Title: Computerized Tomography Virtual Bronchoscopy – Will it replace Fibre optic Bronchoscopy in Tracheobronchial Evaluation?

Authors: Dr Renjini S, Dr Suny Thomas, Dr Mohanan K, Dr Paul V. Puthussery, Dr Raini K.P., Dr Elizabeth Daniel

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i4.174

Abstract

Introduction: Computerized Tomography (CT) Virtual Bronchoscopy is an emerging diagnostic tool in tracheobronchial evaluation with distinct advantages over Fibreoptic Bronchoscopy in that it is noninvasive and able to evaluate beyond significant obstruction. However, it has limited utility in mucosal lesions and there is no option for biopsy.

Aim of the study: To evaluate and compare the efficacy of CT Virtual bronchoscopy and Fibre optic bronchoscopy in the assessment of tracheobronchial lesions.

Materials and Methods: 60 patients with respiratory symptoms underwent CT Virtual Bronchoscopy and Fibre optic Bronchoscopy. The findings in CT Virtual Bronchoscopy were evaluated and compared with Fibreoptic Bronchoscopy which was taken as the gold standard and various statistical calculations assessed.

Results: The sensitivity, specificity and accuracy of CT Virtual Bronchoscopy were assessed for endoluminal, extrinsic compressive, mucosal lesions and secretions in tracheobronchial tree in comparison with Fibreoptic Bronchoscopy.

Conclusions: CT Virtual Bronchoscopy has very high sensitivity, specificity and accuracy in detection of endoluminal and extrinsic compressive tracheobronchial lesions. The major limitation at present seems to be in detection of mucosal lesions and secretions. There is scope for improvisation of Computerized Tomography Virtual Bronchoscopy by decreasing the radiation exposure, improving the resolution to increase accuracy of detecting mucosal lesions and secretions and mathematical models to reduce inter-observer bias.

Keywords: Computerized Tomography, Virtual Bronchoscopy, Fibreoptic Bronchoscopy

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Corresponding Author

Dr Suny Thomas

Additional Professor of Radiodiagnosis

Government Medical College, Thrissur

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