[Virtual bronchoscopy and bronchofiberoscopy--a comparison of diagnostic value in assessment of centrally localized...

Virtual bronchoscopy (VB) is a new, noninvasive diagnostic technique which allows visualizing trachea and bronchi. Virtual images are created on the basis of data derived from helical CT scans using special protocol. A reconstructed, virtual image of the bronchial tree is very similar to that seen during conventional bronchofiberoscopy (FOB). The aim of the study was to compare VB images of the bronchi with those coming from FOB and evaluate diagnostic value of VB in centrally localized lung tumor.

The studied group consisted of 40 patients with suspicion of centrally localized lung cancer. Primary diagnosis was based on the chest X-ray. Each patient underwent CT and bronchofiberoscopy and after those routine procedures the VB analysis was performed. The results of the FOB were not known for radiologist performing VB. In both used methods, FOB and VB, the evaluation and comparison of the features of tumor presence, bronchial stenosis and widening of the carina were performed. In all 40 patients lung cancer was confirmed. The diagnosis was established by histopathologic examination of the tissue biopsy: 32 patients (80%)--non small cell lung cancer, 2 patients (5%)--small cell lung cancer, 5 patients (12.5%)--squamous cell carcinoma, 1 patient (2.5%)--carcinoid.

Diagnostic value of VB in assessment of the for presence of the tumor in bronchus was: sensitivity 79.5%, specificity 95.5%, for bronchial stenosis: sensitivity 58.6%, specificity 98.1% and for widening of carina: sensitivity 60.7%, specificity 97.7%.

The results indicate that virtual bronchoscopy is highly sensitive and specific diagnostic method, a clinically valuable for the evaluation of lung tumor with a central location.