Computerized Classification of Pneumoconiosis on Digital Chest Radiography Artificial Neural Network with Three Stages.

It is difficult for radiologists to classify pneumoconiosis from category 0 to category 3 on chest radiographs. Therefore, we have developed a computer-aided diagnosis (CAD) system based on a three-stage artificial neural network (ANN) method for classification based on four texture features. The image database consists of 36 chest radiographs classified as category 0 to category 3. Regions of interest (ROIs) with a matrix size of 32 × 32 were selected from chest radiographs. We obtained a gray-level histogram, histogram of gray-level difference, gray-level run-length matrix (GLRLM) feature image, and gray-level co-occurrence matrix (GLCOM) feature image in each ROI. For ROI-based classification, the first ANN was trained with each texture feature. Next, the second ANN was trained with output patterns obtained from the first ANN. Finally, we obtained a case-based classification for distinguishing among four categories with the third ANN method. We determined the performance of the third ANN by receiver operating characteristic (ROC) analysis. The areas under the ROC curve (AUC) of the highest category (severe pneumoconiosis) case and the lowest category (early pneumoconiosis) case were 0.89 ± 0.09 and 0.84 ± 0.12, respectively. The three-stage ANN with four texture features showed the highest performance for classification among the four categories. Our CAD system would be useful for assisting radiologists in classification of pneumoconiosis from category 0 to category 3.

[Guidelines for the use of the International Classification of Radiographs of Pneumoconioses of the International Labour Office (ILO): Substantial changes in the currrent edition]. / Wytyczne stosowania Miedzynarodowej Klasyfikacji Radiogramów Pylic Pluc Miedzynarodowego Biura Pracy (ILO) ­ istotne zmiany w obecnie obowiazujacej edycji.

The International Classification of Radiographs of Pneumoconioses is the scheme worked out by the International Labour Office in Geneva (ILO), to register radiographic chest abnormalities in a well-ordered, reproducible and comparable way. It is used for diagnosing abnormalities caused by dust exposure. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses contain detailed information and recommendations on how to use the classification, as well as how the chest X-ray examination should be performed and recorded. To facilitate the diagnosis of observed abnormalities the classification is completed by the set of standard radiograms illustrating typical irregularities referring to lungs and pleura, included in the classification. The article presents the key information on classification and the most important amendments adopted in the 2000 and 2011 ILO guidelines revisions. These changes refer to radiographs quality assessment, the way of presenting abnormalities registered in standard radiographs (QUAD set, digital images) and registration of failures not related to dust exposure. Particularly important complements result from the development of radiological imaging techniques. They are concerned about the classification of radiographic images of the chest recorded digitally. Med Pr 2016;67(6):833-837.

From the definition of silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis, and pulmonary alveolar proteinosis (PAP).

The 1930 International Labour Office Conference on silicosis in Johannesburg identified silicosis by setting a medicolegal framework to its nosology: as with other occupational illnesses, its medical content was fixed under economic pressure. This article follows a reading of all the proceedings of this conference (debates and reports of experts) to examine their potential impact on the etiology and nosology of other diseases, specifically sarcoidosis and pulmonary alveolar proteinosis (PAP), "idiopathic" diseases in which inorganic particles may be involved. We propose renewed study of the role of inorganic particles in these diseases. To do this, we propose to mobilize detection means such as mineralogical analysis and electron microscopy and in depth interviewing that are currently seldom used in France, in order to establish diagnosis and the potential occupational and environmental origin of these diseases.

[Recognize and classify pneumoconiosis]. / Pneumokoniosen erkennen und klassifizieren.

