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However, in light of the finding concerning the high levels of Al reported in Tables 5, 6 for both ECIG-generated aerosol (4 g/cig equivalent) and cigarette smoke (8 g/cig), it is necessary to mention the fact that Al accumulation in neural tissue may be correlated with Alzheimer's disease (Tomljenovic, 2011)

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Patients may not readily admit that theyre using the material, but if a radiologist recognizes these patterns and then tells the clinician that it could be vaping-induced injury, then maybe they could test for a nicotine metabolite or ask the patient about this exposure. Such an approach could help reduce lung biopsies, which carry considerable expense, some risk of complications and additional anxiety for the patient