Acta Biomedica Scientia

QUANTIFICATION OF RADIOLOGICAL CHANGES IN SMOKINGINDUCED AIRWAY DISEASE: A PROSPECTIVE STUDY

Dr. Shetty Sachin Karunakar

Smoking-induced airway disease, Chest radiography, International Labour Organization (ILO) classification, Emphysema, Computed tomography (CT) imaging

In this prospective study, we investigated the quantification of radiological changes associated with smoking-induced airway disease, commonly referred to as "dirty chest," using the International Labour Organization (ILO) classification of pneumoconiosis. The morphological similarity between this condition and anthracosilicosis of coal workers led us to hypothesize that the ILO classification could effectively quantify these changes. Participants' chest radiographs were analyzed for lung markings, emphysema, and thickened bronchial walls by a board-certified radiology team. The ILO profusion score, ranging from zero to nine, was utilized to correlate smoking habits with lung markings. Revised ILO standards were applied to the radiographic ratings. Results revealed higher lung markings in 74% of smokers, with 37% exhibiting a profusion score of 1-4 and 29% a score of 2-2. There was a significant correlation (r=0.68) between pack years, a measure of smoking exposure, and lung markings on chest radiography. Additionally, heavy smokers (those with more than 40 pack years) showed a higher prevalence of emphysema on both CT and chest radiography. However, the prevalence of emphysema did not significantly differ between the two imaging modalities. CT scans further revealed intralobular opacities in 64% of cases and thickened bronchial walls in 62% of cases, with only 7% exhibiting ground-glass opacity. Notably, radiographic bronchial wall thickening and intralobular opacities on CT were inversely correlated with lung markings. These findings underscore the utility of the ILO classification in quantifying radiological changes associated with smoking-induced airway disease, and highlight the complementary role of CT imaging in evaluating associated pathological features