BACKGROUND: In the year 2012, out of the 10 most frequently recognized occupational diseases 6 were forms of pneumoconiosis. With respect to healthcare and economic aspects, silicosis and asbestos-associated diseases are of foremost importance. The latter are to be found everywhere and are not restricted to large industrial areas. PROBLEM: Radiology has a central role in the diagnosis and evaluation of occupational lung disorders. In cases of known exposure mainly to asbestos and quartz, the diagnosis of pneumoconiosis, with few exceptions will be established primarily by the radiological findings. As these disorders are asymptomatic for a long time they are quite often detected as incidental findings in examinations for other reasons. Therefore, radiologists have to be familiar with the pattern of findings of the most frequent forms of pneumoconiosis and the differential diagnoses. STANDARDIZED PROCEDURE IN EXAMINATIONS: For reasons of equal treatment of the insured a quality-based, standardized performance, documentation and evaluation of radiological examinations is required in preventive procedures and evaluations. Above all, a standardized low-dose protocol has to be used in computed tomography (CT) examinations, although individualized concerning the dose, in order to keep radiation exposure as low as possible for the patient. STANDARDIZED EVALUATION: The International Labour Office (ILO) classification for the coding of chest X-rays and the international classification of occupational and environmental respiratory diseases (ICOERD) classification used since 2004 for CT examinations meet the requirements of the insured and the occupational insurance associations as a means of reproducible and comparable data for decision-making.

DLA-Net: dual lesion attention network for classification of pneumoconiosis using chest X-ray images.

Accurate and early detection of pneumoconiosis using chest X-rays (CXR) is important for preventing the progression of this incurable disease. It is also a challenging task due to large variations in appearance, size and location of lesions in the lung regions as well as inter-class similarity and intra-class variance. Compared to traditional methods, Convolutional Neural Networks-based methods have shown improved results; however, these methods are still not applicable in clinical practice due to limited performance. In some cases, limited computing resources make it impractical to develop a model using whole CXR images. To address this problem, the lung fields are divided into six zones, each zone is classified separately and the zone classification results are then aggregated into an image classification score, based on state-of-the-art. In this study, we propose a dual lesion attention network (DLA-Net) for the classification of pneumoconiosis that can extract features from affected regions in a lung. This network consists of two main components: feature extraction and feature refinement. Feature extraction uses the pre-trained Xception model as the backbone to extract semantic information. To emphasise the lesion regions and improve the feature representation capability, the feature refinement component uses a DLA module that consists of two sub modules: channel attention (CA) and spatial attention (SA). The CA module focuses on the most important channels in the feature maps extracted by the backbone model, and the SA module highlights the spatial details of the affected regions. Thus, both attention modules combine to extract discriminative and rich contextual features to improve classification performance on pneumoconiosis. Experimental results show that the proposed DLA-Net outperforms state-of-the-art methods for pneumoconiosis classification.

[The problems of classification of the occupational interstitial lung diseases, approaches to solving].

The analysis of the applied in Russia classifications of pneumoconiosis and occupational hypersensitivity pneumonitis in relation to the international classifications of occupational lung diseases and the classification of interstitial lung diseases (ILD) was performed. The necessity of a new approach to the classification of occupational ILD was proved and solutions of the problem were offered.

[Lung ventilation parameters in various pneumoconiosis forms during follow-up in miners of Kouzbass].

Studies of spirometric parameters in 120 miners who live in Kemerovo region and suffer from diagnosed pneumoconiosis demonstrated disordered pulmonary ventilation in 53.3% of the examinees. The highest velocity parameters in spirometry are seen in nodular form, the lowest ones--in mixed form of pneumoconiosis. During 2 years of follow-up forced expiratory volume over the first second decreased. Velocity and volume spirometric parameters in pneumoconiosis among coal miners of Kemerovo region under 2 years of follow-up demonstrate invert correlation with initial age of the patients when pneumoconiosis was diagnosed.

[On parity in development of obstructive and restrictive changes in miners].

Spirometric studies in 397 miners having pneumoconiosis and chronic dust bronchitis demonstrated 80% occurrence of respiratory failure with equally marked obstructive and restrictive disorders. Therefore, bronchopulmonary diseases in miners do not match the criteria of chronic obstrictive lung disease.

Association of cytokine gene polymorphisms in CWP and its severity in Turkish coal workers.

