HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Dao M. Nguyen David S. Schrump Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Finkelstein, S. E. Articles by Schrump, D. S. Search for Related Content PubMed PubMed Citation Articles by Finkelstein, S. E. Articles by Schrump, D. S. Related Collections Trachea and bronchi

J Thorac Cardiovasc Surg 2002;123:967-972
© 2002 The American Association for Thoracic Surgery

Evolving Technology (ET)

Virtual bronchoscopy for evaluation of malignant tumors of the thorax

From the Thoracic Oncology Section, Surgery Branch, Center for Cancer Research,^a and the Diagnostic Radiology Department, Warren Grant Magnuson Clinical Center,^b National Institutes of Health, Bethesda, Md.

Presented in oral format at the Annual Meeting of the Society of Surgical Oncology, Washington DC, March 16, 2001

Received for publication June 13, 2001. Revisions requested Aug 31, 2001; revisions received Oct 5, 2001. Accepted for publication Oct 26, 2001. Address for reprints: David S. Schrump, MD, Head, Thoracic Oncology Section, Surgery Branch, National Cancer Institute, Building 10, Room 2B07, 10 Center Dr, Bethesda, MD 20892-1502 (E-mail: David_Schrump{at}nih.gov).

Objective: Virtual bronchoscopy is a novel technique making use of 3-dimensional reconstruction of 2-dimensional helical computed tomographic images for noninvasive evaluation of the tracheobronchial tree. This study was undertaken to evaluate the diagnostic potential of virtual bronchoscopy by comparing virtual bronchoscopic images with fiberoptic bronchoscopic findings in patients with thoracic malignant disease.
Methods: Thirty-two consecutive patients with thoracic malignant tumors underwent virtual bronchoscopy for evaluation of suspected tracheobronchial lesions. For each virtual bronchoscopic examination, 200 to 300 contiguous 1.25-mm images of the thorax were obtained in only one or two 17-second breath holds by using a multislice computed tomographic scanner. Virtual bronchoscopy images were reconstructed and interpreted blind to the actual endoscopic findings. Results of virtual bronchoscopy were compared with fiberoptic bronchoscopic findings in 20 patients.
Results: Anatomic computer simulation of the bronchial tree was successfully created in all patients. In 7 (35%) of 20 patients, results of fiberoptic bronchoscopy were found to be within normal limits. In all patients with normal anatomy, virtual bronchoscopy accurately correlated with the fiberoptic findings. Thirteen (65%) patients had a total of 22 abnormal findings on fiberoptic bronchoscopy. Virtual bronchoscopy detected 18 of 22 abnormal fiberoptic bronchoscopic findings: 13 of 13 obstructive lesions, 5 of 6 endoluminal lesions, and 0 of 3 mucosal lesions. The sensitivity of virtual bronchoscopy was 100% for obstructive lesions, 83% for endoluminal lesions, 0% for mucosal lesions, and 82% for all abnormalities; the specificity of virtual bronchoscopy was 100%.
Conclusions: Preliminary evaluation indicates that virtual bronchoscopy may be a promising and noninvasive modality for identifying bronchial obstructions and endoluminal lesions, as well as for assessing the tracheobronchial tree beyond stenoses. However, at present, virtual bronchoscopy does not enable the detection of subtle mucosal lesions, and as such, this modality may not be appropriate for identifying premalignant lesions in the respiratory tract. Although fiberoptic bronchoscopy remains the standard modality for evaluating airway patency and mucosal lesions, virtual bronchoscopy may provide additional information that may be useful in the management of pulmonary malignant tumors.

