Comparative Evaluation of Super High-Resolution CT Scan and Virtual Bronchoscopy for the Detection of Tracheobronchial Malignancies: Conventional CT Scanning
On the other hand, SHR-CT scans revealed 10 additional lesions, and VB demonstrated 11 additional lesions that were not evaluable by FB (Fig 3, bottom left, D, and bottom middle, E) due to the size limitation of the bronchoscope (9 cases) or to the location distal to high-grade stenoses (2 cases). Because many patients went on to undergo resection of a lesion for palliation or cure, pathologic correlation was attainable in nine cases. Of these nine cases, six obstructive lesions (67%) that had not been detected by FB but were visualized by SHR-CT scans and VBs were confirmed to be positive by pathology, With respect to the location of these pathology-proven distal lesions, two were located in the right lower lobe, two were located in the left lower lobe, one was located in the right middle lobe, and one was located in the left upper lobe (Fig 3, bottom left, D, and bottom middle, E). this
Of the 32 patients who underwent correlative FBs, 25 (78%) obtained conventional CT scans in addition to SHR-CT scan and VBs. Seven patients (28%) had normal examination findings by FB. The results of conventional CT scans correlated with those of FBs in six of these patients (specificity, 85%). Conventional CT scans demonstrated two FP obstructive lesions in one patient (Table 1).
Eighteen patients (72%) had a total of 29 abnormal FB findings. Conventional CT scans detected only 17 of these 29 abnormalities, including 13 of 18 obstructive lesions, 4 of 8 endoluminal masses, and 0 of 3 mucosal lesions. In contrast to SHR-CT scans and VBs, the sensitivity of conventional CT scanning was 72% for obstructive lesions, 50% for endolumi-nal masses, 0% for mucosal lesions, and 59% overall (Table 1). Of the 12 FN lesions identified by FB and not detected by conventional CT scanning, only 3 abnormalities were not visualized by SHR-CT scanning and VB. This was due to the fact that conventional CT scanning was not obtained in those patients, and not because conventional CT scans could visualize the lesions missed by SHR-CT scans and/or VBs. Indeed, there was no case in which conventional CT scanning improved on the findings of either SHR-CT scans or VBs (Fig 3).