BACKGROUND: Cytokines appear to play a key role in some inflammatory reactions affecting the interactions among pro- and anti-inflammatory mechanisms that result in several diseases such as coal workers' pneumoconiosis (CWP). In this study, to determine the cytokine gene profiles of Turkish coal miners, we performed genotyping analysis to investigate the polymorphisms of CWP-related pro-inflammatory (TNFA, IL1A, IL1B, and IL6) and anti-inflammatory cytokines (IL-1RN and TGFB1). An additional goal was to observe whether these cytokine gene polymorphisms influence the development risk and severity of. METHODS: Genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. RESULTS: TNFA (-238) gene polymorphism principally affected CWP development and severity (OR = 3.47: 95% CI, 1.12-10.77 and OR = 4.30: 95% CI, 1.25-14.74, respectively) and also risk of CWP (OR = 3.79: 95% CI, 1.37-10.46). The TNFA (-308) variant was associated with a risk for the CWP severity (OR = 2.84: 95% CI, 1.08-7.39). A protective effect of IL6 was found on the development (OR = 0.48: 95% CI, 0.21-0.93) and severity of CWP (OR = 0.37: 95% CI, 0.15-0.91). CONCLUSIONS: We suggest that TNFA (-238) variant may be a risk factor in both development and the severity of CWP, while TNFA (-308) variant seems to be important only in disease severity. On the other hand, IL6 variant may have a protective effect on the development and disease severity.

Relationships (II) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with ventilatory functions indices for parenchymal abnormalities.

The International Classification of High-Resolution Computed Tomography (HRCT) for Occupational and Environmental Respiratory Diseases (ICOERD) is used to screen and diagnose respiratory illnesses. Using univariate and multivariate analysis, we investigated the relationship between subject characteristics and parenchymal abnormalities according to ICOERD, and the results of ventilatory function tests (VFT). Thirty-five patients with and 27 controls without mineral-dust exposure underwent VFT and HRCT. We recorded all subjects' occupational history for mineral dust exposure and smoking history. Experts independently assessed HRCT using the ICOERD parenchymal abnormalities (Items) grades for well-defined rounded opacities (RO), linear and/or irregular opacities (IR), and emphysema (EM). High-resolution computed tomography showed that 11 patients had RO; 15 patients, IR; and 19 patients, EM. According to the multiple regression model, age and height had significant associations with many indices ventilatory functions such as vital capacity, forced vital capacity, and forced expiratory volume in 1 s (FEV1). The EM summed grades on the upper, middle, and lower zones of the right and left lungs also had significant associations with FEV1 and the maximum mid-expiratory flow rate. The results suggest the ICOERD notation is adequate based on the good and significant multiple regression modeling of ventilatory function with the EM summed grades.

Relationships (I) of International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases with the ILO International Classification of Radiographs of Pneumoconioses for parenchymal abnormalities.

The International Classification of High-resolution Computed Tomography (HRCT) for Occupational and Environmental Respiratory Diseases (ICOERD) has been developed for the screening, diagnosis, and epidemiological reporting of respiratory diseases caused by occupational hazards. This study aimed to establish a correlation between readings of HRCT (according to the ICOERD) and those of chest radiography (CXR) pneumoconiotic parenchymal opacities (according to the International Labor Organization Classification/International Classification of Radiographs of Pneumoconioses [ILO/ICRP]). Forty-six patients with and 28 controls without mineral dust exposure underwent posterior-anterior CXR and HRCT. We recorded all subjects' exposure and smoking history. Experts independently read CXRs (using ILO/ICRP). Experts independently assessed HRCT using the ICOERD parenchymal abnormalities grades for well-defined rounded opacities (RO), linear and/or irregular opacities (IR), and emphysema (EM). The correlation between the ICOERD summed grades and ILO/ICRP profusions was evaluated using Spearman's rank-order correlation. Twenty-three patients had small opacities on CXR. HRCT showed that 21 patients had RO; 20 patients, IR opacities; and 23 patients, EM. The correlation between ILO/ICRP profusions and the ICOERD grades was 0.844 for rounded opacities (p<0.01). ICOERD readings from HRCT scans correlated well with previously validated ILO/ICRP criteria. The ICOERD adequately detects pneumoconiotic micronodules and can be used for the interpretation of pneumoconiosis.

