In the evaluation of tracheobronchial lesions, MDCT virtual bronchoscopy with fiber optic bronchoscopy comparison

Year 2019, Volume: 6 Issue: 8, 136 - 144, 30.08.2019

Zeyni Unverdi Resat Kervancioglu Mehmet Sait Menzilcioglu

https://doi.org/10.17546/msd.584332

Abstract

Objective: The aim of this study is compare multislice CT VB and FOB to assess tracheobronchial lesions with multislace CT VB. Material and Methods: In the period between September 2012 and August 2013 found indications for bronchoscopy and the total of 44 patients underwent FOB and FOB MDCT-SB were included in the study to be evaluated. All patients underwent VB and/or FOB. In both methods, tracheobronchial tree were divided into 18 separate segments. FOB virtual bronchoscopic findings as the gold standard method to assess the results were considered. Accordingly, positive and negative predictive values of MDCT for VB, sensitivity, selectivity and specificity values were calculated. Results: Patient ages 1 and 79 (mean: 53 ± 16) of the patients ranged from 7 (16%) female and 37 (84%) were men. In FOB 16 narrowing, 9 congestion, four external compression, 11 mucosal abnormalities were found and in the VB 12 narrowing, 16 obstruction, 8 external compression detected. None of the 11 mucosal findings in the FOB could not be determined in VB. Patients detect in FOB 25 cases were detected in VB; two patients with lesions on the FOB, although not detected in the VB (false negative). In 14 cases both FOB and endoluminal lesion was detected in the VB. FOB lesions not seen in the VB lesion in 5 cases (false positive). According to these values, sensitivity 92%, specificity 73%, positive predictive value (PPV) of 82%, negative predictive value (NPV) 87%, Accuracy: 84%, respectively.  Conclusion: Both mucosal biopsies should not be made to give details because of disadvantages such as virtual bronchoscopy fob is not an alternative for the moment. However tracheobronchial tumor research, interventional bronchoscopic procedures and biopsy guidance, foreign body aspiration of the initial assessment, tracheal injury is evaluation and treatment planning, obstructive lesions of the distal show, stenosis evaluation of endobronchial abnormalities characterization and postoperative follow-up issues of virtual bronchoscopy, constantly evolving detector technology and software when placed through the right indications for routine use will take time, we believe that the rightful place.

Keywords

computed tomography, bronchoscopy, fiber optic bronchoscopy, virtual bronchoscopy

