Asbestos exposure. Thoracic imagery as tool for early detection and follow-up.

Chest radiograph and computed tomography are the most appropriate imaging t ools for detecting asbestos-related pleural and parenchymal disease due to their availability and performances. The cost and irradiation delivery of c onventional chest X-rays are limited. Technical parameters and reading shou ld be standardized. Digital chest radiograph will progressively replace con ventional techniques but technical standards and performance data are lacki ng. Computed tomography, using spiral or conventional mode, explores the wh ole lung and pleura. High resolution computed tomography samples both lung and pleura but its sensitivity for parenchymal fibrosis detection is greate r Several methods cart be employed and should be recommended to reduce radi ation dose in spiral and high resolution computed tomography. Computed tomo graphy is more sensitive and specific than chest radiograph in early detect ion of pleural plaques and parenchymal fibrosis but is not infallible. The error reading rate of chest radiograph for early detection of bronchial car cinoma is high. Computed tomography is more sensitive but lacks specificity , and leads to detect a high rate of lesions the relation to asbestos expos ure of which are difficult to establish. No scientific data are available t o assess the contribution of imaging in early detection of mesothelioma.