Proposed criteria for mixed-dust pneumoconiosis: definition, descriptions, and guidelines for pathologic diagnosis and clinical correlation.

We defined mixed-dust pneumoconiosis (MDP) pathologically as a pneumoconiosis showing dust macules or mixed-dust fibrotic nodules (MDF), with or without silicotic nodules (SN), in an individual with a history of exposure to mixed dust. We defined the latter arbitrarily as a mixture of crystalline silica and nonfibrous silicates. According to our definition of MDP, therefore, MDF should outnumber SN in the lung to make a pathologic diagnosis of MDP. In the absence of confirmation of exposure, mineralogic analyses can be used to support the pathologic diagnosis. The clinical diagnosis of MDP requires the exclusion of other well-defined pneumoconioses, including asbestosis, coal workers' pneumoconiosis, silicosis, hematite miners' pneumoconiosis, welders' pneumoconiosis, berylliosis, hard metal disease, silicate pneumoconiosis, diatomaceous earth pneumoconiosis, carborundum pneumoconiosis, and corundum pneumoconiosis. Typical occupations associated with the diagnosis of MDP include metal miners, quarry workers, foundry workers, pottery and ceramics workers, and stonemasons. Irregular opacities are the major radiographic findings in MDP (ILO 1980), in contrast to silicosis, in which small rounded opacities predominate. Clinical symptoms of MDP are nonspecific. MDP must be distinguished from a variety of nonoccupational interstitial pulmonary disorders.

Variability in the classification of radiographs using the 1980 International Labor Organization Classification for Pneumoconioses.

This study describes the extent of agreement in classification of chest radiographs using the International Labor Organization (ILO) classification among six readers from the United States and Canada. A set of 119 radiographs was created and read by three Canadian and three US readers. The two ratings of interest were profusion (scored from 0/- to 3/+) and pleural abnormalities consistent with pneumoconiosis (scored with the ILO system, then collapsed into a yes/no). We used a number of approaches to evaluate interreader agreement on profusion and pleural changes, determining concordance, observed agreement, kappa statistic, and a new measure to approximate sensitivity and specificity. This study found that five of six readers had good fair to good agreement for pleural findings and for profusion as a dichotomous variable (> or = 1/0 vs < or = 0/1) using the kappa statistic, while a sixth reader had poor agreement. We found that concordance, expressed as percent agreement, was higher for normal radiographs than for ones that showed disease, and describe the use of the kappa statistic to control for this finding. This analysis adds to the existing literature with the use of the kappa statistic, and by presenting a new measure for "underreading" and "overreading" tendencies.

The international labour office classification: use and misuse.

The main characteristics of the International Labour Office (ILO) International Classification of Radiographs of the Pneumoconioses (1980) are reviewed. Applications to epidemiological, research, and clinical problems are outlined. The need for multiple readings, reading protocols and appropriate administrative arrangements is emphasized. Possible improvements to the Classification are discussed. The basic descriptive features of the scheme are distinguished from supplementary interpretative facilities; it is suggested that misuse of the Classification occurs primarily when these two functions are confused.

The 1980 ILO classification of radiographs of the pneumoconioses.

The 1980 ILO classification of radiographs of the pneumoconioses has undergone revision and improvement in response to increases in knowledge and international concerns. Its goal is to standardize the reading and reporting of radiographic manifestations of the inhalation of dust so that international epidemiologic comparisons are possible. It remains an imperfect instrument, but "... although total elimination of variation is impossible, some measure of control can be achieved."

Comparison of chest radiography and high-resolution computed tomography findings in early and low-grade coal worker's pneumoconiosis.

