CHEST RADIOGRAPHY

Chest Image Repository

The National Institute for Occupational Safety and Health (NIOSH) requests contributions to the Institute's new Chest Image Repository (CIR), an image databank of de-identified, digitally-acquired, chest radiographs and computed tomography (CT) scans to be used for research, training, quality assurance, publications and other educational and public health purposes. Examples of minimal to severe occupational parenchymal and pleural lung disorders are sought. Contributors to the repository may include those engaged in health care, academics, or public health, including occupational safety and health. Contributors who agree will be acknowledged on the NIOSH web site. This recognition will not include disclosure of any individually identifiable health information.

Information for potential contributors:

NIOSH is especially seeking chest radiographs that show a minimal or low profusion of small pneumoconiotic opacities, either rounded or irregular types. Because classifications are often done for medical surveillance of exposed workers, it is particularly important for physician readers to accurately identify early disease, at a time when preventive measures can potentially reduce the risk of clinical disease.

NIOSH is hoping to obtain examples of pneumoconioses, preferably with a diagnosis confirmed by clinical evaluation, and/or histopathology:

• Coal workers' pneumoconiosis (simple and complicated) of various levels of small opacity profusion, based on the International Labour Office (ILO) classification (e.g., 0/1, 1/0, 1/1, up to 3/+),
• Silicosis (simple and complicated) of various levels of profusion (0/1, 1/0, 1/1, up to 3/+),
• Asbestosis and asbestos-related pleural disease of varying severity, extent, location, presence of calcification, etc.
• Other pneumoconioses.

Information is requested about relevant personal and occupational exposures, if known:

• Jobs and years of exposure to dusts,
• Cigarette pack-years.
• A chest image repository submission form has been created to assist in the collection and submission of associated information and is available at the repository web site. Only one submission form is needed per individual or patient.

Technical specifications:

• A User's Manual is available for submitting images and clinical data to the NIOSH Chest Image Repository.
• The images must be submitted in the full Digital Imaging and Communications in Medicine (DICOM) file format (not compressed files).
• Support and infrastructure for submission of images to the CIR will be provided by the Electronic Radiology Laboratory (ERL), at the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO.
• Contributors or contributing sites must request approval from NIOSH before images can be submitted to the repository.
• ERL will contact approved sites, and provide instructions and software for removal of protected health information (PHI) from the DICOM files.
• ERL has the expertise and commitment to provide technical assistance and support to contributors to assure that all data (images and any associated information) are de-identified before insertion into the repository.

Legal and Ethical issues:

• Before you can submit images and associated information to the repository, you will be required to electronically sign a “click through agreement” on the repository website certifying that you are the original source of the data, and that release of the data is permitted by your local authorities, laws and regulations, when applicable.
• Every effort will be made to remove protected health information (PHI) from images and associated information, both by the submitter and again by tested automatic de-identification processes by ERL, as required by HIPAA for data use agreements [45CFR164.514(e)(4)], i.e., appropriate safeguards to ensure that protected health information (PHI) is not used or disclosed inappropriately. Nonetheless ethical principles command all users to make no attempt to identify individuals from whatever data elements and metadata remain.

If you wish to contribute to this repository, please send an email to help@world-images.org