Virtual panendoscopy--a new tool to help evaluating oral cancer

Virtual panendoscopy (VP) is a new, non-invasive diagnostic technique available to assess luminal structures. It involves the use of the data obtained from scanning of patients using multidetector CT scanners. The data is manipulated using a software programme to generate 3D models with fly through capability to examine various anatomical tubes. Its use has been studied in colonoscopy and bronchoscopy. However its use in head and neck cancer assessment has not been extensively studied. Therefore this diagnostic tool was used to stage 10 consecutive head and neck cancer patients. The ability of this tool in staging and identification of synchronous primary was assessed. The findings from the VP were also compared with the findings of nasendoscopy. In our pilot study, the virtual panendoscopy has been a useful tool in the assessment of the upper aero digestive tract. Although it has not picked up synchronous primaries, good quality assessment of lumen and the mucosal wall was done in areas not accessed by nasendoscope. It is most useful in areas not accessed by nasendoscope i.e. trachea, bronchus etc. The outcome, its usefulness and shortcomings are discussed.