Accuracy of virtual bronchoscopy for grading tracheobronchial stenosis: correlation with pulmonary function test and fiberoptic bronchoscopy.

STUDY OBJECTIVES To compare the accuracy of virtual bronchoscopy (VB) with fiberoptic bronchoscopy (FOB) and pulmonary function testing (PFT) for the assessment of tracheal stenosis and bronchial anastomotic stenosis. DESIGN Prospective case series. SETTING Pulmonary institute of major tertiary university-affiliated center. PATIENTS The study group included 10 lung transplant recipients and 13 patients with central airway stenosis. INTERVENTIONS All patients underwent PFT, VB, and FOB. All cases were graded by each modality on a scale of 1 to 3, and the findings were compared between modalities. RESULTS Mean +/- SD stenosis score was 2.0 +/- 0.79 for PFT, 1.62 +/- 0.73 for FOB, and 1.82 +/- 0.77 for VB. A statistically significant correlation was found between VB and FOB scores (p < 0.0001, r = 0.76) and between VB scores and PFT (p = 0.03, r = 0.45). There was no correlation between PFT and FOB. CONCLUSIONS VB grading of tracheobronchial stenosis is well correlated with PFT. VB may be used to evaluate patients with known tracheobronchial stenosis after treatment and thereby reduce the frequency of repeated invasive FOB performed for that purpose. The correlation of VB with PFT may improve the reliability of this approach.

[1]  P C Goodman,et al.  Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment. , 1998, Radiology.

[2]  J. Wallwork,et al.  Airway stenoses after lung transplantation: management with expanding metal stents. , 1994, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[3]  R H Choplin,et al.  Virtual Bronchoscopy: Relationships of Virtual Reality Endobronchial Simulations to Actual Bronchoscopic Findings , 1996 .

[4]  P. Rogalla,et al.  Virtual Endoscopy of the Trachea and Bronchi , 2001 .

[5]  S. Nathan,et al.  Obstructive flow-volume loop contours after single lung transplantation. , 1994, The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation.

[6]  Martin Sonnenschein,et al.  Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis. , 2002, AJR. American journal of roentgenology.

[7]  K D Hopper,et al.  Mucosal detail at CT virtual reality: surface versus volume rendering. , 2000, Radiology.

[8]  G. Halter,et al.  Comparison of virtual and fiberoptic bronchoscopy. , 1998, The Thoracic and cardiovascular surgeon.

[9]  J. Verschakelen,et al.  Multidetector CT-generated virtual bronchoscopy: an illustrated review of the potential clinical indications , 2004, European Respiratory Journal.

[10]  K Ramaswamy,et al.  Virtual bronchoscopy for three--dimensional pulmonary image assessment: state of the art and future needs. , 1998, Radiographics : a review publication of the Radiological Society of North America, Inc.

[11]  D. Fullerton,et al.  Airway Problems in Lung Transplantation , 1996 .

[12]  Atul C. Mehta,et al.  Accuracy of virtual bronchoscopy to detect endobronchial lesions , 2004 .

[13]  R. Summers,et al.  Virtual bronchoscopy for evaluation of malignant tumors of the thorax. , 2002, The Journal of thoracic and cardiovascular surgery.

[14]  G. Massard,et al.  Airway complications in lung transplantation. , 1994, The Annals of thoracic surgery.

[15]  H. Colt,et al.  Endoscopic management of bronchial stenosis after double lung transplantation. , 1992, Chest.

[16]  A J Aschoff,et al.  Comparison of real-time virtual and fiberoptic bronchoscopy in patients with bronchial carcinoma: opportunities and limitations. , 1997, AJR. American journal of roentgenology.

[17]  R Polverosi,et al.  [Evaluation of tracheobronchial lesions with spiral CT: comparison between virtual endoscopy and bronchoscopy]. , 2001, La Radiologia medica.

[18]  D J Vining,et al.  Virtual bronchoscopy. , 1999, Clinics in chest medicine.