Search Our Scientific Publications & Authors

BMJ Open 2022 Jan 25;12(1):e057663. Epub 2022 Jan 25.

National Centre for Asbestos Related Diseases (NCARD), Institute for Respiratory Health, Perth, Western Australia, Australia.

Introduction: There is a strong theoretical rationale for combining checkpoint blockade with cytotoxic chemotherapy in pleural mesothelioma and other cancers. Two recent single-arm, phase 2 trials [DuRvalumab with chEmotherapy as first-line treAtment in advanced pleural Mesothelioma (DREAM) and Phase II multicenter study of anti-PD-L1, durvalumab, in combination with cisplatin and pemetrexed for the first-line treatment of unresectable malignant pleural mesothelioma (PrE0505)] combining the programmed death ligand-1 (PD-L1) inhibitor durvalumab with standard first-line chemotherapy exceeded prespecified safety and activity criteria to proceed to a phase 3 confirmatory trial to assess this combination. We present the protocol of the DREAM3R trial. Read More

Lung Cancer 2022 02 16;164:76-83. Epub 2021 Dec 16.

Department of Radiology, Beth Israel Lahey Health, Harvard Medical School, Boston, MA, USA.

Imaging of mesothelioma plays a role in all aspects of patient management, including disease detection, staging, evaluation of treatment options, response assessment, pre-surgical evaluation, and surveillance. Imaging in this disease impacts a wide range of disciplines throughout the healthcare enterprise. Researchers and clinician-scientists are developing state-of-the-art techniques to extract more of the information contained within these medical images and to utilize it for more sophisticated tasks; moreover, image-acquisition technology is advancing the inherent capabilities of these images. Read More

Am J Ind Med 2022 03 27;65(3):196-202. Epub 2021 Dec 27.

Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA.

Background: Vermiculite ore from Libby, Montana contains on average 24% of a mixture of toxic and carcinogenic amphibole asbestiform fibers. These comprise primarily winchite (84%), with smaller quantities of richterite (11%) and tremolite (6%), which are together referred to as Libby amphibole (LA).

Methods: A total of 1883 individuals who were occupationally and/or environmentally exposed to LA and were diagnosed with asbestos-related pleuropulmonary disease (ARPPD) following participation in communitywide screening programs supported by the Agency for Toxic Substances and Disease Registry (ATSDR) and followed up at the Center for Asbestos Related Disease (CARD) between 2000 and 2010. Read More

Radiol Case Rep 2021 Dec 9;16(12):3824-3828. Epub 2021 Oct 9.

Department of Radiology, University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA, 98195, USA.

We describe a 78-year-old initially presenting with left breast cancer, status post mastectomy and bilateral dual-lumen breast implant placement, subsequently developed lung cancer years later status post lobectomy, who later developed FDG-avid pleural nodularity and thickening. The differential diagnosis of pleural thickening and nodularity can be broad, including metastatic cancer, asbestos-related pleural disease, loculated fluid (including simple pleural effusion, hemothorax, or chylothorax), and pleural infection. However, in the setting of two different primary malignancies, our patient's FGD-avid pleural thickening was concerning for metastatic disease. Read More

Cancers (Basel) 2021 Aug 20;13(16). Epub 2021 Aug 20.

Curtin Medical School, Curtin University, Perth, WA 6845, Australia.

Mesothelioma is a cancer predominantly of the pleural cavity. There is a clear association of exposure to asbestos with a dose dependent risk of mesothelioma. The incidence of mesothelioma in different countries reflect the historical patterns of commercial asbestos utilisation in the last century and predominant occupational exposures mean that mesothelioma is mostly seen in males. Read More

J Transl Med 2021 05 31;19(1):232. Epub 2021 May 31.

Department of Oncology, Oslo University Hospital, Oslo, Norway.

Background: Malignant pleural mesothelioma (MPM) is a rare and aggressive tumour. For patients with inoperable disease, few treatment options are available after first line chemotherapy. The combination of ipilimumab and nivolumab has recently shown increased survival compared to standard chemotherapy, but most patients do not respond and improvements are called for. Read More

Med Lav 2020 Oct 31;111(5):379-387. Epub 2020 Oct 31.

Department of Medical, Surgical and Neurological Sciences, University of Siena, Unit of Respiratory Disease and Lung Transplant, Siena University Hospital, Viale Bracci 16, 53100 Siena, Italy.

Background: Asbestos-related lung diseases are a group of heterogeneous disorders with different pathogenesis and prognosis. Very few studies investigated the BALF cell profile of asbestos exposed workers. The existence of a relationship between bronchoalveolar lavage fluid (BALF) cellular pattern and specific diagnosis and/or asbestos exposure biomarkers would allow the identification of effect biomarkers useful in the follow up of asbestos-exposed workers and in the diagnosis of asbestos-related diseases. Read More

CEN Case Rep 2020 11 13;9(4):385-391. Epub 2020 Jun 13.

Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan.

Here, we present a 67-year-old Japanese man who developed insidious-onset nephrotic syndrome. He had a history of occupational asbestos exposure for about 8 years during his 30s, and was found to have pleural effusion 3 years before his present illness. At that time, repeated cytology testing of his pleural effusion found no malignant cells, and pleural biopsy found fibrous pleuritis without evidence of malignant mesothelioma. Read More

BMC Pulm Med 2019 Nov 12;19(1):213. Epub 2019 Nov 12.

Center for interstitial and rare lung diseases, Pneumology, Thoraxklinik, University of Heidelberg, Germany and German Center for Lung Research, Heidelberg, Germany.

Background: Fibrosing, non-idiopathic pulmonary fibrosis (non-IPF) interstitial lung diseases (fILDs) are a heterogeneous group of diseases characterized by a different amount of inflammation and fibrosis. Therapy is currently based on corticosteroids and/or immunomodulators. However, response to these therapies is highly variable, sometimes without meaningful improvement, especially in more fibrosing forms. Read More

Sci Rep 2019 10 10;9(1):14640. Epub 2019 Oct 10.

National Centre for Asbestos Related Diseases (NCARD), Lv5 QQ Block (M503), QEII Medical Centre, The University of Western Australia, Perth, Western Australia, 6009, Australia.

Non-small cell lung cancer (NSCLC) causes 19% of all Australian cancer deaths, with a 5-year survival post-resection of around 60%. Post-operative recurrence is due to metastases that were undetectable pre-operatively, or growth of microscopic locoregional residual disease. However, post-operative imaging modalities typically only detect more advanced tumours; where PET-CT has a detection limit of 6-7 mm. Read More

Am J Ind Med 2019 12 18;62(12):1112-1116. Epub 2019 Sep 18.

Barry Commoner Center for the Environment and Health, Queens College, City University of New York, Flushing, New York.

Background: Lung cancer screening with low-dose computed tomography (CT) scanning (LDCT) is accepted as a screening tool, but its application to populations exposed to recognized occupational or environmental carcinogens is limited. We apply LDCT to a population with a predominantly nonoccupational exposure to a recognized human lung carcinogen, Libby amphibole asbestos (LA).

Methods: Patients in an asbestos disease clinic in Libby, Montana who were aged 50 to 84 years, greater than or equal to 20 pack-year history of tobacco use (irrespective of quit date), and asbestos-related pleuropulmonary disease on high-resolution CT scan were offered free annual lung cancer screening over a 39-month period. Read More

Ann Glob Health 2019 07 15;85(1). Epub 2019 Jul 15.

Dornsife School of Public Health of Drexel University, US.

Background: Asbestos products are manufactured and used in Sri Lanka in the construction and automobile industries.

Objective: To determine radiologically if exposure to asbestos caused lung disease among workers handling asbestos products, and to generate data in Sri Lanka where no such data exist due to poor reporting and a poor surveillance system.

Methods: Following ethics approval and written consent plain chest X-rays and exposure data were obtained in 230 workers in asbestos manufacturing, building construction, building demolition, tsunami debris cleanup, and other trades. Read More

Expert Rev Respir Med 2019 03 25;13(3):241-249. Epub 2019 Jan 25.

a Department of Respiratory Medicine , Sir Charles Gairdner Hospital , Perth , WA , Australia.

Introduction: The diagnosis of lung disease in asbestos-exposed individuals is a process that not only requires a detailed occupational and tobacco smoking history, but the correlation with physical signs, appropriate imaging, detailed lung function assessment and histology/cytology when required. Worldwide, the total quantity of asbestos mined is static, having decreased dramatically in developed countries but increased in countries where there is no restriction on mining: for example, Russia, China, Brazil, and Kazakhstan. The predominant diagnostic challenge in most cases of possible asbestos-related disease is the significant interval between exposure and development of the disease. Read More

J Thorac Imaging 2019 Sep;34(5):320-325

Cardio-thoracic Research Center of Bordeaux, U1045, CIC 1401.

Rationale: As pleural plaque has been reported as a risk factor in the occurrence of lung cancer and mesothelioma, a reproducible and precise method of measurement of pleural plaque volume (PPV) is needed to further describe these relationships. The aim of the study was to assess the reproducibility of a 3-dimensional computed tomography (3D-CT) volumetric analysis of PPV in patients with occupational exposure to asbestos.

Material And Methods: A total of 28 patients were retrospectively randomly selected from the multicenter APEXS (Asbestos Post Exposure Survey) study, which was held between 2003 and 2005. Read More

Transl Lung Cancer Res 2018 Oct;7(5):520-536

Laboratory of Experimental Medicine and Paediatrics, Antwerp University, Wilrijk, Belgium.

