Source: Annual Congress 2002 - Oncology imaging: CT, MRI and PET
Disease area: Thoracic oncology

Abstract

Purpose:
The aim of the study is to present the technique of computed tomography virtual bronchoscopy (CTVB) and to evaluate its efficiency in diagnosing tumors (presence of pathologies and degree of obstruction) of bronchial tree compared with fiberoptic bronchoscopy (FB).
Materials and methods:
Spiral - CT studies (Helicat Flash - Marconi) of the chest were performed in 91 patients with by lung tumors. Parameters of all studies were: collimation 2,7 mm, overlap 1,3, pitch 1.5. The stenoses were assessed on a 3-point scale (1 - involving up to 1/3 of bronchial lumen; 2 - from 1/3 to 2/3 of lumen; 3 - over 2/3 of lumen).
Results:
In the entire study group of 91 patients, FB revealed central airway tumour and CTVB in 84 cases, respectively. In 7 patients CTVB images were of poor quality due to artefacts related to cardiovascular system pulse or to breathing. Sensitivity of CTVB was 92.3%.
In 84 patients out of 91 examined, FB confirmed 161 bronchial tree lumen stenoses, and CTVB 138. Sensitivity of CTVB related to the stage of stenosis was 1st stage - 61.7%, 2nd stage - 100%, and 3rd stage - 100%.
Conclusion:
VB is a promising, non-invasive tool in the presentation of bronchial tree tumors. CTVB enables to [dsquote]pass through[dsquote] the stenosis in bronchial tree and to visualise situation behind the obstacle. However, subtle alteration in epithelial texture is hard to visualise. It should be underlined that CTVB data are obtained as digital postprocessing of images from spiral chest CT. Therefore, it makes possible the evaluation of the pathologies located in the bronchial tree wall and outside, i.e. lymph nodes, infiltrations extent, and involvement of arterial vessels.

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A. Urbanik, W. Wojciechowski, T. J. Popiela, R. Chrzan, E. Nizankowska, M. Zielinski, J. Mlodkowski (Krakow, Zakopane, Poland). Comparative study of computed tomography virtual bronchoscopy and fiberotic bronchoscopy - evaluation of malignant central airway obstruction. Eur Respir J 2002; 20: Suppl. 38, 3767

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