclusion. Computed tomography is a more accurate method of detecting pneumoconiosis compared to radiography. It was found that the CT sensitivity and specificity indices (98.9% and 81.8%) significantly exceed the corresponding values for radiography (85.1% and 9.1%). This confirms the need to include CT in standard diagnostic protocols for occupational lung diseases. Ethics. The study was approved by the Local Ethics Committee of the Izmerov Research Institute of Occupational Health (extract from the minutes of the meeting No. 6 dated 06/17/2014).