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[Virtual bronchoscopy: the correlation between endoscopic simulation and bronchoscopic findings].
Radiol Med. 1997 Nov; 94(5):454-62.RM

Abstract

PURPOSE

We carried out a preliminary clinical validation of 3D spiral CT virtual endoscopic reconstructions of the tracheobronchial tree, by comparing virtual bronchoscopic images with actual endoscopic findings.

MATERIALS AND METHODS

Twenty-two patients with tracheobronchial disease suspected at preliminary clinical, cytopathological and plain chest film findings were submitted to spiral CT of the chest and bronchoscopy. CT was repeated after endobronchial therapy in 2 cases. Virtual endoscopic shaded-surface-display views of the tracheobronchial tree were reconstructed from reformatted CT data with an Advantage Navigator software. Virtual bronchoscopic images were preliminarily evaluated with a semi-quantitative quality score (excellent/good/fair/poor). The depiction of consecutive airway branches was then considered. Virtual bronchoscopies were finally submitted to double-blind comparison with actual endoscopies.

RESULTS

Virtual image quality was considered excellent in 8 cases, good in 14 and fair in 2. Virtual exploration was stopped at the lobar bronchi in one case only; the origin of segmental bronchi was depicted in 23 cases and that of some subsegmental branches in 2 cases. Agreement between actual and virtual bronchoscopic findings was good in all cases but 3 where it was nevertheless considered satisfactory. The yield of clinically useful information differed in 8/24 cases: virtual reconstructions provided more information than bronchoscopy in 5 cases and vice versa in 3. Virtual reconstructions are limited in that the procedure is long and difficult and needing a strictly standardized threshold value not to alter virtual findings. Moreover, the reconstructed surface lacks transparency, there is the partial volume effect and the branches < or = 4 pixels phi and/or meandering ones are difficult to explore.

CONCLUSIONS

Our preliminary data are encouraging. Segmental bronchi were depicted in nearly all cases, except for the branches involved by disease. Obstructing lesions could be bypassed in some cases, making an indication for endoscopic laser therapy. Future didactic perspectives and applications to minimally invasive or virtual reality-assisted therapy seem promising, even though actual clinical applications require further studies.

Authors+Show Affiliations

Istituto di Semeiologia, Diagnostica e Terapia strumentale, Università di Ancona.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
English Abstract
Journal Article

Language

ita

PubMed ID

9465209

Citation

Salvolini, L, et al. "[Virtual Bronchoscopy: the Correlation Between Endoscopic Simulation and Bronchoscopic Findings]." La Radiologia Medica, vol. 94, no. 5, 1997, pp. 454-62.
Salvolini L, Gasparini S, Baldelli S, et al. [Virtual bronchoscopy: the correlation between endoscopic simulation and bronchoscopic findings]. Radiol Med. 1997;94(5):454-62.
Salvolini, L., Gasparini, S., Baldelli, S., Bichi Secchi, E., & Amici, F. (1997). [Virtual bronchoscopy: the correlation between endoscopic simulation and bronchoscopic findings]. La Radiologia Medica, 94(5), 454-62.
Salvolini L, et al. [Virtual Bronchoscopy: the Correlation Between Endoscopic Simulation and Bronchoscopic Findings]. Radiol Med. 1997;94(5):454-62. PubMed PMID: 9465209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Virtual bronchoscopy: the correlation between endoscopic simulation and bronchoscopic findings]. AU - Salvolini,L, AU - Gasparini,S, AU - Baldelli,S, AU - Bichi Secchi,E, AU - Amici,F, PY - 1998/2/18/pubmed PY - 1998/2/18/medline PY - 1998/2/18/entrez SP - 454 EP - 62 JF - La Radiologia medica JO - Radiol Med VL - 94 IS - 5 N2 - PURPOSE: We carried out a preliminary clinical validation of 3D spiral CT virtual endoscopic reconstructions of the tracheobronchial tree, by comparing virtual bronchoscopic images with actual endoscopic findings. MATERIALS AND METHODS: Twenty-two patients with tracheobronchial disease suspected at preliminary clinical, cytopathological and plain chest film findings were submitted to spiral CT of the chest and bronchoscopy. CT was repeated after endobronchial therapy in 2 cases. Virtual endoscopic shaded-surface-display views of the tracheobronchial tree were reconstructed from reformatted CT data with an Advantage Navigator software. Virtual bronchoscopic images were preliminarily evaluated with a semi-quantitative quality score (excellent/good/fair/poor). The depiction of consecutive airway branches was then considered. Virtual bronchoscopies were finally submitted to double-blind comparison with actual endoscopies. RESULTS: Virtual image quality was considered excellent in 8 cases, good in 14 and fair in 2. Virtual exploration was stopped at the lobar bronchi in one case only; the origin of segmental bronchi was depicted in 23 cases and that of some subsegmental branches in 2 cases. Agreement between actual and virtual bronchoscopic findings was good in all cases but 3 where it was nevertheless considered satisfactory. The yield of clinically useful information differed in 8/24 cases: virtual reconstructions provided more information than bronchoscopy in 5 cases and vice versa in 3. Virtual reconstructions are limited in that the procedure is long and difficult and needing a strictly standardized threshold value not to alter virtual findings. Moreover, the reconstructed surface lacks transparency, there is the partial volume effect and the branches < or = 4 pixels phi and/or meandering ones are difficult to explore. CONCLUSIONS: Our preliminary data are encouraging. Segmental bronchi were depicted in nearly all cases, except for the branches involved by disease. Obstructing lesions could be bypassed in some cases, making an indication for endoscopic laser therapy. Future didactic perspectives and applications to minimally invasive or virtual reality-assisted therapy seem promising, even though actual clinical applications require further studies. SN - 0033-8362 UR - https://www.unboundmedicine.com/medline/citation/9465209/[Virtual_bronchoscopy:_the_correlation_between_endoscopic_simulation_and_bronchoscopic_findings]_ DB - PRIME DP - Unbound Medicine ER -