This article has been cited by other articles:

				K. M. Horton, M. R. Horton, and E. K. Fishman Advanced Visualization of Airways with 64-MDCT: 3D Mapping and Virtual Bronchoscopy Am. J. Roentgenol., December 1, 2007; 189(6): 1387 - 1396. [Abstract] [Full Text] [PDF]

				C. M. Heyer, T. G. Nuesslein, D. Jung, S. A. Peters, S. P. Lemburg, C. H. L. Rieger, and V. Nicolas Tracheobronchial Anomalies and Stenoses: Detection with Low-Dose Multidetector CT with Virtual Tracheobronchoscopy--Comparison with Flexible Tracheobronchoscopy Radiology, February 1, 2007; 242(2): 542 - 549. [Abstract] [Full Text] [PDF]

				Fluoroscopy-assisted thoracoscopic resection of pulmonary nodules after computed tomography-guided bronchoscopic metallic coil marking. J. Thorac. Cardiovasc. Surg., March 1, 2006; 131(3): 704 - 710.

				J. S. Ferguson and G. McLennan Virtual Bronchoscopy Proceedings of the ATS, December 1, 2005; 2(6): 488 - 491. [Abstract] [Full Text] [PDF]

				D. Shitrit, P. Valdsislav, A. Grubstein, D. Bendayan, M. Cohen, and M. R. Kramer Accuracy of Virtual Bronchoscopy for Grading Tracheobronchial Stenosis: Correlation With Pulmonary Function Test and Fiberoptic Bronchoscopy Chest, November 1, 2005; 128(5): 3545 - 3550. [Abstract] [Full Text] [PDF]

				C. M. Jones and T. Athanasiou Is Virtual Bronchoscopy an Efficient Diagnostic Tool for the Thoracic Surgeon? Ann. Thorac. Surg., January 1, 2005; 79(1): 365 - 374. [Abstract] [Full Text] [PDF]

				K. Toyota, H. Uchida, H. Ozasa, A. Motooka, S. Sakura, and Y. Saito Preoperative airway evaluation using multi-slice three-dimensional computed tomography for a patient with severe tracheal stenosis Br. J. Anaesth., December 1, 2004; 93(6): 865 - 867. [Abstract] [Full Text] [PDF]

				K Dheda, C M Roberts, M R Partridge, and I Mootoosamy Is virtual bronchoscopy useful for physicians practising in a district general hospital? Postgrad. Med. J., July 1, 2004; 80(945): 420 - 423. [Abstract] [Full Text] [PDF]

				W. De Wever, V. Vandecaveye, S. Lanciotti, and J.A. Verschakelen Multidetector CT-generated virtual bronchoscopy: an illustrated review of the potential clinical indications Eur. Respir. J., May 1, 2004; 23(5): 776 - 782. [Abstract] [Full Text] [PDF]

				Y. Lacasse, S. Martel, A. Hebert, G. Carrier, and B. Raby Accuracy of virtual bronchoscopy to detect endobronchial lesions Ann. Thorac. Surg., May 1, 2004; 77(5): 1774 - 1780. [Abstract] [Full Text] [PDF]

				N. Shinagawa, K. Yamazaki, Y. Onodera, K. Miyasaka, E. Kikuchi, H. Dosaka-Akita, and M. Nishimura CT-Guided Transbronchial Biopsy Using an Ultrathin Bronchoscope With Virtual Bronchoscopic Navigation Chest, March 1, 2004; 125(3): 1138 - 1143. [Abstract] [Full Text] [PDF]

				H. Hoppe, H.-P. Dinkel, B. Walder, G. von Allmen, M. Gugger, and P. Vock Grading Airway Stenosis Down to the Segmental Level Using Virtual Bronchoscopy Chest, February 1, 2004; 125(2): 704 - 711. [Abstract] [Full Text] [PDF]

				S. E. Finkelstein, D. S. Schrump, D. M. Nguyen, S. M. Hewitt, T. F. Kunst, and R. M. Summers Comparative Evaluation of Super High-Resolution CT Scan and Virtual Bronchoscopy for the Detection of Tracheobronchial Malignancies Chest, November 1, 2003; 124(5): 1834 - 1840. [Abstract] [Full Text] [PDF]