Abstract
Background: Virtual bronchoscopy software is now available to district general hospitals (DGHs). There is limited information on the clinical utility of virtual bronchoscopy and whether it offers any additional information over conventional axial computed tomography in the setting of a busy DGH chest unit.
Methods: Virtual bronchoscopy and computed tomography findings were compared in all patients who had a virtual bronchoscopy study over a 12 month period.
Results: Eighteen consecutive patients had virtual bronchoscopy for a specific clinical indication over the study period. Additional information was conveyed by virtual bronchoscopy in five patients (in four patients the airways distal to an obstruction were better visualised thereby influencing decisions about airway stenting and in one patient the virtual bronchoscopy study showed an endobronchial lesion missed on computed tomography). In nine patients who were unfit for fibreoptic bronchoscopy (FOB) the radiologist was more confident in excluding an obstructive airway lesion. The main indication for performing a virtual bronchoscopy study was to rule out an obstructive airway lesion in patients who were unfit for FOB (n = 11).
Conclusion: Virtual bronchoscopy is feasible and useful in the management of a few selected patients in a DGH chest unit. Virtual bronchoscopy may convey additional information over computed tomography when the distal airways need to be visualised and for discrete endoluminal lesions.
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Selected References
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- Aquino S. L., Vining D. J. Virtual bronchoscopy. Clin Chest Med. 1999 Dec;20(4):725-30, vii-viii. doi: 10.1016/s0272-5231(05)70251-3. [DOI] [PubMed] [Google Scholar]
- Ferretti G. R., Knoplioch J., Bricault I., Brambilla C., Coulomb M. Central airway stenoses: preliminary results of spiral-CT-generated virtual bronchoscopy simulations in 29 patients. Eur Radiol. 1997;7(6):854–859. doi: 10.1007/s003300050218. [DOI] [PubMed] [Google Scholar]
- Finkelstein Steven E., Summers Ronald M., Nguyen Dao M., Stewart John H., 4th, Tretler Jean A., Schrump David S. Virtual bronchoscopy for evaluation of malignant tumors of the thorax. J Thorac Cardiovasc Surg. 2002 May;123(5):967–972. doi: 10.1067/mtc.2002.121495. [DOI] [PubMed] [Google Scholar]
- Fleiter T., Merkle E. M., Aschoff A. J., Lang G., Stein M., Görich J., Liewald F., Rilinger N., Sokiranski R. Comparison of real-time virtual and fiberoptic bronchoscopy in patients with bronchial carcinoma: opportunities and limitations. AJR Am J Roentgenol. 1997 Dec;169(6):1591–1595. doi: 10.2214/ajr.169.6.9393172. [DOI] [PubMed] [Google Scholar]
- Haponik E. F., Aquino S. L., Vining D. J. Virtual bronchoscopy. Clin Chest Med. 1999 Mar;20(1):201–217. doi: 10.1016/s0272-5231(05)70135-0. [DOI] [PubMed] [Google Scholar]
- Higgins W. E., Ramaswamy K., Swift R. D., McLennan G., Hoffman E. A. Virtual bronchoscopy for three--dimensional pulmonary image assessment: state of the art and future needs. Radiographics. 1998 May-Jun;18(3):761–778. doi: 10.1148/radiographics.18.3.9599397. [DOI] [PubMed] [Google Scholar]
- Kalender W. A., Seissler W., Klotz E., Vock P. Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation. Radiology. 1990 Jul;176(1):181–183. doi: 10.1148/radiology.176.1.2353088. [DOI] [PubMed] [Google Scholar]
- Kauczor H. U., Wolcke B., Fischer B., Mildenberger P., Lorenz J., Thelen M. Three-dimensional helical CT of the tracheobronchial tree: evaluation of imaging protocols and assessment of suspected stenoses with bronchoscopic correlation. AJR Am J Roentgenol. 1996 Aug;167(2):419–424. doi: 10.2214/ajr.167.2.8686619. [DOI] [PubMed] [Google Scholar]
- Lacrosse M., Trigaux J. P., Van Beers B. E., Weynants P. 3D spiral CT of the tracheobronchial tree. J Comput Assist Tomogr. 1995 May-Jun;19(3):341–347. doi: 10.1097/00004728-199505000-00001. [DOI] [PubMed] [Google Scholar]
- Liewald F., Lang G., Fleiter T., Sokiranski R., Halter G., Orend K. H. Comparison of virtual and fiberoptic bronchoscopy. Thorac Cardiovasc Surg. 1998 Dec;46(6):361–364. doi: 10.1055/s-2007-1010254. [DOI] [PubMed] [Google Scholar]
- Naidich D. P., Gruden J. F., McGuinness G., McCauley D. I., Bhalla M. Volumetric (helical/spiral) CT (VCT) of the airways. J Thorac Imaging. 1997 Jan;12(1):11–28. doi: 10.1097/00005382-199701000-00003. [DOI] [PubMed] [Google Scholar]
- 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 Feb;109(2):549–553. doi: 10.1378/chest.109.2.549. [DOI] [PubMed] [Google Scholar]