References

• 1. Vining D.j., Gelfand D.W., and Bechtold R.E.,Technical feasibility of colon imaging with helical CT and virtual realtiy. AJR Am J Roentgenol, 1994; 162 (1): 104.
• 2. Vining D. J., Liu K., Choplin R. H., Haponik E. F. Virtual bronchoscopy: relationships of virtual reality endobronchial simulations to actual bronchoscopic findings. Chest, 1996; 109(2): 549-553
• 3. Vining D. J., Zagoria R. J., Liu K., Stelts D. CT cystoscopy: an innovation in bladder imaging. AJR. American journal of roentgenology, 1996; 166(2): 409-410.
• 4. Vining D. J. Virtual endoscopy: is it reality?. Radiology, 1996; 200(1):30-31.
• 5. Hoppe H., Walder B., Sonnenschein M., Vock P., Dinkel H. P. Multidetector CT virtual bronchoscopy to grade tracheobronchial stenosis. American Journal of Roentgenology, 2002; 178(5), 1195-1200.
• 6. Rapp-Bernhardt U., Weite T., Doehring W., Kropf S., Bernhardt T. M. Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP?. European radiology, 2000; 10(6), 981-988.
• 7. Crawford S. W., Colt H. G. Virtual reality and written assessments are of potential value to determine knowledge and skill in flexible bronchoscopy. Respiration, 2004; 71(3): 269-275.
• 8. Buthiau D., Antoine E., Piette J. C., Nizri D., Baldeyrou P., Khayat, D. Virtual tracheo-bronchial endoscopy: educational and diagnostic value. Surgical and Radiologic Anatomy, 1996; 18(2): 125-131.
• 9. Haliloglu M., Ciftci A. O ., Oto A., Gumus B., Tanyel F. C., Senocak M. E., .at all. CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration. European journal of radiology. Eur J Radiol, 2003; 48(2): 188-92.
• 10. Simpson F. G., Arnold A. G., Purvis A., Belfield P. W., Muers M. F., Cooke N. J. Postal survey of bronchoscopic practice by physicians in the United Kingdom. Thorax, 1986; 41(4), 311-317.
• 11. Berger I., Waldhorn R. E., Magruder S. Bronchoscopy in North America: The ACCP Survey. Chest, 1992; 102(5): 1638-1639.
• 12. Kaparianos A., Argyropoulou E., Sampsonas F., Zania A., Efremidis G., Tsiamita M.at all, Indications, results and complications of flexible fiberoptic bronchoscopy: a 5-year experience in a referral population in Greece. Eur Rev Med Pharmacol Sci; 2008; 12(6): 355-63.
• 13. Lacasse Y., Martel S., Hébert A., Carrier G., Raby, B. Accuracy of virtual bronchoscopy to detect endobronchial lesions. The Annals of thoracic surgery; 2004; 77(5): 1774-1780.
• 14. Sakarya M.E., Uzun K., Yuca K., Harman M., İşlek A., Temizöz O., Sezgi C., Trakeobronsialobstruksiyonlardamultidedektor BT sanalbronkoskopi. TıpArastirmaDergisi, 2004; 2(3):19-24.
• 15. De Wever W., Bogaert J., Verschakelen, J. A. Virtual bronchoscopy: accuracy and usefulness—an overview. In Seminars in Ultrasound, CT and MRI . WB Saunders., 2005; 26(5): 364-73.
• 16. Heyer C. M., Nuesslein T. G., Jung D., Peters S. A., Lemburg, S. P., Rieger, C. H., at all. Tracheobronchial anomalies and stenoses: detection with low-dose multidetector CT with virtual tracheobronchoscopy—comparison with flexible tracheobronchoscopy. Radiology, 2007; 242(2): 542-549.
• 17. Finkelstein S. E., Summers R. M., Nguyen D. M., Schrump, D. S. Virtual bronchoscopy for evaluation of airway disease. Thoracic surgery clinics, 2004; 14(1): 79-86.
• 18. Konen E., Katz M., Rozenman J., Ben-Shlush A., Itzchak Y., Zeinberg, A. Virtual bronchoscopy in children: early clinical experience. AJR. American journal of roentgenology, 1998; 171(6): 1699-1702.
• 19. Xiong M., Zhang W., Wang D., Xu, J. CT virtual bronchoscopy: imaging method and clinical application. Chinese medical journal, 2000; 113(11): 1022-1025.
• 20. Ferretti GR., Thony F., Bosson JL., Pison C., Arbib F., Coulomb M. Benign abnormalities and carcinoid tumors of the central airways: diagnostic impact of CT bronchography. American Journal of Roentgenology, 2000; 174(5): 1307-1313.
