[Exposure to asbestos. Role of thoracic imagery in screening and follow-up].

Chest radiograph and computed tomography are the most appropriate imaging tools for detecting asbestos-related pleural and parenchymal disease due to their availability and performances. The cost and irradiation delivery of conventional chest X-rays are limited. Technical parameters and reading should be standardized. Digital chest radiograph will progressively replace conventional techniques but technical standards and performance data are lacking. Computed tomography, using spiral or conventional mode, explores the whole lung and pleura. High resolution computed tomography samples both lung and pleura but its sensitivity for parenchymal fibrosis detection is greater. Several methods can be employed and should be recommended to reduce radiation dose in spiral and high resolution computed tomography. Computed tomography is more sensitive and specific than chest radiograph in early detection of pleural plaques and parenchymal fibrosis but is not infallible. The error reading rate of chest radiograph for early detection of bronchial carcinoma is high. Computed tomography is more sensitive but lacks specificity and leads to detect a high rate of lesions the relation to asbestos exposure of which are difficult to establish. No scientific data are available to assess the contribution of imaging in early detection of mesothelioma.