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3-Dimensional Quantification of Composite Pleural Plaque Volume in Patients Exposed to Asbestos Using High-resolution Computed Tomography

A Validation Study

Dournes, Gael MD, PhD*,†,‡; Dubois, Adrian MD; Benlala, Ilyes MD*,†,‡; Lacourt, Aude MD§,∥; Paris, Christophe MD¶,#; Gislard, Antoine MD**; Clin, Benedicte MD††,‡‡; Pairon, Jean-Claude MD§§,∥∥; Baldacci, Fabien PhD*,†,¶¶; Laurent, François MD*,†,‡

doi: 10.1097/RTI.0000000000000377
Original Articles

Rationale: As pleural plaque has been reported as a risk factor in the occurrence of lung cancer and mesothelioma, a reproducible and precise method of measurement of pleural plaque volume (PPV) is needed to further describe these relationships. The aim of the study was to assess the reproducibility of a 3-dimensional computed tomography (3D-CT) volumetric analysis of PPV in patients with occupational exposure to asbestos.

Material and Methods: A total of 28 patients were retrospectively randomly selected from the multicenter APEXS (Asbestos Post Exposure Survey) study, which was held between 2003 and 2005. All patients underwent a 3D-CT scan. Two readers specialized in chest radiology completed the 3D semiautomated quantification of lung volume using dedicated software. They also had to categorize the visual extent of pleural plaque in terms of thickness and circumference. Reproducibility of the continuous PPV variable was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Reproducibility of categorical variables was assessed using the κ test.

Results: Intraobserver reproducibility of PPV was almost perfect (ICC=0.98 [95% interval: 0.97-0.99]), and interobserver reproducibility was very good (ICC=0.93 [0.88-0.97]). At Bland-Altman analysis, the mean differences were 0.1 (limit of agreement: −11.0 to 11.2) and 3.7 cc3 (−17.8 to 25.2), respectively. Visual analysis of both plaque in terms of thickness and circumference were fair to moderate, with κ values ranging from 0.30 to 0.60.

Conclusions: 3D semiautomatic quantification of PPV is feasible and reproducible using CT in patients with occupational exposure to asbestos. PPV measurement may be useful to correlate with other asbestos-related disease outcomes and prognosis.

*Cardio-thoracic Research Center of Bordeaux, U1045, CIC 1401

§University of Bordeaux ISPED

INSERM, Cardio-thoracic Research Center of Bordeaux, U1045, CIC 1401

INSERM U1219, Bordeaux Population Heath Centre, EPICENE, Bordeaux

Departments of Cardio-Thoracic Imaging, Pneumology, Functional Respiratory Exploration, University Hospital of Bordeaux, CIC 1401, Pessac


#University Hospital of Rennes, Department of Occupational Medicine, Rennes

**University Hospital of Rouen, Department of Occupational Medicine, Rouen

††INSERM U1086, ANTICIPE; University Hospital of Caen, Department of Occupational Medicine, Caen

§§INSERM U955, Team 4, Medecine University

∥∥Institute of Occupational Medecine Paris East, Intercommunal Hospital Centre, Créteil

¶¶Bordeaux INP, CNRS, LaBRI, UMR 5800, University of Bordeaux, Talence, France

The authors declare no conflicts of interest.

Correspondence to: Gaël Dournes, MD, PhD, Cardio-thoracic Research Center of Bordeaux, INSERM U1045, Université Bordeaux Segalen, 146 rue Léo Saignat, Bordeaux Cedex 33076, France (e-mail:

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