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ACR Appropriateness Criteria® Occupational Lung Diseases

Bacchus, Leon MD*; Shah, Rakesh D. MD*; Chung, Jonathan H. MD; Crabtree, Traves P. MD; Heitkamp, Darel E. MD§; Iannettoni, Mark D. MD; Johnson, Geoffrey B. MD, PhD; Jokerst, Clinton MD#; McComb, Barbara L. MD**; Saleh, Anthony G. MD††; Steiner, Robert M. MD‡‡; Mohammed, Tan-Lucien H. MD§§; Ravenel, James G. MD∥∥Expert Panel on Thoracic Imaging

doi: 10.1097/RTI.0000000000000194
Web Exclusive Content—ACR Appropriateness Criteria®

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.

*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

This article is a summary of the complete version of this topic, which is available on the ACR website at Practitioners are encouraged to refer to the complete version.

Reprinted with permission of the American College of Radiology.

The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document.

The authors declare no conflicts of interest.

Correspondence to: Rakesh D. Shah, MD, American College of Radiology, 1891 Preston White Drive, Reston, VA 20191 (e-mail:

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