Use Of Virtual Bronchoscopy Research Articles

A systematic review and meta-analysis of computed tomography in the diagnosis of pediatric foreign body aspiration

Rigid bronchoscopy remains the gold standard for the diagnosis of foreign body aspiration (FBA) despite high rates of negative bronchoscopies. The use of computed tomography (CT) imaging in the assessment of FBA has recently emerged and could help obviate unnecessary bronchoscopy in these patients. The aim of this study is to assess the diagnostic accuracy of CT in the diagnosis of pediatric FBA. A systematic literature review was conducted to identify studies reporting the use of CT imaging in suspected pediatric FBA. The search included published articles in Ovid MEDLINE, Ovid EMBASE, PubMed MEDLINE and Web of Science. The search strategy included all articles from inception of the database to January 2021. Manuscripts were reviewed and graded for quality using the QUADAS-2 tool. Subgroup analyses based on the use of virtual bronchoscopy (VB) and sedation was conducted. A meta-analysis evaluating the use of VB in the diagnosis of FBA was also conducted. Sixteen manuscripts met all inclusion criteria. In total, 2056 pediatric patients ranging from 0.3 to 15 years underwent CT for suspected FBA. The sensitivity and specificity of CT were 98.8% and 96.6%, respectively. VB was used in 71.4% (1391/1948) of patients while sedation during CT was required in 70.2% (1263/1800) of patients. Radiation dosing ranged from 0.04 to 2mSv, 0.99-59.1mGy-cm and 0.03-16.99mGy. CT can accurately diagnose pediatric FBA and can help decrease the rate of unnecessary bronchoscopies with an acceptable dose of radiation.

Predictive factors for a successful diagnostic bronchoscopy of ground-glass nodules.

INTRODUCTION:Since the National Lung Screening Trial demonstrated the utility of low-dose computed tomography screening for lung cancer, the detection rate of ground-glass nodules (GGNs) has increased. Endobronchial ultrasound with a guide sheath (EBUS-GS) is widely performed to diagnose peripheral pulmonary lesions, but there are not enough reports on the predictive ability of EBUS-GS in diagnosing GGNs. The aim of this study is to investigate the predictive factors for a successful diagnostic bronchoscopy for GGNs.METHODS:Consecutive patients who underwent diagnostic bronchoscopy for GGNs from September 2012 to January 2016 were enrolled in this study. From these, cases who underwent EBUS-GS were selected. They were reviewed and analyzed to examine the association between the diagnostic yield and the following clinical factors: lesion size, lobar position, location, consolidation-to-tumor ratio, visibility on X-ray, use of virtual bronchoscopy, bronchus sign, guide sheath size, and number of biopsies.RESULTS:We enrolled 254 cases, of which 167 were diagnosed using EBUS-GS (65.7% diagnostic yield). Univariate analysis indicated that a positive bronchus sign was a significant factor for higher diagnostic yield (72.9% vs. 34.0%; P < 0.001). The use of virtual bronchoscopy also tended toward a higher yield, but the result was not significant (69.0% vs. 54.4%; P = 0.058). However, multivariate analysis indicated that both were significantly associated with higher diagnostic yield (P < 0.001, odds ratio [OR]: 5.35; P < 0.001, OR: 1.97, respectively).CONCLUSIONS:Our results suggest that a positive bronchus sign and the use of virtual bronchoscopy are positive predictive factors for successful diagnostic bronchoscopy of GGNs.

Integrated Use of Virtual Bronchoscopy and Endobronchial Ultrasonography on the Diagnosis of Peripheral Lung Lesions

Endobronchial ultrasound (EBUS) improves bronchoscopic diagnosis of peripheral lung lesions (PLLs). The procedure time is lengthened by the search through multiple bronchial branches to PLLs. Virtual bronchoscopy (VB) provides endobronchial views that simulate findings at bronchoscopy. An open source software can be employed to study VB and hence the endobronchial route to a PLL. It allows VB to be studied in a Macintosh platform such as a laptop computer. Our purpose was to test if VB generated by this software could shorten procedure time of EBUS-guided bronchoscopy as compared with no VB assistance. The most feasible route to a PLL was manually selected using this software to study VB (VB group). For non-VB group, 2D CT axial +/- coronal images were reviewed to plan bronchoscopy. Before bronchoscopic biopsies, the location of PLL was confirmed by EBUS. Thirty-three subjects were recruited including 16 in VB group and 17 in non-VB group. The mean EBUS examination time and mean total procedure time were reduced in the VB group compared with non-VB group: 5.3 versus 10.5 minutes (P=0.04) and 22.4 versus 29.9 minutes (P=0.044), respectively. There was no complication in the VB group. Although the diagnostic yield was higher in the VB group than non-VB group, our study was not powered to test the difference. This pilot study suggests that VB assistance is safe and shortens procedural time of EBUS-guided bronchoscopy for PLL. Further study is warranted to confirm these findings.

