Flexible Bronchoscopy and Helical Computed Tomography with Three-Dimensional Reconstructions in Non-small Cell Carcinoma of the Lung

Cicero, Ruúl; Criales, José Luis; Lorenzo, José M.; Saldaña, Yolanda; Cardoso, M. Jorge; Casillas, Catalina; Navarro, Francisco

doi:10.1097/00128594-199804000-00003

Cited by 5 publications

(4 citation statements)

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“…This may be helpful in decisions regarding palliative tertiary care referral for stenting or laser resection. 9 10 13 We also found virtual bronchoscopy to be clinically useful in evaluating patients with suspected laryngotracheal pathology where FOB may be hazardous or initially unfeasible.…”

Section: Discussionmentioning

confidence: 89%

“…We also found a good correlation between virtual bronchoscopy and FOB findings as others have previously reported. [5][6][7][8][9][10][11] However these studies focused on determining the sensitivity and concordance of virtual bronchoscopy with respect to a specific bronchoscopic diagnosis. Instead our study examined how virtual bronchoscopy was actually being used in a clinical context.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9][10][11] However there are few data on what additional information virtual bronchoscopy provides over computed tomography in a clinical setting. 12 This is important as virtual bronchoscopy is within reach of many DGHs that have spiral computed tomography scanners and the software to perform multiplanar reconstruction and virtual bronchoscopy.…”

mentioning

confidence: 99%

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Is virtual bronchoscopy useful for physicians practising in a district general hospital?

Dheda

Roberts

Partridge

et al. 2004

Postgraduate Medical Journal

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Background: Virtual bronchoscopy software is now available to district general hospitals (DGHs). There is limited information on the clinical utility of virtual bronchoscopy and whether it offers any additional information over conventional axial computed tomography in the setting of a busy DGH chest unit. Methods: Virtual bronchoscopy and computed tomography findings were compared in all patients who had a virtual bronchoscopy study over a 12 month period. Results: Eighteen consecutive patients had virtual bronchoscopy for a specific clinical indication over the study period. Additional information was conveyed by virtual bronchoscopy in five patients (in four patients the airways distal to an obstruction were better visualised thereby influencing decisions about airway stenting and in one patient the virtual bronchoscopy study showed an endobronchial lesion missed on computed tomography). In nine patients who were unfit for fibreoptic bronchoscopy (FOB) the radiologist was more confident in excluding an obstructive airway lesion. The main indication for performing a virtual bronchoscopy study was to rule out an obstructive airway lesion in patients who were unfit for FOB (n = 11). Conclusion: Virtual bronchoscopy is feasible and useful in the management of a few selected patients in a DGH chest unit. Virtual bronchoscopy may convey additional information over computed tomography when the distal airways need to be visualised and for discrete endoluminal lesions.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Is virtual bronchoscopy useful for physicians practising in a district general hospital?

Dheda

Roberts

Partridge

et al. 2004

Postgraduate Medical Journal

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“…8) [7,22]. VB and three-dimensional images also provide an easier global understanding of the tracheobronchial status [23] and the relationship with the surrounding normal or pathological structures.…”

Section: Pre-and Postoperative Assessmentmentioning

confidence: 99%

Multidetector CT-generated virtual bronchoscopy: an illustrated review of the potential clinical indications

Wever¹,

Vandecaveye²,

Lanciotti³

et al. 2004

Eur Respir J

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Multidetector computed tomography-generated virtual bronchoscopy (VB) is a recent technical development that allows visualisation of the lumen and wall of the trachea and proximal part of the bronchial tree. A dynamic image is produced that resembles what is seen with fibreoptic bronchoscopy (FB).Although the technique has not yet reached daily clinical practice and it can never replace FB, performing VB can be useful in well-defined clinical situations.In this paper, the value and limitations of virtual bronchoscopy will be reviewed, to illustrate the potential role of virtual bronchoscopy in the evaluation of trachea and bronchial tree pathology. Virtual bronchoscopy (VB) is a novel computed tomography (CT)-based imaging technique that allows a noninvasive intraluminal evaluation of the tracheobronchial tree. Several studies have shown that VB can accurately show the lumen and the diameter of the trachea, the left and right main stem bronchi, and the bronchial tree down to the fourth order of bronchial orifices and branches [1,2]. The morphology of the carinas can be evaluated accurately and the images look very similar to that seen with fibreoptic bronchoscopy (FB).Although VB is a promising imaging tool, this technique is not currently used in daily clinical practice and more randomised clinical trials are necessary to prove its clinical use. Nevertheless, it seems valuable to review its potential clinical indications. The purpose of this paper is to discuss and illustrate these indications based on VBs generated from the CT scans of a randomly selected group of patients. Materials and methodsCases were selected retrospectively and randomly from patients undergoing a multidetector row CT (MDCT) examination of the chest for various reasons. Selection was based on the presence of tracheal and bronchial abnormalities identified on the regular axial images and, when made, on additional coronal and sagittal reconstructions. MDCT was performed on a Phillips 16 slice CT (Philips, Best, the Netherlands). Technical parameters were: Kvp: 120; mAs: 150; collimation: 16*0.75; pitch: 0.9; rotation time: 0.42; slice thickness: 1 mm and an increment of 1 mm. MDCT was either performed with or without IV contrast administration depending on the clinical question. A proprietary virtual endoscopic software program (Endo3D; Philips) was used to reconstruct the CT data into VB images. This software program uses a volume rendering technique. A threshold value between -400 and -600 HU was chosen to evaluate the central bronchial tree. The more distal bronchial tree was evaluated using a threshold of -750 HU.Endo3D generates a perspective three-dimensional view from the inside of an anatomical structure, such as the inner wall of the colon, trachea or abdominal aorta. This insideview is generated step by step, creating a film at the end-point. The thickness of each step is 2 mm. The images are orientated with the posterior side at 12 o9clock, the left side at 3 o9clock, the anterior side at 6 o9clock and the right side at...

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Future of Flexible Bronchoscopy

Ahmad

Dweik²

1999

Clinics in Chest Medicine

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Flexible Bronchoscopy and Helical Computed Tomography with Three-Dimensional Reconstructions in Non-small Cell Carcinoma of the Lung

Cited by 5 publications

References 0 publications

Is virtual bronchoscopy useful for physicians practising in a district general hospital?

Is virtual bronchoscopy useful for physicians practising in a district general hospital?

Multidetector CT-generated virtual bronchoscopy: an illustrated review of the potential clinical indications

Future of Flexible Bronchoscopy

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