Malignant pleural mesothelioma (MPM) is a tumour related to a historical exposure to asbestos fibres. Currently, the definite diagnosis is made only by the histological examination of a biopsy obtained through an invasive thoracoscopy. However, diagnosis is made too late for curative treatment because of non-specific symptoms mainly appearing at advanced stage disease. Read More

Ind Health 2018 Oct 26;56(5):382-393. Epub 2018 May 26.

Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.

Two hundred and thirty-three individuals read chest x-ray images (CXR) in the Asian Intensive Reader of Pneumoconiosis (AIR Pneumo) workshop. Their proficiency in reading CXR for pneumoconiosis was calculated using eight indices (X1-X8), as follows: sensitivity (X1) and specificity (X2) for pneumoconiosis; sensitivity (X3) and specificity (X4) for large opacities; sensitivity (X5) and specificity (X6) for pleural plaques; profusion increment consistency (X7); and consistency for shape differentiation (X8). For these eight indices, one-way analysis of variance (ANOVA) and Scheffe's multiple comparison were conducted on six groups, based on the participants' specialty: radiology, respiratory medicine, industrial medicine, public health, general internal medicine, and miscellaneous physicians. Read More

J Thorac Oncol 2018 07 9;13(7):1012-1021. Epub 2018 May 9.

Medical School and National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Western Australia and Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Introduction: Malignant pleural mesothelioma poses unique difficulties in tumor measurement and response assessment; however, robust and reproducible assessment of response is critically important in the conduct, interpretation, and reporting of clinical trials.

Methods: The current de facto standard for the assessment of mesothelioma tumor response, "modified RECIST" (Response Evaluation Criteria in Solid Tumors), was published in 2004 as a research paper. Practical application of the modified RECIST guidelines has suffered from varied interpretations, resulting in inaccuracies and inconsistencies in tumor response assessment across and within mesothelioma clinical trials. Read More

J Occup Environ Med 2018 02;60(2):167-173

Mount Sinai Health System, Icahn School of Medicine, New York, New York (Drs Miller, Henschke, Yankelevitz, Liang, Liu, Ms Yip, Ms Linker, Dr Flores); Northwell Health, Department of Occupational Medicine, Epidemiology and Prevention, Great Neck, New York (Dr Szeinuk); University of Montana, Missoula, Montana (Dr Noonan); Montana State University, Bozeman, Montana (Dr Pfau); and Center for Asbestos Related Disease, Libby, Montana (Dr Black, Ms McNew).

Objective: This article describes radiologic and pulmonary function findings among miners exposed to Libby amphibole. Computed tomography (CT) permits the detection of the characteristic thin, lamellar pleural thickening (LPT).

Methods: Individuals who worked at the mine for a minimum of 6 months had chest CT and pulmonary function tests. Read More

Int J Occup Med Environ Health 2018 Jan 2;31(3):293-305. Epub 2017 Nov 2.

Ruhr University Bochum, Bochum, Germany (Institute for Pathology).

Objectives: This study has researched the significance of histologically raised findings and lung dust analyses in the context of claiming the recognition of and thus compensation for an asbestos-associated occupational disease.

Material And Methods: For this approach, all findings from the German Mesothelioma Register in 2015 that included lung dust analyses were evaluated and were compared with information on asbestos fiber exposure at work based on fiber years, and with the results of radiological findings.

Results: For 68 insured persons, recognition of an asbestos-induced lung disease according to Section 4104 of the German Ordinance on Occupational Diseases (Berufskrankheitenverordnung - BKV) could be recommended solely on the basis of the histological examinations of lung tissues and complementary lung dust analyses. Read More

Clin Respir J 2018 Apr 23;12(4):1676-1684. Epub 2017 Nov 23.

Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Background: Asbestos exposure may cause asbestos-related lung diseases including asbestosis, pleural abnormalities and malignancies. The role of asbestos exposure in the development of small airway obstruction remains controversial. Anatomic and physiologic small airway abnormalities may develop as part of the pathophysiologic process of asbestosis. Read More

ERJ Open Res 2017 Jul 25;3(3). Epub 2017 Aug 25.

School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

The accurate diagnosis of asbestos-related diseases is important because of past and current asbestos exposures. This study evaluated the reliability of clinical diagnoses of asbestos-related diseases in former mineworkers using autopsies as the reference standard. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Read More

Arch Bronconeumol 2017 Aug 6;53(8):437-442. Epub 2017 Mar 6.

Hospital Universitario 12 de Octubre, Madrid, España.

