Abstract:
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Purpose: To determine whether performing multislice CT prior to conventional bronchoscopy adds relevant information to the initial evaluation and management of patients with central airways disorders.
Methods and Materials: An ongoing prospective study is being performed in which all new patients referred to the invasive pulmonary service for bronchoscopy at our hospital since 11/02 are undergoing CT imaging of the central airways prior to the procedure. All patients are scanned on an 8-channel multislice CT scanner (Lightspeed, General Electric, Milwaukee, WI) with 1.25 mm collimation and 0.6 mm reconstruction interval. Additional multiplanar reformation and 3-D reconstructions (external rendering and virtual bronchoscopy) are performed routinely for each case. CT images are reviewed and reported prior to bronchoscopy by an experienced thoracic radiologist. Bronchoscopic findings are recorded by an experienced pulmonologist. Following bronchoscopy, CT and bronchoscopic findings are reviewed jointly and evaluated for any discrepancies. Following bronchoscopy, the pulmonologist determines whether CT provided additional relevant information by either aiding planning of a procedure or providing significant complementary information that affected patient management.
Results: To date, the study cohort is comprised of 23 patients, including 14 men and 9 women, with a mean age of 52 years (range = 16 to 83). Final pathologic diagnoses include 9 malignant and 14 benign airway disorders. CT and bronchoscopic findings for the trachea and bronchi were concordant in 21 (91%) of 23 cases. Although CT identified all sites of pathology, 2 benign stenoses were more accurately characterized as complex rather than simple at bronchoscopy. CT provided clinically relevant additional information in 21 (91%) of 23 cases, by providing complementary information about the airways or adjacent structures (n=18) and/or by providing information for planning a procedure (n=13).
Conclusion: Multislice CT of the central airways provides additional relevant information to bronchoscopy in the vast majority of patients undergoing initial evaluation of central airways disease and should be performed prior to this procedure.
Questions about this event email: pboisell@caregroup.harvard.edu
Boiselle MD, P,
Multislice CT of the Central Airways: Does it Provide Additional Information to Conventional Bronchoscopy?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102164.html