• 21. Summers R. M., Selbie W. S., Malley J. D., Pusanik L. M., Dwyer A., Courcoutsakis, N. Holland, S. M. Polypoid lesions of airways: Early experience with computer-assisted detection by using virtual bronchoscopy and surface curvature. Radiology, 1998; 208(2): 331-337.
• 22. Burke A. J., Vining D. J., McGuirt Jr W. F., Postma G., Browne, J. D. Evaluation of airway obstruction using virtual endoscopy. The Laryngoscope, 2000; 110(1): 23-29.
• 23. Hoppe H., Dinkel H. P., Walder B., Von Allmen G., Gugger M., Vock, P. Grading airway stenosis down to the segmental level using virtual bronchoscopy. Chest, 2004; 125(2): 704-711.
• 24. Finkelstein S. E., Summers R. M., Nguyen D. M., Stewart IV J. H., Tretler J. A., Schrump, D. S. Virtual bronchoscopy for evaluation of malignant tumors of the thorax. The Journal of thoracic and cardiovascular surgery, 2002; 123(5): 967-972.
• 25. Liewald F., Lang G., Fleiter T. H., Sokiranski R., Halter G., Orend, K. H. Comparison of virtual and fiberoptic bronchoscopy. The Thoracic and cardiovascular surgeon, 1998; 46(06): 361-364.
• 26. Fleiter T., Merkle E. M., Aschoff A. J., Lang G., Stein M., Görich J., Sokiranski, R. Comparison of real-time virtual and fiberoptic bronchoscopy in patients with bronchial carcinoma: opportunities and limitations. AJR. American journal of roentgenology, 1997; 169(6): 1591-1595.
• 27. Adali F., Uysal A., Bayramoglu S., Guner N. T., Yilmaz G., Cimilli, T. Virtual and fiber-optic bronchoscopy in patients with indication for tracheobronchial evaluation. Annals of thoracic medicine, 2010; 5(2): 104.
• 28. McAdams H. P., Palme S. M., Erasmus J. J., Patz E. F., Connolly J. E., Goodman P., at all. Bronchial anastomotic complications in lung transplant recipients: virtual bronchoscopy for noninvasive assessment. Radiology, 1998; 209(3): 689-695.
• 29. Bricault I., Ferretti G., Cinquin, P. Registration of real and CT-derived virtual bronchoscopic images to assist transbronchial biopsy. IEEE transactions on medical imaging, 1998; 17(5): 703-714.
• 30. Ferretti G. R., Kocier M., Calaque O., Arbib F., Righini C., Coulomb M., Pison, C. Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy. European radiology, 2003; 13(5): 1172-1178.
• 31. Bernhardt T., Schmidl H., Philipp C., Allhoff E., Rapp-Bernhardt U. Diagnostic potential of virtual cystoscopy of the bladder: MRI vs CT. Preliminary report. European radiology, 2003; 13(2): 305-312.
• 32. Bakir B., Tüzün U., Terzibaşioğlu E., Dursun M., Güven K., Salmaslioğlu A., at all... The diagnostic efficiency of multislice CT virtual bronchoscopy in detecting endobronchial tumors. Tuberkuloz ve toraks, 2008; 56(1): 43-49.
• 33. Horton K. M., Horton M. R., Fishman, E. K. Advanced visualization of airways with 64-MDCT: 3D mapping and virtual bronchoscopy. American Journal of Roentgenology, 2007; 189(6): 1387-1396.
• 34. Van Der Drift M. A., Van Der Wilt, G. J., Thunnissen, F. B., Janssen J. P. A prospective study of the timing and cost-effectiveness of bronchial washing during bronchoscopy for pulmonary malignant tumors. Chest, 2005; 128(1): 394-400.
• 35. Lam W. K., So S. Y., Hsu C., Yu D. Y. Fibreoptic bronchoscopy in the diagnosis of bronchial cancer: comparison of washings, brushings and biopsies in central and peripheral tumours. Clinical oncology, 1983; 9(1): 35-42.
• 36. Hopper K. D., Lucas T. A., Gleeson K., Stauffer J. L., Bascom, R., Mauger, D. T., Mahraj, R. Transbronchial biopsy with virtual CT bronchoscopy and nodal highlighting. Radiology, 2001; 221(2): 531-536.
• 37. Shinagawa N., Yamazaki K., Onodera Y., Miyasaka K., Kikuchi E., Dosaka-Akita, H., Nishimura, M. CT-guided transbronchial biopsy using an ultrathin bronchoscope with virtual bronchoscopic navigation. Chest, 2004; 125(3):1138-1143.