Asbestos is the term used for a set of mineral silicates that tend to break up into fibers. Its use has been associated with numerous diseases affecting the lung and pleura in particular, all of which are characterized by their long period of latency. Asbestos, moreover, has been recognized by the WHO as a Group IA carcinogen since 1987 and its use was banned in Spain in 2002. Read More

BMJ Open 2016 11 24;6(11):e013324. Epub 2016 Nov 24.

Department of Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK.

Introduction: Malignant pleural mesothelioma (MPM) is an asbestos-related cancer, which is difficult to diagnose. Thoracoscopy is frequently required but is not widely available. An accurate, non-invasive diagnostic biomarker would allow early specialist referral, limit diagnostic delays and maximise clinical trial access. Read More

Am J Ind Med 2017 Jan 16;60(1):20-34. Epub 2016 Nov 16.

Mount Sinai Health System, Icahn School of Medicine, New York, New York.

Background: The purpose of Pre-Adult Latency Study was to evaluate lung findings among adults who had been environmentally exposed to Libby Amphibole only during childhood and adolescence.

Methods: Recruitment was restricted to volunteers who attended primary and/or secondary school, lived in Libby, MT, prior to age 23 years for males and 21 years for females and subsequently left the area. Subjects completed exposure and respiratory questionnaires, underwent pulmonary function tests (PFTs), and chest CT scans. Read More

Lung Cancer 2016 11 5;101:48-58. Epub 2016 Sep 5.

School of Medicine and Pharmacology and National Centre for Asbestos Related Diseases, University of Western Australia, Perth, Western Australia and Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Imaging plays an important role in the detection, diagnosis, staging, response assessment, and surveillance of malignant pleural mesothelioma. The etiology, biology, and growth pattern of mesothelioma present unique challenges for each modality used to capture various aspects of this disease. Clinical implementation of imaging techniques and information derived from images continue to evolve based on active research in this field worldwide. Read More

Radiol Clin North Am 2016 Nov 27;54(6):1077-1096. Epub 2016 Aug 27.

Department of Radiology, 1959 Northeast Pacific Street, RR 215, Box 357115, Seattle, WA 98195, USA.

Occupational lung diseases span a variety of pulmonary disorders caused by inhalation of dusts or chemical antigens in a vocational setting. Included in these are the classic mineral pneumoconioses of silicosis, coal worker's pneumoconiosis, and asbestos-related diseases as well as many immune-mediated and airway-centric diseases, and new and emerging disorders. Although some of these have characteristic imaging appearances, a multidisciplinary approach with focus on occupational exposure history is essential to proper diagnosis. Read More

Korean J Radiol 2016 Sep-Oct;17(5):674-83. Epub 2016 Aug 23.

Department of Radiology, Gachon University Gil Medical Center, Gachon University, Incheon 21565, Korea.

Asbestosis is the most important change noted in the lung parenchyma after environmental and occupational exposure to asbestos fibers. It is characterized by diffuse interstitial pulmonary fibrosis. In Korea, the incidence of asbestosis will continue to increase for many years to come and the government enacted the Asbestos Damage Relief Law in 2011 to provide compensation to those suffering from asbestos-related diseases. Read More

Int J Occup Environ Health 2016 04 8;22(2):167-72. Epub 2016 Jul 8.

a Asbestos Diseases Research Institute, University of Sydney , Sydney , NSW , Australia.

Introduction: Global asbestos consumption has shifted toward lower income countries, particularly in the Asian region including Vietnam where asbestos and asbestos-containing products have been imported since the late 1960s.

Methods: This pilot descriptive epidemiological study aimed to provide contemporary estimates of malignant mesothelioma incidence (histological subtype M9050/3; ICD-O-3) by gender and age group as recorded across nine cancer registries in Vietnam.

Results: We identified 148 incident cases of malignant mesothelioma during 1987-2013. Read More

Respirology 2016 11 16;21(8):1419-1424. Epub 2016 Jun 16.

Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Background And Objective: Computed tomography (CT)-based studies of asbestos-exposed individuals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of asbestos-exposed subjects in Western Australia.

Methods: A total of 906 subjects from the Western Australian Asbestos Review Programme underwent LDCT of the chest as part of regular annual review. Read More

Lung 2016 08 14;194(4):501-9. Epub 2016 Jun 14.

Federal University of Rio de Janeiro, Rua Thomaz Cameron, 438. Valparaiso, Rio De Janeiro, Petrópolis, CEP 25685.120, Brazil.

The aim of this review was to present the main aspects of pleural diseases seen with conventional and advanced magnetic resonance imaging (MRI) techniques. This modality is considered to be the gold standard for the evaluation of the pleural interface, characterization of complex pleural effusion, and identification of exudate and hemorrhage, as well as in the analysis of superior sulcus tumors, as it enables more accurate staging. The indication for MRI of the thorax in the identification of these conditions is increasing in comparison to computerized tomography, and it can also be used to support the diagnosis of pulmonary illnesses. Read More