Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features

Radiology. 2003 Dec;229(3):731-6. doi: 10.1148/radiol.2293020668. Epub 2003 Oct 23.


Purpose: To identify differences, if any, in thin-section computed tomographic (CT) features between asbestosis and idiopathic pulmonary fibrosis (IPF) and to test the findings in a subset of histopathologically proved cases of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP).

Materials and methods: Consecutive patients with a diagnosis of IPF (n = 212) or asbestosis (n = 74) were included. The relationships derived from the initial comparison were tested in a separate group of biopsy-proved UIP (n = 30) and NSIP (n = 23) cases. Two observers independently scored thin-section CT images for extent, distribution, and coarseness of fibrosis; proportion of ground-glass opacification; severity of traction bronchiectasis; and extent of emphysema.

Results: After controlling for extent of fibrosis, patients with asbestosis had coarser fibrosis than those with IPF (odds ratio, 1.52; 95% CI: 1.25, 1.84; P <.001). Compared with the biopsy-proved cases, the asbestosis cases involved coarser fibrosis (after controlling for disease extent) than the NSIP cases (odds ratio, 2.48; 95% CI: 1.49, 4.11; P <.001) but fibrosis similar to that in the UIP cases. A basal and subpleural distribution of disease was usual in all subgroups but significantly more prevalent (P, <.01 to.001) with asbestosis than with UIP or NSIP.

Conclusion: The thin-section CT pattern of asbestosis closely resembles that of biopsy-proved UIP and differs markedly from that of biopsy-proved NSIP.

Publication types

  • Comparative Study

MeSH terms

  • Asbestosis / diagnostic imaging*
  • Asbestosis / pathology
  • Biopsy
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung Diseases, Interstitial / diagnostic imaging
  • Lung Diseases, Interstitial / pathology
  • Male
  • Pulmonary Fibrosis / diagnostic imaging*
  • Pulmonary Fibrosis / pathology
  • Tomography, X-Ray Computed*