Diagnostic performance of digital tomosynthesis to evaluate silicone airway stents and related complications

Abstract

Background: Digital tomosynthesis (DTS) is an imaging technique with benefits in reconstructing sequential cross-sectional images. We evaluated the diagnostic performance of DTS for silicone airway stents and stent-related complications in patients who underwent bronchoscopic intervention. Methods: This retrospective study included patients who underwent bronchoscopic intervention after chest radiography (CXR) and DTS examinations from September 2013 to August 2020. The interval between CXR, DTS, and bronchoscopic intervention was a maximum of 10 days. CXR and DTS images were evaluated using a bronchoscopic view as a reference. We calculated the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for assessing the diagnostic performance. Results: The total CXR, DTS, and bronchoscopic intervention-matching datasets comprised 213 cases from 119 patients and, silicone stents were present in 167 of them. The ability of DTS to detect silicone stents was better than that of CXR (sensitivity, 92.8% vs. 71.3%, P<0.001). Of the 167 cases with silicone stents, 53 experienced stent migration and 121 experienced stent obstructions due to granulation tissue or fibrosis. The sensitivity for detecting stent migration was also higher with DTS than with CXR (45.3% vs.24.5%, P=0.025). The sensitivity for detecting the stent obstruction was better with DTS than with CXR (64.5% vs. 19.0%, P<0.001). Conclusions: DTS was more sensitive and accurate in revealing silicone airway stents and silicone stentrelated complications than CXR. However, there were limitations in confirming stent migration and obstruction with DTS due to granulation tissue growth and fibrosis.

In Vitro Evaluation of Zinc Oxide Tetrapods as a New Material Component for Glaucoma Implants

“…Due to the antiproliferative properties shown, the PDMS/ZnO-T composite materials might be also useful for other medical indications, e.g., tracheobronchial airway stents, as postoperative fibrosis is also a known complication [44,45].…”

Rigid bronchoscopic intervention for malignant central airway obstruction: A narrative review

“…However, based on our experience, we recommend digital tomosynthesis and spirometry for routine surveillance after the procedure. In our previous study, digital tomosynthesis demonstrated greater sensitivity and accuracy than simple chest radiography to identify silicone airway stents and silicone stent-related complications [34]. Moreover, the patient is exposed to a lower radiation dose than in CT.…”