ILO-Standard- and CT/HRCT-Reference-Films - Is there a need for new sets?

Introduction: The preliminary discussion for classification of silicosis started back in 1930 in Johannesburg, South Africa. In 1950 the International Labour Office (ILO) Sydney Classification has been introduced followed by revisions and additions with regard to content and practicability in 1950, 1958, 1968 and 1980. The revised edition 2000 is accompanied by copies from digitized full-sized analogue standard radiographs of 1980 including a new arrangement for pleural abnormalities compared to the 1980-set.  For 2011 the development of standard digital images in a DICOM-format, corresponding to the ILO (2000) standard radiographs, are being prepared from the ILO for using PACS-or Stand-alone-Units.   A general accepted classification of pulmonary and pleural findings with High-Resolution-Computed-Tomography (HRCT) till today does not exist. In 2005 a monograph “International Classification of HRCT for Occupational and Environmental Respiratory Diseases - ICOERD” has been published. The work represents a consensus of international experts from Belgium, Finland, France, Germany, Great Britain, Japan and United States on a principal coding system along with reference films and imaging parameters. The reference films include examples with 5 and 1 mm slice thickness (incremental CT) for typical pleural and parenchymal findings.  

Conclusion and Take Home Points: • Digital techniques in chest radiology require standard radiographs in a DICOM-format for comparing candidate- and standard-films side by side each on diagnostic monitors • The 2011 standard digital images correspondent to ILO 2000 standard images to maintain continuity of and consistency with former data; a completely digital acquired new set has to be taken into account • HRCT-findings of occupational respiratory lung diseases should be classified using a standardized coding and scoring system. Reference films are provided to harmonize the description and documentation to achieve a reproducible score of the disease. • German experience with the system for coding asbestosis, asbestos-related pleural findings, silicosis and other occupational lung diseases will be presented.