Virtual bronchoscopy for evaluating cervical tumors of the fetus

We report on four cases of fetal cervical tumor, comprising three lymphangiomas and one teratoma, evaluated by ultrasound and magnetic resonance imaging (MRI) between 26 and 37 weeks' gestation. The aim was to investigate the use of virtual bronchoscopy to evaluate fetal airway patency in each case. A three-dimensional (3D) model of the airway was created from overlapping image layers generated by MRI. The files obtained were manipulated using 3D modeling software, allowing the virtual positioning of observation cameras, adjustment of lighting parameters and creation of simulated 3D movies for analysis of a virtual path through the model. In all fetuses, fetal airway patency was clearly demonstrated by virtual bronchoscopy and this was confirmed postnatally. MRI with virtual bronchoscopy could become a useful tool for studying fetal airway patency in cases of cervical tumor.

Wykorzystanie wirtualnej bronchoskopii w nowoczesnej diagnostyce dróg oddechowych u dzieci – opis wybranych przypadków

IntroductionVirtual bronchoscopy is a relatively new tool used in imaging diagnostics, which is based on Spiral Scan Multi-Slice Computed Tomography. Virtual bronchoscopy allows non-invasive evaluation of bronchial tree light. The procedure allows bronchial tree scanning distally from each narrowing, as well as a free manipulation of the direction and estimation of virtual camera. AimThe aim of this study is to show the technical potential of virtual bronchoscopy in selected clinical cases. Material and MethodIn this study two clinical cases of the use of virtual bronchoscopy in diagnostics of respiratory tracks in children are presented. The first case applies to a tumor in main, left bronchus, the second case describes foreign body in bronchial tree. The chest examination was performed by the use of Multi-Slice CT apparatus which had an adequate software with narrower collimated light than in a typical tomographic chest examination. ResultsIn the cases described above, virtual bronchoscopy was the examination which determined recognition and way of treatment. In the first case virtual bronchoscopy decided about the kind and range of surgery procedure. The second case is an example of the use of Virtual Bronchoscopy in difficult diagnostic cases. ConclusionThe authors suggest to perform virtual bronchoscopy in every clinically unclear case, because in virtual bronchoscopy scanning of the line of trachea light as well as bronchial tubes to the fifth or even seventh partition are possible. Simultaneously, a reliable measurement of their diameter can be received.

Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho

Foreign body aspiration (FBA) into the tracheobronchial tree is a common problem in children, especially in those under three years of age. Preliminary radiological evaluation reveals normal chest X-rays in nearly 30% of such patients. Tomography-generated virtual bronchoscopy (VB) can facilitate the early diagnosis and rapid management of these cases. The definitive treatment is the removal of the foreign body by means of rigid bronchoscopy under general anesthesia. The objective of this study was to describe the use of VB in two patients with suspicion of FBA, as well as to review the literature regarding this topic. The two patients presented with sudden onset of respiratory symptoms and history of cough or choking with foods before these symptoms. Both patients were submitted to VB. In both cases, we detected an endobronchial foreign body, which was then removed by conventional rigid bronchoscopy in one of the cases. Only recently developed, VB is a noninvasive imaging method that has potential for use in detecting foreign bodies in the airways of children. In select cases, VB can indicate the exact location of the foreign body and even preclude the need to submit patients to rigid bronchoscopy in the absence of a foreign body.

The diagnosis of non-traumatic tracheal perforation with virtual bronchoscopy: a case report

A case of severe COPD patient complicated by pneumomediastinum due to spontaneous tracheal perforation related to post-influenza vaccination is presented. The virtual bronchoscopy was superior to fiberoptic bronchoscopy and classic multi-slice CT in diagnosing the tracheal perforation. The use of virtual bronchoscopy should be considered as a reliable diagnostic tool in cases of pneumomediastinum especially due to the ability to explore the airways in both antegrade and retrograde navigation.

Virtual bronchoscopy

Flexible bronchoscopy represents a clinically well-established invasive diagnostic tool. Virtual bronchoscopies, calculated from thin-slice CT sections, allow astonishing immitations of reality although principal differences exist between both technologies: the fact that colour representation is artificial and concommitant interventions are impossible limits the clinical use of virtual bronchoscopy. However, its value increases when calculations can be attained within minutes due to technological advancements, and when virtually any chest CT is suitable for further postprocessing. Indications, findings and the clinical role of virtual bronchoscopy are discussed.

CT virtual bronchoscopy of simulated endobronchial lesions: effect of scanning, reconstruction, and display settings and potential pitfalls.

V irtual bronchoscopy is a type of three-diniensional reconstruction of the airways in which the obserVatiOt point is placed within the airway lumen to produce an endoscopelike display I 1-31. One potential use of virtual bronchoscopy is detection and size nieasurenient of’ endobronchial masses 31Size measurements are now son etinies difficult to make troti source CT inlages because the axes of the lesion may not niatch those of the imaging plane and during conventional bronchoscopy because of distortions in the bronchoscopic images. For nieasuren ents of lesion size from virtual bronchoscopy to be useful they must be valid. In this study. we assess the capability of a coniiiiercially available virtual endoscopy system in detection and measurement of simulated endobronchial lesions in a phantom niodel and we describe potential pitfalls in measurement due to the perspective rendering effect and poorer hetween-sec-