Abstract:
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Purpose: To compare multislice CT with conventional bronchoscopy in patients undergoing follow-up evaluation of benign and malignant central airways disorders with regard to assessment of disease status and complications of interventional therapy.
Methods and Materials: An ongoing, prospective study is being performed in which all patients undergoing follow-up bronchoscopic evaluation by the invasive pulmonary service at our hospital since 11/02 have been 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 with regard to assessment of disease status (improved/stable/progressed) and evaluation for complications of intervention. Subsequently, an assessment is rendered by the pulmonologist as to whether CT could have avoided the need for diagnostic bronchoscopy.
Results: To date, the study cohort is comprised of 22 patients, including 9 men and 13 women, with a mean age of 49 years (range, 16 to 83). Final pathologic diagnoses include 10 malignant and 12 benign airway disorders. CT and bronchoscopic assessments of disease status were concordant in 22 (100%) of 22 cases (10 improved, 7 stable, and 5 progressed). In the subgroup of 14 patients with airway stents, CT accurately detected 8 (100%) of 8 stent complications (stent migration or development of granulation tissue). CT could have avoided the need for diagnostic bronchoscopy in 21 (95%) of 22 cases.
Conclusion: Multislice CT of the central airways has the potential to replace conventional bronchoscopy for the follow-up evaluation of patients with benign and malignant airway disorders.
Questions about this event email: pboisell@caregroup.harvard.edu
Boiselle MD, P,
Can Multislice CT Replace Conventional Bronchoscopy for Follow-up of Patients with Benign and Malignant Central Airway Disorders?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102167.html
