Evaluating Diagnostic Capability of Computed Tomography and Role of Bronchoscopy in Admitted Cases With Pulmonary...

To evaluate AU: Please specify the corresponding author name. capability of CT scan in diagnosing pulmonary diseases, identifying malignancy, and role of bronchoscopy in confirming or changing imaging diagnosis.

A retrospective record-based cross-sectional study was performed evaluating data of all consecutive adult patients who had CT and bronchoscopies performed in a period of 2 years (between Jan. 2023 to Jan. 2025). Demographic, clinical symptoms, CT chest and bronchoscopy findings were recorded. Final diagnoses were based on clinical (improvement with time or resolution of symptoms with specific antimicrobial drugs), laboratory (bronchoalveolar lavage and biopsy, blood or sputum cultures) and imaging guided biopsies (where performed). Patients without imaging or bronchoscopy data were excluded. Data was collected on SPSS version 22. A 2×2 contingency table was used to determine diagnostic capability of CT in identifying malignancy. Also, multivariate analysis (for certain variables), receiver operating characteristic (ROC) curve and area under curve (AUC) were acquired.

Of 97 patients, majority were males (n = 64, 66%) with mean age of 54.4 (range, 13-93, Std deviation- 18). Cough with other symptoms (CO; n = 43) and hemoptysis (H; n = 25) constituted most clinical presentations. More than half of patients (50/97) were smokers. Benign findings were mostly recorded (n = 78, 80%) and that too were mainly infections (69/78). A changed diagnosis was made on bronchoscopy in 18 cases. Sensitivity, specificity, and accuracy of CT in diagnosing malignancy was calculated as 75% (Confidence Interval/ CI, 50.90-91.34), 95% (87.23-98.57), and 91% (CI, 83.12-95.67) respectively, with a high performance (AUC, 0.753).

Computed tomography of the chest is highly useful for identifying pulmonary lesions however bronchoscopy remains essential for definitive diagnosis in a notable proportion of cases.