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(Chest. 2005;128:3545-3550.)
© 2005 American College of Chest Physicians

Accuracy of Virtual Bronchoscopy for Grading Tracheobronchial Stenosis*

Correlation With Pulmonary Function Test and Fiberoptic Bronchoscopy

David Shitrit, MD; Postinikov Valdsislav, MD; Ahuva Grubstein, MD; Daniele Bendayan, MD; Maya Cohen, MD and Mordechai R. Kramer, MD, FCCP

* From the Pulmonary Institute and Department of Radiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Correspondence to: Mordechai R. Kramer, MD, FCCP, Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel; e-mail: davids3{at}clalit.org.il

Study objectives: To compare the accuracy of virtual bronchoscopy (VB) with fiberoptic bronchoscopy (FOB) and pulmonary function testing (PFT) for the assessment of tracheal stenosis and bronchial anastomotic stenosis.

Design: Prospective case series.

Setting: Pulmonary institute of major tertiary university-affiliated center.

Patients: The study group included 10 lung transplant recipients and 13 patients with central airway stenosis.

Interventions: All patients underwent PFT, VB, and FOB. All cases were graded by each modality on a scale of 1 to 3, and the findings were compared between modalities.

Results: Mean ± SD stenosis score was 2.0 ± 0.79 for PFT, 1.62 ± 0.73 for FOB, and 1.82 ± 0.77 for VB. A statistically significant correlation was found between VB and FOB scores (p < 0.0001, r = 0.76) and between VB scores and PFT (p = 0.03, r = 0.45). There was no correlation between PFT and FOB.

Conclusions: VB grading of tracheobronchial stenosis is well correlated with PFT. VB may be used to evaluate patients with known tracheobronchial stenosis after treatment and thereby reduce the frequency of repeated invasive FOB performed for that purpose. The correlation of VB with PFT may improve the reliability of this approach.

Key Words: CT • fiberoptic bronchoscopy • pulmonary function testing • virtual bronchoscopy






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