Comparison of computerized tomography with fiberoptic bronchoscopy in identifying endobronchial abnormalities in patients with known or suspected lung cancer

Determining the presence and extent of endobronchial involvement is an important part of the evaluation of patients with known or suspected lung cancer. Bronchoscopy is accepted as the best technique for such an evaluation. We have studied the potential usefulness of computerized tomography (CT) for examining the airways by retrospectively comparing CT scans with fiberoptic bronchoscopy findings in 53 patients with known or suspected lung cancer undergoing both tests during the same hospitalization. We have found CT to be moderately accurate in predicting the presence of airway abnormalities (sensitivity from 63 to 85%, specificity form 61 to 77%) but inaccurate in defining the type of abnormality seen at bronchoscopy (localized mucosal abnormality, endobronchial mass, or extrinsic compression). We feel that CT, using standard techniques, should not be relied on for the identification of endobronchial abnormalities in patients with known or suspected lung cancer.