INTRODUCTION: High-resolution computed tomography (HRCT) is more sensitive than chest X-ray (CXR) in the depiction of parenchymal abnormalities. We aimed to present and compare CXR and HRCT findings in coal workers with and without early and low-grade coal worker's pneumoconiosis (CWP). MATERIALS AND METHODS: 71 coal workers were enrolled in this study. All workers were male. The CXR and HRCT of those workers were obtained and graded by two trained readers. HRCT's were graded according to Hosoda and Shida's Japanese classification. After grading, 67 workers with CXR profusion 0/0-2/2 were included in the study. Four patients with major opacity were excluded. Profusion 0/1 to 1/1 cases were accepted as early and profusion 1/2 and 2/2 cases as low-grade pneumoconiosis. RESULTS: Discordance between CXR and HRCT was high. Discordance rate was found higher in the early pneumoconiosis cases with negative CXR than low-grade pneumoconiosis (60, 36 and 8%, respectively). When coal miners with normal CXR were evaluated by HRCT, six out of 10 cases were diagnosed as positive. In low-grade pneumoconiosis group, the number of patients with positive CXR but negative HRCT were low in comparison to patients with CXR negative and early pneumoconiosis findings. Most of the CXR category 0 patients (10/16) were diagnosed as category 1 by HRCT. Eleven cases diagnosed as CXR category 1 were diagnosed as category 0 (7/11) and category 2 (4/11) by HRCT. In CXR category 2 (eight cases), there were four cases diagnosed as category 1 by HRCT. CONCLUSIONS: Discordance between CXR and HRCT was high, especially for CXR negative and early pneumoconiosis cases. The role of CXR in screening coal workers to detect early pneumoconiosis findings should be questioned. We suggest using HRCT as a standard screening method instead of CXR to distinguish between normal and early pneumoconiosis.

[Classification of spot-shaped lung changes by texture analysis]. / Klassifizierung fleckförmiger Lungenveränderungen durch Texturanalyse.

Classification of opacities in pneumoconiosis was accomplished by textural analysis in digitised chest x-rays. A good discrimination was achieved by a set of 10 parameters. These texture measures were computed by algorithms for edge detection, local extremes, difference statistics, the co-occurrence matrix and the power spectrum. The classes of the training set were classified correctly at 99%. A test set comprising additional classes that were not contained in the training set, was classified at 82%.

[Comparison of digital selenium radiography with an analog screen-film system in the diagnostic process of pneumoconiosis according to ILO classification]. / Vergleich der digitalen Selenradiographie mit einem analogen Film-Folien-System in der Diagnostik von Staublungenerkrankungen anhand der ILO-Klassifikation.

UNLABELLED: Comparison of digital selenium radiography with an analog screen-film system in the diagnostic process of pneumoconiosis according to ILO classification. PURPOSE: The aim of the study was to determine the diagnostic value of digital selenium radiography in patients with pneumoconiosis. For this purpose chest x-rays by digital selenium radiography and analog screen-film system were compared according to the ILO classification of pneumoconiosis. METHOD: After approval of the study by the local ethic commission and the Federal German Office for Radiation Protection 50 patients were subjected to x-rays by digital selenium radiography (Thoravision; Philips Medical Systems, Hamburg, Germany) and analog screen-film system of the same day within the scope of an industrial medicine preventive checkup. Four investigators rated the chest x-rays according to the ILO classification of pneumoconiosis. RESULTS: The findings demonstrated by chest x-rays according to ILO classification were rated similar by digital selenium radiography and analog screen film systems. Image quality of the digital pictures was rated significantly better. CONCLUSION: The use of digital selenium radiography in evaluating chest x-rays according to the ILO classification does not result in over- or underestimation of pulmonary pathologies. Hence, in the diagnosis of pneumoconiosis, digital selenium radiography can replace the tested analog screen-film system.

Pneumoconiosis assistant: a hypermedia-based classification of the pneumoconioses.

Workers exposed to harmful dusts such as coal often are screened for possible pneumoconiosis. A classification devised by the International Labor Office (ILO) is used for film interpretation. Film interpretation is time consuming and requires the comparison of the subject's radiograph with as many as 22 standard films and the completion of a nonintuitive form. A computer program has been written to aid in interpretation of films. This program, written in SuperCard, uses hypermedia concepts to link textual, diagrammatic, and digital images. The program includes digitized ILO radiographs, guidelines, references, and other textual and radiographic material. The program is easy to use and reduces the time required to interpret films. The concepts of how the program is constructed are emphasized so that others may devise similar program aids.